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Special Issuance of Third-Class Airman Medical Certificates to Insulin-Treated Diabetic Airman Applicants

Effective December 23, 1996, the Federal Aviation Adminstration (FAA) of the United States will allow certain individuals with insulin-treated diabetes mellitus (ITDM) diabetes to receive the Third-Class Airman Medical Certificate required to obtain a private pilot's license. This action culminates efforts by the American Diabetes Association that began with a petition to the FAA in February, 1991.

Issuance of the certificate will be under the following conditions:

  1. ITDM individuals may be issued only a third-class airman medical certificate.
  2. ITDM individuals may exercise only the privileges of a student, recreational, or private pilot certificate.
  3. ITDM individuals are prohibited from operating an aircraft as a required crewmember on any flight outside the airspace of the United States of America.
  4. ITDM individuals are required to be in compliance with the monitoring requirements of the following protocol while exercising the privileges of a third-class airman medical certificate.

While details of the protocol are found in the complete document text, the key points are:

  1. Have had no recurrent (two or more) hypoglycemic reactions resulting in a loss of consciousness or seizure within the past 5 years. A period of 1 year of demonstrated stability is required following the first episode of hypoglycemia; and
  2. Have had no recurrent hypoglycemic reactions requiring intervention by another party within the past 5 years. A period of 1 year of demonstrated stability is required following the first episode of hypoglycemia; and
  3. Have had no recurrent hypoglycemic reactions resulting in impaired cognitive function which occurred without warning symptoms within the past 5 years. A period of 1 year of demonstrated stability is required following the first episode of hypoglycemia.
  4. Submit detailed medical records, including
    1. The two most recent glycated hemoglobin (A1c) readings;
    2. A detailed report of the individualís insulin dosages (including types) and diet utilized for glucose control;
    3. Appropriate examinations and tests to detect any peripheral neuropathy or circulatory insufficiency of the extremities.
    4. Confirmation by an ophthalmologist of the absence of clinically significant eye disease.

Further, pilots with IDDM must:

  1. Submit to a medical evaluation by a specialist every 3 months.
  2. Carry and use a digital whole blood glucose measuring device with memory that is acceptable to the FAA. Provide records of all daily blood glucose measurements for review by the specialist at each 3-month evaluation required above and, if required, to the FAA at any time.
  3. Provide to the FAA, on an annual basis, written confirmation by a specialist that the individualís diabetes remains under control and without significant complications and that he or she has demonstrated reasonable accuracy and recordation of his or her blood glucose measurements with the above described device.
  4. Provide to the FAA, immediately, a written report of any episode of hypoglycemia associated with cognitive impairment, whether or not it resulted in an accident or adverse event.

Download the FAA Statement

The full text of the FAA statement is published in a Microsoft Word document named dia-fr34.doc. The document is 67 KB. You can download the document from the following sources:

For More Information

FAA Contact:

Tina Lombard, Program Analyst
Aeromedical Standards Branch (AAM-210)
Office of Aviation Medicine
Federal Aviation Administration
800 Independence Avenue, SW
Washington, DC 20591
Telephone (202) 267-9655
Fax (202) 267-5399

Updated 8 April 2001

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