Class 3 Medical question - Diabetes

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Ketel1

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Ketel1
Hello - I am very interested in getting my private pilot license so that I may operate my own plane and fly with friends and family only. I am concerned that I will not qualify because I have type 2 diabetes. I have an exam scheduled for next Friday so I went to my doctor to get an A1C and it unfortunately was 7.1. I recently had oral surgery and had an infection that required a couple rounds of antibiotics so the doc thinks that may have temporarily elevated my level. She said she would be happy to write me a letter but also wanted me to come back in next Thursday the day before to redo to see if by any chance it will fall att least .1 by then.

I guess my question is will the fact that I have a recent A1C of 7.1 keep me from getting a class 3 medical certificate?

Thanks any and all who can help guide me through the process.
 
Are you on medication? Insulin. Even getting A1C to 7 is horrendous unless you're a type I. You are damaging your internal organs every day you stay that elevated. Get healthy first, and then worry about your medical.

You should talk to an endocrinologist. Your personal doc seems to be an idiot. A1c is not a short term indicator.

9 is the limit, but there are other things other than your two (90 day apart) A1c's that are required. You should have a frank talk PRIOR to application with an AME to see if you're likely certifiable to leave open the possibility of sport pilot. The higher you are above 7, the more question the FAA will have as to your control (coupled with other things in your submittal).
 
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flyingron said:
Are you on medication? Insulin. Even getting A1C to 7 is horrendous unless you're a type I. You are damaging your internal organs every day you stay that elevated. Get healthy first, and then worry about your medical.



You should talk to an endocrinologist. Your personal doc seems to be an idiot. A1c is not a short term indicator.



9 is the limit, but there are other things other than your two (90 day apart) A1c's that are required. You should have a frank talk PRIOR to application with an AME to see if you're likely certifiable to leave open the possibility of sport pilot. The higher you are above 7, the more question the FAA will have as to your control (coupled with other things in your submittal).
Click to expand...


My doctor is not an idiot and didn't high five me and yell way to go. My doctor knows my history and understands the impacts of infections and antibiotics of blood levels. I of course was instructed on a corrective path and am monitored closely. I hope you don't judge all people that quickly and incorrectly. And to answer your questions I am on oral medications.
 
Sorry, your implications in your post seemed to point out a rather cavalier attitude to the implications of the high A1C. Just saying "Oh, I was on antibiotics and I'm going to get below 7 next moth" is nonsense.

Which drug? How long have you been on it. There's a lot of variability in he Type II Special Issuance (obviously you are not issuable because it is not controlled solely by diet).

Sorry if I'm a little sensitive. I've got a son who is missing one leg, both kidneys, and much of his retinas from a long time at high A1C.
 
Flyingron - understood and appreciate your response. I am on janumet which is basically metformin. I know a week will not make a difference but she said there are fluctuations and was not sure if a test of 7.0 vs 7.1 would make a difference and she said it was worth a try. She was happy that I wanted to do this as it is another motivator to constantly watch and maintain my levels. Have never had any issues related to it. I am sure that in 30-60 days I can get it back into a 6.5 range.

My question is without being judged, will a level of 7.1 be a disqualified or is there possibility that I can get a class 3 approved with continued monitoring as long as I am not on insulin.

Glad we cleared that up
 
Work on this for your health. The FAA starts getting really cranky at 6.5. My A1C wandered from 5.3 up to 6.2. I am working hard to get it back down.

You sound like you need a low carb diet. That does the trick for me. The minute I stray off of it, my A1C cilmbs fast.

A low carb diet will help you lose weight. I've been on one for 5 years since I learned I was diabetic...and no complications at all. I am for 5.5 A1C MAX.
 
Here is some good reading as well:

FAA.GOV for the T2D on medications (other than Insulin):
FAA.GOV for T2D Diet Controlled.
FAA.GOV for the TID or T2D on Insulin

In short, it says that you have to be in good control. When speaking to a flight surgeon, he said that this is the baseline (for T1D, which I am):
A1C below 7
Screened every 6 months
Blood sugar checked before flight, and it has to be above 100, and checked every hour in flight. (FAA is more strict... >300, you're grounded, <100, take glucose pill)
Fast acting glucose (glucose tabs or gel) must be on you in flight, and taken if blood sugar drops below 100

As for the blood sugar, I have a CGM, a pump, and he would look into whether the CGM is a viable alternative to finger pokes in flight. If I fly with my wife, she can take the yoke while I do that, but solo? I'd rather just look at the CGM. It, at least, shows trending.
 
Capt. Geoffrey Thorpe said:
http://www.pilotsofamerica.com/forum/showpost.php?p=1273648&postcount=8
Click to expand...

Everything in the posted quote is what to do and works... Except for "call to get approval" which the agency no longer allows for third class.

Your doctor needs to write a plainly worded status letter saying:

  • He is treating you for type 2 diabetes controlled by oral medication.
  • Name of medication, dosage, frequency
  • You are tolerating the medication well and there are no adverse side effects
  • You are not showing any signs of
    • Cardio vascular disease (heart disease and blood vessel damage)
    • Neuropathy (kidneys)
    • Retinopathy (eyes, especially retina)
    • Nephropathy (Peripheral nerves, especially extremities such as hands/feet)

Bring that letter plus the results of the blood labs when you visit the AME. Keep copies for yourself. Extra credit for you if you show this letter to your AME in advance of your official visit asking him/her if you have covered everything or if additional items are required.

If your doctor has you on cholesterol or blood pressure meds as a preventative, these need to be mentioned in the letter as well. Since you're going to list them on the FAA form anyhow, better if your doctor says why and how well you're doing on them.


Ketel 1....

An A1C at 6.5 or higher will get you onto the Special Issuance.

However, if you can delay your AME visit and get busy lowering your A1C to below 6.5% and present this to the AME along with the lab report showing your fasting blood glucose as 124 or below, then you can be issued your medical under the CACI program (Conditions an AME Can Issue). Worksheet: Pre-Diabetes

Dropping 1 point on your A1C is doable in 4-6 weeks if you can tighten up on your nutrition and increase your exercise. You're looking to post a daily blood glucose average of 120 mg/dl or lower on your fingertip meter during this period.

So if you can delay, you will not only make the FAA happier, you will make your doc and your body happier.
 
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Home A1C tests are available from WalMart under their "ReliOn" brand.

These are the same tests that Bayer had under their brand quit making 12-18 months ago.

Costs about $30.00 and includes two tests.
 

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Jeffythequick said:
Here is some good reading as well:

FAA.GOV for the T2D on medications (other than Insulin):
FAA.GOV for T2D Diet Controlled.
FAA.GOV for the TID or T2D on Insulin

In short, it says that you have to be in good control. When speaking to a flight surgeon, he said that this is the baseline (for T1D, which I am):
A1C below 7
Screened every 6 months
Blood sugar checked before flight, and it has to be above 100, and checked every hour in flight. (FAA is more strict... >300, you're grounded, <100, take glucose pill)
Fast acting glucose (glucose tabs or gel) must be on you in flight, and taken if blood sugar drops below 100

As for the blood sugar, I have a CGM, a pump, and he would look into whether the CGM is a viable alternative to finger pokes in flight. If I fly with my wife, she can take the yoke while I do that, but solo? I'd rather just look at the CGM. It, at least, shows trending.
Click to expand...

I'm pretty sure I remember Dr. Bruce mentioning at some point or another that the FAA loves pumps. Not sure about CGM, but I can't think of any reason why they wouldn't love that, too.

Rich
 
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