How does FAA define diabetes?

A

aging pilot

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The last time I visited my PC doctor, she said "Your numbers are not too high but once I plug your blood numbers, your weight, height and weight into my phone app, you are pre-diabetic."
My question is "what number" really defines "diabetic" to the FAA? I really worry that some app written by a drug company may be using 'other things' to get more of their drugs sold but those same items don't matter to the FAA who is not trying to sell drugs.
Oh, and just two days after that last DR visit, the gyms closed down killing the exercise plan I had put together. I get to see her again Thursday. :-(
 
I don't have the number written down. But since I have to see her Thursday, I thought I would get some more info before I go. If I am over the FAA number, then I know I should not refuse meds.
 
The FAA doesn’t define diabetes. The medicos do.

Your Hemoglobin A1C is used to state what percent of your red blood cells are Glycated.

Glycated hemoglobin (HbA1c, hemoglobin A1c, A1c, or less commonly HbA1c, HgbA1c, Hb1c, etc.) is a form of hemoglobin (Hb) that is chemically linked to a sugar.

The formation of the sugar-Hb linkage indicates the presence of excessive sugar in the bloodstream, often indicative of diabetes. A1C is of particular interest because it is easy to detect. The process by which sugars attach to Hb is called glycation. HbA1c is a measure of the beta-N-1-deoxy fructosyl component of hemoglobin.[3]

A1c is measured primarily to determine the three-month average blood sugar level and can be used as a diagnostic test for diabetes mellitus and as an assessment test for glycemic control in people with diabetes.[4] The test is limited to a three-month average because the average lifespan of a red blood cell is four months. Since individual red blood cells have varying lifespans, the test is used as a limited measure of three months. Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. In diabetes, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, neuropathy, and retinopathy.

Normal, prediabetic, and diabetic range
The 2010 American Diabetes Association Standards of Medical Care in Diabetes added the =HbA1c ≥ 48 mmol/mol (≥6.5 DCCT %) as another criterion for the diagnosis of diabetes.

Diagnostic Standard for HbA1C in Diabetes
HbA1C Diagnosis
<5.7% ...... Normal
5.7-6.4% ...Prediabetes
>6.5% ......Diabetes
​
Pre diabetes needs to be taken seriously..... it is a big warning and it is possible to correct.

Full blown diabetes is difficult to correct, if ever at all.

As far as the FAA, there is an SI you can obtain for Type 2 pill controlled. But it is better to not even go there if possible by making better lifestyle choices.
 
FAA prefers to see 6.4 and below for Class 3 with SI. Basic Med - up to your doctor. Oral meds, no problem. I'm officially Type 2 and keep the numbers 6.3-6.5, and it really is possible to get out of the Type2 category. Improve the diet (very difficult when working from home for the past 5 months at a computer terminal and the kitchen is upstairs) and increase the exercise. I really need to lose weight (helps with W&B in the cherokee, too) but again...the kitchen is right there, and tonight, I think dinner is chicken parm with....no, I'll be good and have a salad instead of pasta with it but wait! there are chocolate brownie with nuts in the freezer for desert! Rats - no ice cream....
 
two types of diabetes...

Type 1 called Juvenile Diabetes. insulin required. it's called juvenile diabetes because it's usually starts in the very early years and continues for life. it can be controlled thru insulin, diet and exercise.

Type 2 called Adult Onset diabetes. usually comtrolled by oral meds but can morph into Type 1. meds, diet and exercise. my wife has lost a lot of weight and is now on just one oral med...last a1c is 5. something.
 
WannFly said:
anything above 9 in A1C is something FAA frowns at.
Click to expand...
More than just frown at... you run the risk of not getting approved.

