Flying (as a pilot) with diabetes: possible?

What are the rules with that? Are you still allowed to fly a private plane on your own, and just not be a professional pilot?

Like I can drive a car without any special requirements for a license. And I could get a commercial driver’s license if I applied for a Federal Diabetes Exemption. I got scuba certified without it being brought up. I went through skydiving training and solo jump without it being brought up.

What is the rule for flying, if it is not as a professional?

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I could jump through the FAA Medical hoops to get a Third Class Special Issuance medical certificate which would allow me to fly recreationally (i.e. not for hire, not professionally). The hurdles and maintenance of such a certificate are a PITA, IMO. After initial diagnosis, before I had to start on insulin, I did temporarily get my First Class medical certificate back…but only after my Aviation Medical Examiner spent 2.5 hours on the phone with the FAA going through all of my blood sugar logs and convincing them I was well controlled. It was four months from that day to when I started insulin. At that point, my professional career took a turn. It looks like the FAA started considering insulin to be allowable on a case-by-case basis for professional pilots in April 2015…well after I changed my career course.

The hyperlinks on this webpage will tell you the specifics…which you will not like…

For instance, during flying, here is the rule:
" One hour into the flight, at each successive hour of flight, and within one half hour prior to landing, the airman must measure their blood glucose concentration. If the concentration is less than 100 mg/dl, a 20 gm glucose snack shall be ingested. If the concentration is 100 – 300 mg/dl, no action is required. If the concentration is greater that 300 mg/dl, the airman must land at the nearest suitable airport and may not resume flight until the glucose concentration can be maintained in the 100 – 300 mg/dl range. In respect to determining blood glucose concentrations during flight, the airman must use judgment in deciding whether measuring concentrations or operational demands of the environment (e.g., adverse weather, etc.) should take priority. In cases where it is decided that operational demands take priority, the airman must ingest a 10 gm glucose snack and measure his or her blood glucose level 1 hour later. If measurement is not practical at that time, the airman must ingest a 20 gm glucose snack and land at the nearest suitable airport so that a determination of the blood glucose concentration may be made."


Yeah, it’s stringent, but flying low would be a bad idea. I can run low without a problem, but running does not take much brainpower. Lows affect me more mentally than physically, I think.

The 100 bottom target is not horrible. It’s better than some of the insulin pumps now, with their 120 or 150 target!

Thanks for the details!

What this means is that if you want to be the official pilot of FUD, you can still do it, but we just can’t pay you for doing it…


ha ha ha - Good point !!!


I believe my last flight was October 2005. We gotta long way to go to get me back into proficiency!


I would fly with you.



Now, @T1Allison, I don’t worry about much, but that would frighten me :slight_smile:


@Michel, maybe one day I’ll tell you legit reasons you should be scared. In other words, I won a longstanding bet among the female flight students. It was glorious.


If glancing at your CGM qualifies as measuring blood glucose concentration, that’s not onerous, is it? Most of us do that at least several times an hour anyway, and only in some mega-disaster-movie scenario could “operational demands” stop you from glancing at your CGM. The only thing that seems an over-reaction to me is needing to land if you’re over 300. First off, someone with a CGM and on a pump (not to mention as well controlled as you) isn’t likely to get that high, so it’s theoretical, and secondly, that level doesn’t impair mental alertness, at least not in me, or at least not that I’ve noticed. The issue for me at 300 would be having enough water on board to drink, and having somewhere to pee gallons. If they want proof of stabilized diabetes, just show them some of the Dex traces you’ve posted here!

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The thing to know about the FAA is that they are very slow to adopt advances. CPAP machines have only recently become allowed.

So…going out on a limb here…I cannot fathom they would allow anything other than a fingerstick.

How many FUDers treat a 100 with 20 grams of carbs? That seems odd, I think.

But it is revolutionary that they allow insulin at all now…that was not an option when I reached this juncture.

The other part, aside from in-air considerations, is that the Letter of Special Issuance which would detail your obligations to maintain your medical certification requires evaluations every 3 months by your doctor and annually by the FAA. That is a lot of paperwork to make sure that it gets submitted correctly, received correctly, and processed correctly. And the first sign that something might be missing (or someone made a mistake, which is known to happen not infrequently), the FAA sends you a nice letter letting you know that you will be suspended or have your certificates revoked if this oversight is not taken care of in 30 days or whatever. Been there done that with lots of pilots. It’s stressful. It requires a lot to begin with…and then add bureaucracy and scary form letters…it just makes your heart stop a bit when you get that letter and can’t get anyone on the phone to discuss it with you.


Just so you know, there is an Air Canada Captain with T1 who got back to flying commercial (767s I think) after 16 years grounded because of T1

Does this look like a man with diabetes?



That’s awesome! It looks like Canada allowed insulin for pilots in 2001. FAA was only 14 years later! :grinning:

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It is interesting to note that the man got a law degree, which sounds very useful in his situation where you need to get a medical every 6 months :smile:


Not many, but I’d guess it’s a pre-emptive move: treat before you’re actually low and flying a piece of machinery while maybe not at your brightest. Not that I’m making any excuses for the FAA…

Commercial/multi-crew in 2002. T1s have been able to get a recreational licence (up to four seats) since the mid-90s. C’mon up! Most fun I ever had in a plane was going up the west coast of Vancouver Island to Tofino, in a two-seater 1950s Beaver, in January, in a raging storm. [ETA: I was the passenger, not the pilot.]

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That’s awesome!!! Sounds great!!!

I once flew into the air show at Oshkosh. It was amazing! Airspace gets so busy no one is allowed to talk on the frequency but controllers…we just had to listen and rock our wings to acknowledge…and we took off two by two to leave the airshow. I camped under the wing of an Archer for a week and would wake up to a Ford Trimotor taking off and breaking north over my head. So cool!


@Beacher, what are the requirements for insulin dependent diabetics in Canada?

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Is this what you’re after?

Skip way down to Appendix 1.

This was interesting – kinda similar to what I thought the FAA was after with their low limit of 100:

Note: Blood Glucose levels will be required to be maintained at higher than optimal values prior to and during flight, in order to minimize the risk of hypoglycemia.

There’s also this page, with diabetes in the row starting at sec. 1.18.


This is amazingly organized, thorough and well communicated. Way to go, Canada!


The FAA wants you to have an A1c above 9. Flying can be dangerous, but not in the way we thought!


Well there’s my problem!! And here I thought I was struggling lately…

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