This must be used in conjunction with a glucometer to measure the glucose levels throughout the day. The insulin pump provides continuous short-acting insulin to be released in the body. The first insulin pump was invented in 1963 and the first glucometer was on the market in 1971. The pilots use a variety of different insulins and measuring devices for glucose monitoring. The FAA has set up glucose parameters that must be met before and during flight. The pilots were testing their blood glucose with finger-stick glucose testing. The long-acting insulin covers all the stressors during the day that will increase glucose in the body and the short acting insulin covers glucose spikes from the three meals throughout the day.īefore November 2019, there were approximately 500 ITDM pilots with a special-issuance third class medical certificate. It is called Basal/Bolus insulin therapy. This combination simulates the pancreas production of insulin throughout the day. The preferred insulin regimen recommended by endocrinologists is a combination of long-acting, non-peaking insulin and short-acting insulin, aspart (NovoLog®) or lispro (Humalog®). Examples of long acting insulin are insulin glargine (Lantus®) or insulin detemir (Levemir®). There is long-acting insulin that controls glucose levels for 24 hours or longer. There are many different types of insulin products that are utilized. The risk for hypoglycemia is much higher in ITDM patients. This risk for hypoglycemia is lower for these patients. Any break in this treatment can lead to the biggest fear of the FAA, hypoglycemia (low blood glucose).ĭiabetics who do not have to administer insulin are controlling their blood sugars with diet, exercise, and oral hypoglycemic medications. Insulin therapy requires extra time and attention to ensure it is administered properly, at the right dose and at the right time. For ITDM, glucose control with insulin is tantamount to a healthy lifestyle. Diabetics are a high-risk patient population for heart attacks, strokes, blindness, and kidney disease. ITDM medical risks include cardiovascular, neurological, ophthalmological, and renal complications. This CFR also addresses the safety of persons and property in other aircraft and on the ground. CFR 67.401 addresses the reasonable risks to the pilot and property that are not acceptable in the exercise of the commercial or airline transport pilot privileges. Previous to this announcement, pilots with ITDM could only apply for a third-class special issuance.ĬFR 67.401 is the standard for all airmen that addresses the freedoms of exercising the privileges of the private pilot certificate.
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