U.S. pilots with Type 2 diabetes mellitus that is controlled by diet alone are eligible for any class of license through the regular issuance procedure, provided they have no evidence of associated disqualifying cardiovascular, neurological, renal or ophthalmological disease.
The FAA will consider an applicant with a diagnosis of Type 2 diabetes that is controlled by the use of medication for a special issuance medical certificate. Following initiation of medication treatment, a 60-day period must elapse before certification to establish that the condition is stabilized, under adequate control and without side effects or complications from the medication.
For pilots taking an oral medication, the Aerospace Medical Certification Division makes the initial decision. An examiner may re-issue a subsequent airman medical certificate under the provisions of the special issuance (waiver).
The FAA has established a policy that permits the special issuance medical certification of insulin-treated applicants for third-class medical certification only. The agency currently is not granting special issuance for first- and second-class medicals. Consideration will be given only to those individuals who have been clinically stable on their current regimen for a period of six months or more.
For pilots controlling diabetes by diet alone, medical documentation of control is required at the time of the FAA medical examination. The AME can issue a certificate immediately if the pilot has supporting documentation, including a current report of blood glucose level.
A blood glucose determination is not a routine part of the FAA medical evaluation for any class of medical certificate. However, the examination does include a routine urinalysis. According to AOPA, the FAA authorized the use of insulin in 1996, and about 400 pilots hold medical special issuances (third-class only) for insulin-treated diabetes. Another 6,000 are flying while using oral medications.