FAA to allow pilots with diabetes to fly commercial jets

The Federal Aviation Administration is set to allow pilots with insulin-treated diabetes to apply to fly commercial airliners, according to a Department of Transportation official who spoke with CNN.

The new protocol, which could be announced as early as next week, will allow pilots with insulin-treated diabetes to apply for a first- or second-class medical certificate, which is required to fly commercially.

Since 1996, pilots with insulin-treated diabetes have been allowed to act as pilot-in-command of an airplane in the United States, but only on private flights. They could not act as pilots on airliners or other commercial flights. The FAA maintained this position even as countries like the United Kingdom and Canada gradually allowed pilots with diabetes to fly commercially, provided there was a second pilot in the cockpit.

The Aircraft Owners and Pilots Association, which supported the change, applauded the forthcoming decision.

“Many private pilots who are insulin dependent have been flying safely since 1996. With medical advancements, such as continuous glucose monitoring along with proper protocols, the FAA’s impending proposal should help many highly qualified pilots fly commercially,” said Jim Coon, the group’s senior vice president of government affairs.

The concern was that a pilot with diabetes may suffer an episode of high or low blood sugar in flight, which could potentially lead to an emergency situation if the pilot passes out or loses control of the aircraft. Episodes of low blood sugar, known as hypoglycemia, are particularly dangerous. For that reason, the FAA deemed it too risky to allow pilots with insulin-treated diabetes to control a commercial aircraft.

“A hypoglycemic event, which can result in impaired cognitive function, seizures, unconsciousness, and even death, that occurs in the cockpit of a commercial flight has the potential to place the safety of hundreds of individuals in jeopardy,” the FAA wrote in a court filing in early-October, in a lawsuit brought by a pilot looking to ease the rules on medical certification. Pilots with diabetes that does not require insulin treatment are at a substantially lower risk of severe episodes of low blood sugar.

But advances in the treatment of diabetes and the management of blood sugars have mitigated that risk, the FAA stated in the court filing on October 7. “Recent advances in technology and diabetes medical science have allowed the FAA to develop an evidence-based protocol that can both identify a subset of low-risk applicants whose glycemic stability is sufficiently controlled and also ensure these pilots can safely maintain diabetic control for the duration of a commercial flight,” wrote the Federal Air Surgeon, Michael Berry.

Continuous glucose monitors that constantly monitor blood sugar are now readily available, while improvements in insulin pumps have made the delivery of insulin easier and more reliable, among other options.

The FAA declined to comment.

Pilots with insulin-treated diabetes interested in applying for first- and second-class medical certificates will have to provide a comprehensive medical background and show a history of managing blood sugars effectively. If approved, the pilots will be given a special-issuance medical certificate.

“Blanket bans based on diagnosis alone are never appropriate, even in safety sensitive positions,” said the American Diabetes Association in a statement provided to CNN. “Not all persons with diabetes are fit to pilot a commercial aircraft, but certainly some are, and they should be afforded individual assessment of their medical condition and qualifications.”

The Air Line Pilots Association, the largest airline pilot union in the world, said the decision was long overdue. “ALPA is pleased that the FAA will be implementing this long-overdue policy change that will allow pilots who are insulin dependent to continue their airline careers,” the union said in a statement to CNN. “ALPA has been advocating for years for the FAA to join the global community in revising their career ending position that pilots who are diagnosed with [insulin-treated] diabetes cannot continue to hold their first class medical certificate.”