FAA publishes 1st/2nd class IDDM criteria

Discussion in 'Medical Topics' started by bbchien, Nov 7, 2019.

  1. bbchien

    bbchien Touchdown! Greaser!

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    I’m working off a pretty basic IPad so I put the link on my homepage...see signature line.....

    Pretty tough but now we know the effort might not be ruinous....
     
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  2. bflynn

    bflynn Final Approach

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    To save others the lookup: IDDM = insulin dependent diabetes mellitus. So they now have a protocol for insulin, which I find surprising.
     
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  3. AggieMike88

    AggieMike88 Touchdown! Greaser! PoA Supporter

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  4. Let'sgoflying!

    Let'sgoflying! Touchdown! Greaser! PoA Supporter

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    Is this better/more onerous/no change for airmen III with an existing SI (& and excellent control), for those not familiar with the terms and history? (the document references III)
     
  5. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    Third class medicals can still use the old protocol if they want (in flight testing regimin). The new Class I/II requires a CGM (something not readily available when the third class ITDM protocol was done). There are more detailed vision and cardiac follow up as well. Much like your sleep apnea SI, the FAA wants dumps of your CGM history as well.
     
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  6. Tarheelpilot

    Tarheelpilot En-Route

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    Can pumps be approved under this change?
     
  7. midlifeflyer

    midlifeflyer Touchdown! Greaser!

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    A welcome change for professional pilots a few years in the making.
     
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  8. lbfjrmd

    lbfjrmd Line Up and Wait

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    Onerous yes ... but steps in the right direction for professional pilots.
     
  9. midlifeflyer

    midlifeflyer Touchdown! Greaser!

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    Definitely. Most probably aren't aware there have been at least two lawsuits against the FAA pushing for this. One was decided (against the pilot) a few years ago. Another is currently pending.
     
  10. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    Provided they have the continuous glucose data that can be downloaded, they can. Otherwise you're going to need something like Dexcomm.
     
  11. bbchien

    bbchien Touchdown! Greaser!

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    About the only way to succeed given the glucose limits, is a pump, + CGM....
     
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  12. lbfjrmd

    lbfjrmd Line Up and Wait

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    and likely the intent of the regulation ... to enable pump technology to lead to future approvals.
     
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  13. Jeffythequick

    Jeffythequick Pre-takeoff checklist

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    I've reviewed it, and it's pretty much what I thought it would be.

    A few thoughts:
    1. At least we get to explain highs and lows. For example, waking up with a 400 mg/dl, and then a sharp drop, while on the surface might seem suspicious, but is easily explained with an infusion set that got pulled out. I get it... an incident like this every few (6) months is "acceptable" but every week might get a little concerning.
    2. 70 (THANK YOU!!!!) - 250 is a lot better than 100-300. I like keeping my blood sugar the same as the Muggles (non-diabetic folk), where there's is 65-80 (fasting) to 160 (after that piece of cake).
    3. Documenting what you did on a flight to low/high BG at least lets us explain what happened.
    4. I'm glad at least they had a Dexcom report in there. Being vague with the requirements is not helpful. It'd be nice if they, at least, said, "These CGM systems meet the FAA requirements: Dexcom, Medtronic, Abbott Labs, and Sensonics" Heck, the FAA keeps a list of "no-fly" drugs, make a list of "OK CGM's"
    5. The rest of it is pretty much the same as it was for the Class 3, with the exception of the non-sequitur "Insulin Pumps are acceptable" (The previous Class 3 went through a bunch of (from an airman perspective) bizarre conditions and prescriptive actions, and then one sentence at the end, just listed, made no sense in the context.)
    6. I absolutely LOVE the fact that the FAA finally said that CGM's are better than fingersticks, plus the silliness of poking my fingers at altitude, making sure I didn't bleed all over the yoke/throttle, and make an evaluation, while I had a perfectly good CGM attached to me. (Never mind the attempts to get the test strip out, inserted into the meter, and getting the fingerstick cocked and poked in a pain-free area. I'm just glad it didn't prescribe using a new lancet, or else my lancet cost would have increased 50 fold each year. - Those that use fingersticks will get that joke...)
    7. Dexcom G6's don't require FSBS calibration... since I have about 12 meters, do I have to bring all 12 in for those monthly random checks?
    8. Item 4.B.10 I've never heard of anyone sharing a CGM. How is that done? I get it, the FAA (logically) wants to see only your CGM data, but that was a weird (meaning, who does this? and why?) requirement.


    All in all, I'm looking forward to someone seeing the pump tube while I'm doing the "buh bye, hope you enjoyed the flight" and says, "I didn't know diabetics could fly!"
     
  14. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    Well, it's not like you're posting it on social media like your fitness watch. However, a lot of endos look at the data. The invasiveness of the FAA has precedent for the inane sleep apnea dumps.

    Coming up next: Continuous Blood Alcohol monitors.
     
  15. Jeffythequick

    Jeffythequick Pre-takeoff checklist

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    Yeah, the Dexcom Share is where I was going with it, after I thought about it. Then, is there a community CGM system out there, or is this to knock it down from ever happening? To me, this has all the logic of a CGM system that voices the numbers to you, and you have to write them down in your blood sugar logbook.

    If the Dexcom Share isn't allowed, why? So my wife can't see my numbers, or Nightscout can't broadcast my numbers to my Garmin Edge 1030 so I can see my blood sugar while riding my bike?

    In all my dealings with the FAA, they haven't been illogical. They've been wrong, but teachable, so I'm guessing it's the (yet to be invented) Community CGM that they're prohibiting.