Blindsided at the AME's office...

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Last month I went to my Doc for an updated status letter for the few items I have to worry about at the AME. Get all the blood work done, get the status letter and everything checks out.

Then I go in for my physical and find out that I tested positive for glucose in my urine and 2 subsequent finger sticks show glucose levels over 200...

I had no idea... Honestly I've not had any problems or issues. Lesson learned here: ask your doctor for a diabetes screening if you're in the risk zone...

So my AME deferred me and gave me a ton of paperwork on diabetes and a sheet showing exactly what he'll need to see once I can show 90 days of control. I'm off to my doc's office next chance I get.

Ugh, what a day. :(
 
Seems kinda odd that your regular doc doesn't check your urine during your annual checkup. I'd be more upset at him/her than anyone else for having missed this.
 
Unregistered said:
Then I go in for my physical and find out that I tested positive for glucose in my urine and 2 subsequent finger sticks show glucose levels over 200...
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Just be happy you found it and can deal with it. Flying is secondary to
your health.

I had a friend that ate a sweet roll and a soda on the way to his. Oops.
At least the doc let him come back in a couple days and do it right.
 
If you don't have diabetes, you can eat as many cakes and sodas you want before going to your medical exam, it won't matter since your body will keep the blood glucose level under 120.

The sugar will make you gain weight though - and overweight is a leading cause of diabetes (type 2).

Physical exercise, weight loss and a balanced diet can lower your blood sugar considerably without medications.
 
Armageddon Aviator said:
If you don't have diabetes, you can eat as many cakes and sodas you want before going to your medical exam, it won't matter since your body will keep the blood glucose level under 120.

The sugar will make you gain weight though - and overweight is a leading cause of diabetes (type 2).

Physical exercise, weight loss and a balanced diet can lower your blood sugar considerably without medications.
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True (sort of) but if you are a borderline type II diabetic, controlling your glucose levels with diet, consuming raw sugar is indeed likely to put you over the edge. The thing is AFaIK, moderately high glucose levels aren't an immediate problem WRT the ability to control an airplane, it's the long term effects of high blood sugar that matter. For insulin users, there is a short term risk of low blood sugar as a result of too much insulin which would have very serious consequences for a pilot.
 
From what I gathered from my visits to the doctor and discussing my family history, and what I remember about diabetes from EMT, Paramedic, and PYA training long ago:

For most people, as we age, our metabolism changes. If our diet and exercise don't change as well, we gain weight. Eventually, our cells may become insulin-resistant, meaning that the pancreas must put out higher levels of insulin to let the glucose in our blood cross into the cells for processing. This leads to higher levels of glucose in the blood, which is hard on your eyes, your nerves, and your kidneys, which usually end up lowering the blood glucose by spilling the glucose into your urine.

It's quite possible that your blood sugar spikes after a meal of foods that quickly convert to glucose, but your "average" glucose level during the day may be normal. Losing weight, increasing fitness , and altering your diet can have a dramatic effect on your bodies ability to process sugar.

The standard for diagnosing type II diabetes is having two consecutive fasting blood sugar readings above 126 (not sure of the specific number, but I think it's right). A single instance of sugar in the urine is NOT diagnostic, but certainly messes up your airman application.

If you work with your primary care physician, he'll give you a metabolic workup, make the definitive call (you DO or DO NOT have diabetes), and help you get all your paperwork in order. Even if you require medication, after 90 days of control, you're good to go.

I hope Dr. Bruce will correct any errors here, and I'm wondering... If his doctor does the fasting glucose tests and A1c and says "you don't have diabetes", does he have to go through the whole 90 day waiting game? Should he still leave the "diabetes" box unchecked on the application? I'm just wondering if a previous aviation medical exam with glucose in the urine flags an applicant as a diabetic in the FAA's eyes forevermore.
 
AS he will have to report the doc's visits, the AME is bound to inquire what they were about. Best to bring a note that says, "diabetes controlled by diet and exercise" for that not-quite requiring-medication level of glucose intolerance.

Don't fool yourself, though. It needs to be controlled. You'll live longer and prosper longer if it is.

And Tim, the criteria for calling it diabetes is changing. Most communities use the Hb A1c int he normal range to exclude it, the 100 gm glucose load, Gluc. <140 2 hours after is pretty much gone.
 
Thanks, Bruce... My doc told me the glucose tolerance test was not used anymore, and that they just relied on fasting glucose levels and you needed multiple visits with elevated levels to be considered diabetic, with the A1c being the gold standard of how controlled your glucose is.

I do know that when I was 30-40 lbs heavier I once spilled sugar into my urine after eating, even though my A1c was normal. Now that I'm lighter my fasting glucose levels are down, my A1c is still normal, and I can go eat anything and not spill sugar afterwards. I report all my doctor visits, but don't check the diabetes box as my doc told me I was not a diabetic. No problem renewing my medical

For folks who are overweight, I'll also add that my wife and I did weight watchers together, and I'm now under 210 (previous peak was 255) and have been there for almost six months. My wife also lost 40 lbs and is maintaining it. So it is possible to lose the weight, and you don't have to starve to do it. Just paying attention to what you eat and being disciplined will do the trick, and doing it with your spouse helps a lot as you can support each other and change your eating habits together.
 
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