FAA Proposes Easing Medical Certification for Pilots with Non-Insulin Diabetes

The FAA proposed changes on Thursday that would make it easier for pilots with diabetes controlled by non-insulin medications to obtain medical certificates. Under the proposed rule, those applicants could qualify for first-, second-, or third-class certificates under general medical standards instead of the Special Issuance process.

Diabetes requiring insulin or other hypoglycemic drugs is currently a specifically disqualifying condition. Pilots using non-insulin medications can still be certified, but an aviation medical examiner must typically defer the application to the FAA for Special Issuance review. The proposal would remove non-insulin medications from that provision.

The agency said numerous new diabetes medication classes and other non-insulin treatments have substantially improved disease management. The diabetes standard dates to 1959, and the FAA noted advances have reduced severe complications including cardiovascular events and hypoglycemia.

The FAA estimates AMEs could issue certificates at the time of examination in about 3,000 cases each year. Another 1,200 cases currently handled through Special Issuance could transition to AME-managed certification. Over five years, the change would save applicants between $39.7 million and $80.2 million in labor costs.

Processing all non-insulin-dependent diabetes mellitus cases through Special Issuance places a burden on applicants and the FAA, the agency said. It expects the proposal to reduce certification wait times and its own processing workload while shortening the process for pilots whose diabetes is well controlled.