Diabetes is a chronic condition, meaning it can stay with you for a lifetime.
Our bodies need a hormone called insulin to convert glucose (sugar) from food into energy. Diabetics either don't produce insulin at all or don't produce enough to keep their bodies functioning properly.
Blood glucose levels are higher in people with diabetes because they can't convert the glucose found in foods into energy. Foods include:
- breads
- cereals
- fruit
- starchy vegetables
- legumes
- milk
- yoghurt and sweets.
Type 1 diabetes
In type 1 diabetes the pancreas stops making insulin. Since the cells can't turn glucose into energy, the body burns fats instead.
People with type 1 diabetes need daily injections of insulin up to four times a day to prevent a build-up of dangerous chemicals in their blood. This can cause a life-threatening condition known as ketoacidosis.
They must test blood glucose levels several times daily. Type 1 diabetes typically starts to affect people before they reach 30, but can occur at any age. About 10% to 15% of all cases of diabetes are type 1.
Type 2 diabetes
In type 2 diabetes, the insulin the pancreas produces is not enough to meet the body's needs and does not work effectively.
The most common form of diabetes, type 2affects up to 90% of all people with diabetes. While it usually affects older adults, growing numbers of younger people, even children, are getting type 2 diabetes.
Effects of flying on diabetes
People with both type 1 and 2 diabetes are affected by irregular meal and sleep times whether they need insulin or not.
The sedentary nature of flying is detrimental for those living with diabetes. Insulin-dependent diabetics (type 1 or 2) may also have trouble with regular blood-sugar monitoring.
A lack of access to emergency treatment (for example, glucose and glucagon) during a flight can also affect diabetics with a high risk of hypoglycaemia.
Effects of diabetes on operators (types 1 and 2)
Diabetic episodes during a flight can lead to either overt or subtle incapacitation. They include:
Overt incapacitation
- Cardiovascular event
- Cerebrovascular event
Subtle incapacitation
- End-organ damage
- Visual impairment (fields, low contrast sensitivity, colour)
- Impaired motor and sensory nerve function
- Impaired autonomic function (hypoglycaemia awareness)
Effects of diabetes treatments on operators
Insulin dependent diabetics (type 1 or 2) risk loss of consciousness due to a hypoglycaemic event.
Non-insulin-dependent type 2 diabetics with a low risk of hypoglycaemia risk side-effects including an elevated glycemic index (GI) and pancreatitis.
Implications for pilots and controllers
Pilots and controllers diagnosed with type 1 or type 2 diabetes must ground themselves and notify their Designated Aviation Medical Examiner (DAME) of this condition.
The type 1 diabetes protocol is only applicable for Class 2 (private) pilots. Not all pilots may be able to satisfy the entry or ongoing requirements in the protocol.
Diabetes treated with insulin does not meet the medical standards. However, we may consider Class 2 applicants in some circumstances.
Type 2 certificate has a limit of 12 months duration. This is because of the variable nature of the condition and its complications.
Approach to medical certification
More likely to gain certification
You are more likely to gain certification if there is:
- absence of hypoglycaemic episodes
- absence of complications of diabetes
- satisfactory control of glucose
- complete and consistent personal glucose monitoring
- good understanding of personal management of diabetes.
Less likely to gain certification
You are less likely to gain certification if there is:
- hypoglycaemia and hypoglycaemic unawareness
- end-organ damage
- poor or unpredictable glucose control
- no or inconsistent personal glucose monitoring.
You are unique
Every case of diabetes is different. How your diabetes affects you will depend on a range of circumstances. We make aeromedical decisions on a case-by-case basis. We base a particular assessment decision on the individual circumstances of the applicant under consideration.
Further information
For further information see: