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."