The FAA on Thursday proposed changing its medical certification rules to allow pilots whose diabetes is controlled using non-insulin medications to potentially receive first-, second- or third-class medical certificates without going through the agency’s Special Issuance process. The proposed rule is scheduled for publication in the Federal Register on Friday.
AMEs Could Issue Certificates
Under current regulations, diabetes that requires insulin or another hypoglycemic drug for control is considered a specifically disqualifying condition. Pilots using non-insulin medications can still qualify for a medical certificate, although an aviation medical examiner generally must defer the application to the FAA for Special Issuance review. The proposal would remove non-insulin medications from that provision and allow qualified applicants to be evaluated under the FAA’s general medical standards.
“The availability of numerous new diabetes medication classes and other non-insulin treatments has substantially improved disease management,” the FAA said in the proposed rule.
The agency noted that the diabetes standard dates to 1959 and said advances in treatment have reduced severe complications including cardiovascular events and hypoglycemia.
The FAA estimates the change could allow AMEs to issue medical certificates at the time of examination in about 3,000 cases each year. Another 1,200 cases currently handled through Special Issuance could potentially transition to AME-managed certification. Over five years, the agency estimates the change would save applicants between $39.7 million and $80.2 million in labor costs.
“Processing all NIDDM cases via the SI process places a burden on applicants and FAA,” the agency said. The FAA expects the proposal to reduce certification wait times and its own processing workload while shortening the process for pilots whose diabetes is well controlled.
Safety Review
As part of the proposal, the FAA reviewed 51 fatal accidents from 2008 through 2025 involving pilots who were reported to be using non-insulin diabetes medications. The agency determined that diabetes, related complications or diabetes medication were unlikely to have contributed to 50 of those accidents. One case remains under investigation.
The proposal would not change the requirements for pilots whose diabetes is treated with insulin, who would continue to require Special Issuance authorization. Pilots using non-insulin treatments could also be denied or deferred on a case-by-case basis when the FAA or an AME determines the condition or treatment could interfere with the safe exercise of pilot privileges.
Comments will be accepted for 30 days following publication of the proposal.
0 replies