Doc Bruce told me many years ago... (this is paraphrased)
  • 6's, we can make this happen easy enough... But I want you working to be at 6.5 or lower
  • 7's, I am going to give you a nasty look and counsel you to do better...
  • 8's, I'm going to stop the process until I give you a come to gospel lecture and you agree to never go there again. You may get approved, but we (the royal we) are not happy.
  • 9's, I'm not even going to start, since the FAA won't (and shouldn't) accept this malarkey.
 
murphey said:
but wait! there are chocolate brownie with nuts in the freezer for desert! Rats - no ice cream....
Click to expand...
You get brownies???!!!!???? Daaaammmnnnnn....... I think I get an unmolested rice cake
 
aging pilot said:
The last time I visited my PC doctor, she said "Your numbers are not too high but once I plug your blood numbers, your weight, height and weight into my phone app, you are pre-diabetic."
My question is "what number" really defines "diabetic" to the FAA? I really worry that some app written by a drug company may be using 'other things' to get more of their drugs sold but those same items don't matter to the FAA who is not trying to sell drugs.
Oh, and just two days after that last DR visit, the gyms closed down killing the exercise plan I had put together. I get to see her again Thursday. :-(
Click to expand...

First off pre diabetes is diabetes, its just the at point where if your a type 2 good diet and lifestyle choices can reverse it. Pre diabetes is associated with an A1C ranging from 5.6-6.4, once your A1C hits 6.5 your labeled diabetic and chances are its with you for life.

At the age of 38 and being pretty darned healthy all my life a random physical found my A1C was 12.3. The doc labeled me type 2 and started me on metformin. The faa will allow any ame to issue a third class so long as the only drug you take is metformin and your A1C is below 6.5 and your fasting glucose is below 126. While I have many issues with the faa medical process I do have to admit that the relatively easy hoops they made me jump through ultimately saved and greatly extended my life. I read and every book I could get my hands on and tested, tested, tested my blood sugar. Ultimately I found a book call Dr. Bernstiens diabetes solution. Following Dr. Bernstiens suggestions got my A1c Down to 5.6 in just under six months.

Blood sugar levels above 140 are where diabetic complications start to occur (Vascular damage, neuropathy, retinopathy, etc.) An A1C of 6.5 Represents a 24 hour average blood sugar of 140... Personally I strive to keep my blood sugar below 140 at all times and my A1C below 5.6. With diet changes I've found it pretty easy to keep my A1C in the 5.4 to 5.9 range for the last 4 years. Feel free to pm if you ever need any help.

Regards,

Jim
 
Sorry it took so long to get back to this. I finally got access to my records online.
The Dr kept talking about GLU levels, not A1C levels. She is concerned because the last level, in 11/2019 was 107. Three weeks ago, the level was 106. There was no GLU levels for any of the blood work between 11/19 and now. She never mentioned A1C levels.
When looking at my online results, I found the following some previous A1C levels:
11/19 6.0
8/19 5.8
4/19 5.8
1/19 5.6
11/18 5.7
There are no A1C reports since 11/19. 11/19 was the last lab I had from a previous Dr (at the same clinic) who has retired. My current thinking is that I will insist that my next labs include an A1C level. As for the 11/19 lab, that lab was ordered by the previous Dr in 8/19 for my next scheduled visit, but the labs actually occurred after she retired and so the new Dr read them, The same new Dr that did not order an A1C level since then. It's either not been ordered, or they are way behind on the online charting.
 
rk911 said:
Type 2 called Adult Onset diabetes. usually comtrolled by oral meds but can morph into Type 1.
Click to expand...
No it can’t. Type 1 and Type 2 are completely different. The treatment of Type 2 can become similar to treatment of Type 1, but that doesn’t make it Type 1.
 
aging pilot said:
My current thinking is that I will insist that my next labs include an A1C level
Click to expand...
If the numbers you shared are good numbers for A1C, then you are doing pretty good. Maybe edging a bit into the yellow arc (see post #4), but not terrible and easily reigned back into the solid green arc.

I agree that insisting on the A1C as part of the routine is a good idea.

What you can do now is visit one of the "minute clinics" at the CVS's and ask for an A1C from them. Cash pay so it doesn't wind up on a database some where, but within 10 minutes or so, you have a current value.

Another thing that can help is to start using a food diary app that permits easy tracking of Net Carbs (amongst the other items like fats, protein, sodium, etc). The one I use is MyFitnessPal. For me, recording what foods I eat has helped me be more aware and better about "Eat This, Not That". The recent switch to monitoring Net Carbs has seen a slow reduction and curve leveling in my finger stick numbers. I'm also shedding ballast easier than before.

Thanks for the update and happy flying to ya!
 
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