DIABETES TYPE II (adult onset) REQUIRING ORAL MEDICATION
This is NOT insulin dependent diabetes, that is another, different process.

ALL CLASSES

The use of oral medications to control diabetes is disqualifying according to the FAA rules however, after favorable review by the certification division at OKC, the airman may be certified under a “special issuance”. The first time the pilot seeks certification the information must be sent to Oklahoma City. The airman may than be issued a “special issuance” for a 12 month period. Usually the AME may issue subsequent certificates as long as the condition is stable. As a pilot, you need your FAA medical exam on your normal schedule. You may submit your annual follow up report directly to the FAA in OKC, or, you can bring it to me and I will issue a new certificate. (You will NOT need an FAA exam unless you would be due one anyway.)

Before the FAA aeromedical certification division will consider any application for medical certification the following must apply:

        1. At least 60 days must have elapsed from the start of treatment. Medical information must be supplied that supports good control, stable blood sugar levels, and no adverse side effects from medications. (See “doc’s letter” below*)

        2. A fresh FAA medical exam must accompany the initial application to show that the airman is otherwise physically qualified.

        3. A fresh blood test called an “A1c” or glycosolated hemoglobin is needed. This gives an idea of the average blood sugar for the past 3-4 months. The usual range is 4-6%, the FAA will approve up to 8.5%. A previous A1c test from at least 60 days earlier is needed to document continuing or improving control.

        4. There is a specific type of blood pressure medication that a diabetic may not take and still be certified. That type is called a “beta-blocker”. It may mask the symptoms of low blood sugar.

        5. Weight loss and exercise are extremely important in control.  Documentation of sustained weight loss is a very favorable point for your physician to include in the letter.

*The treating doc (MD or DO) needs to write a letter stating there is:   (Copy of an example letter below)

        a. No on going medical or surgical problem or complication    
        b. No evidence of diabetic eye problems (e.g., retinopathy) This statement may also be obtained from an ophthalmologist or optometrist
        c. No diabetic related heart or cardiovascular disease
        d. No peripheral diabetic vascular complications
        e. No diabetic neurological symptoms (e.g., burning, tingling feet, etc.)
        f.  No diabetic renal (kidney) problems, and
        g. There have been NO hypoglycemic episodes (low blood sugar) due to the medications
        h.  No beta blocker has been prescribed,   and .....

A closing paragraph that summarizes your history of treatment, medications, and favorable progress. A statement that you are at no greater or less risk of having a problem than the average person, would be excellent.

Hint: A report will be required annually so suggest to your physician that their office might want to keep a copy in their word processor so it can be updated next year.  The above format will adequately cover the FAA follow up requirements.  You will need this letter again next year.  Help your doc's frustration with writing letters, ask him/her to keep a copy and simply update it with new information next year.

Normally this fairly extensive evaluation needs to be done only on the initial application. As long as the airman maintains good A1c numbers, no complications, continues weight loss if recommended, and little or no change of medications, they usually can be re-certified by either submitting information to the FAA directly or through an AME.  Upon certification, the FAA will give you a letter that outlines the report you need to submit next time, usually annually.  Follow the instructions exactly and you should have no problem.  You can submit your report directly to the FAA or bring it to your AME and they can issue a fresh medical certificate for another 12 months.  You need your FAA exam on the usual rotation, i.e., every 2-3 years if third class, 6 months if first class, etc.

HERE IS AN EXAMPLE OF THE BEST CONSULT LETTER I HAVE EVER RECEIVED
>CLICK HERE<

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