I recently had a 43-year-old diabetic pilot in my office for a Third Class Medical. My examination of the airman was unremarkable. His urinalysis was negative for sugar. He was slightly obese. Reports were provided stating he had no hypoglycemic reactions and no ophthalmological, neurological or nephrology problems. His A1C blood test, a measure of average blood glucose control for the past two to three months, was 8.0 — within FAA limits. A report from his family physician stated he was in great shape and his diabetes was adequately controlled. With the information provided, I passed the airman.
But this is not the end of the story. I stepped aside from my job as an Aviation Medical Examiner and let my family doctor side kick in. I told the pilot to return to his family physician to get help on his A1C test. We need his result closer to 6.0. The FAA will accept an A1C less than 9.0, but it’s not a good control of diabetes.
The pilot would be far healthier in the long run on medicines that push his A1C to around 6.0. After 60 days on these medicines — and improved blood levels — we can call the FAA and get a multi-year special issuance with yearly updates. It’s very easy to do. But the long-term affects of uncontrolled diabetes are anything but easy — they can be disastrous.
Diabetics on oral medicines and insulin can fly. They have small hoops to jump through if they are on oral medicines and large hoops to jump through if they are insulin dependent.
There’s even an insulin dependent diabetic pilot on the air show circuit. His name is Michael Hunter and he actually checks his blood sugar while flying. Be sure to look at his website at FlightForDiabetes.com.
For more information about diabetes Type I and II, contact the American Diabetic Association at 800-DIABETES (800-342-2383) or Diabetes.org.
If you have any questions, please feel free to contact my office at 918-437-4993.
Dr. Guy Baldwin is a family physician and Senior Aviation Medical Examiner in Tulsa, Okla. A member of the EAA Aeromedical Council, he has more than 4,000 hours. He owns a Harvard T-6, a Cessna 210 and an Extra 300, in which he flies in airshows and aerobatic contests.