Saturday 20 September 2014

The conflicting medical position on flying and Type 1 Diabetes

The CAA guidance on the medical safety and therefore licensing of pilots with Diabetes is confusing and in some places contradictory. This puts my Medical Examiner in a difficult position! Consider the following…


1. No: The basic CAA guidance to Medical Examiners says don’t give a medical certificate to someone with Type 1 Diabetes…



Statement C covers the rules if you have Type 1 Diabetes (the condition is known in the medical world as Diabetes Melitus):
  • Part 1 below appears to say that Type 1 Diabetics cannot be given a medical certificate.
  • Part 2 is odd because there is no other practical way to stay alive if you have Type 1 Diabetes other than to use insulin. I wondered if you could live entirely on Protein and Oils (think of a meat, hard cheese, salad, green veg, peanuts, olive oil diet – essentially zero carb/sugar) just did some research. The answer is this just won’t work as even when your body burns natural fats and oils your blood sugar rises.
A Class 1 medical is needed if you want to be a commercial pilot. I do not, I only need a Class 2 medical for a PPL.

Class 2 Statement G covers how compliance can be achieved, but the language is odd as the first sentence says that people with Type 1 may be assed as fit, and the second sentence says medications that will not make you go low may be acceptable. Um, there are no medications for Type 1 that I know of that cannot make you go low, as by definition they transfer blod sugar into cells thereby lowering blood sugar that can lead to hypoglycemia. Are the sentances linked? I guess so but it’s not entirely clear. In other words can the first sentence be taken on it’s own and give me hope – “Applicants with diabetes mellitus may be assessed as fit”?


2. Yes: The UK CAA Diabetes certification guidance gives testing and blood glucose targets for pilots with insulin-treated Diabetes (thought doesn’t specifically state Type 1 or Type 2)…



Here it clearly states how to test blood sugar when treating Diabetes with insulin, and I have used this to make a flip-out extra page in my flying log-book so I record blood sugar at different stages before and during a flight.


3. Yes: The UK CAA provides a Briefing Sheet for pilots with Diabetes…



This repeats the blood-testing routine that is needed for safe flying that maps to the tracking page in my flying log book.


4. Yes: The UK CAA provides a Specification for Diabetes Reports by Medical Examiners…



So there is a clear way that Medical Examiners can provide medical reports on Pilots with Diabetes.


5. Yes: The CAA held a European Panel on “Pilots and ATCO’s with Insulin-Treated Diabetes”



This event was held at Gatwick in Feb 2014 which is clearly “friendly” towards Diabetics flying, and the Final Summary and Conclusions are here…


It looks from this like the UK is positive about supporting well controlled Diabetics fly whilst data is gathered on any risks based on actual issues found rather than fear.


Wish me luck.


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