Diabetes and insulin in ATC
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Diabetes and insulin in ATC
Recently a friend lost his medical due to being prescribed slow release insulin for Type 2 diabetes. The rules surrounding it seem to vary markedly, however, in the country where he works (ME), they are quite rigid. It seems pilots can follow a monitoring protocol, yet controllers cannot 
.
Does anyone have any different experience? What are the rules where you are? Is it disqualifying?
.Does anyone have any different experience? What are the rules where you are? Is it disqualifying?
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What I do know is that a colleague of mine at Heathrow - an ATC Assistant - used to inject himself with insulin and he died suddenly at a very young age. ATC Assistants were not subject to regular medicals but he was a very "fit" person.
Another colleague at Heathrow, a Thames Radar controller, had her medical temporarily suspended because of Type 2 diabetes, once it was under control the suspension was lifted.
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Ferris
in days gone by it was a No No.
In your time in the UAE the licence of a local was suspended by me, you might recall the case. In that instance it was initially type 2 which could have been and should have been controlled by suitable diet, etc but the newly instigated GCAA Doc put him on insulin straight away which wrecked the chaps chance of ever getting his licence back.
Since then the procedures have been updated and UAE CIVIL AVIATION ADVISORY PUBLICATION CAAP 19 AEROMEDICAL applies. (internet search required)
The current procedure re Type 2 is in line with what Brian48Nav says.
in days gone by it was a No No.
In your time in the UAE the licence of a local was suspended by me, you might recall the case. In that instance it was initially type 2 which could have been and should have been controlled by suitable diet, etc but the newly instigated GCAA Doc put him on insulin straight away which wrecked the chaps chance of ever getting his licence back.
Since then the procedures have been updated and UAE CIVIL AVIATION ADVISORY PUBLICATION CAAP 19 AEROMEDICAL applies. (internet search required)
The current procedure re Type 2 is in line with what Brian48Nav says.
EASA European ATCO licence
ATCO.MED.B.025 Metabolic and endocrine systems
(a) Applicants with metabolic, nutritional or endocrine dysfunction may be assessed as fit
subject to demonstrated stability of the condition and satisfactory aero-medical evaluation.
(b) Diabetes mellitus
(1) Applicants with diabetes mellitus requiring insulin shall be assessed as unfit
(a) Applicants with metabolic, nutritional or endocrine dysfunction may be assessed as fit
subject to demonstrated stability of the condition and satisfactory aero-medical evaluation.
(b) Diabetes mellitus
(1) Applicants with diabetes mellitus requiring insulin shall be assessed as unfit
As part of the consultative process EASA was planning changes around the medical side.
I believe that the UK Aeromed section made submissions to change the ban.
I believe that the UK regs were different and at the end of the consultation process EASA elected to kick the process to touch.
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I have type 2 diabetes and have recently retired from being an ATCO.
My understanding was that so long as it was controlled by tablet/diet/exercise and subject to additional testing by the CAA ( effectively a second medical carried out by the doctors at Gatwick ) I was good to carry on.
If it became neccessary for me to have the diabetes controlled by insulin then my medical would have been revoked.
For a full discussion on the subject I would suggest a chat with your local AME.
My understanding was that so long as it was controlled by tablet/diet/exercise and subject to additional testing by the CAA ( effectively a second medical carried out by the doctors at Gatwick ) I was good to carry on.
If it became neccessary for me to have the diabetes controlled by insulin then my medical would have been revoked.
For a full discussion on the subject I would suggest a chat with your local AME.
I know of 2 cases in Oz. First could continue as ATC whilst condition was stable using diet - no insulin. He eventually required insulin and became an instructor.
Second requires insulin and he now expects to regain his medical - not sure how likely this is.
Second requires insulin and he now expects to regain his medical - not sure how likely this is.
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The reference you provide Verci offers the same,
Confused ATCO- I have also seen a submission from the Italians to Eurocontrol back in 2012. I gather it didn't go anywhere as there doesn't seem to have been any changes.
Eastern wiseguy- those are the circumstances that this person has been operating under. Condition now requires insulin, so loss of medical.
Shue- yes, he is looking at options, but a non-op role looks like the only way to remain in the industry.
Basically, the regs are not keeping up with medical advances. Except for pilots.
Insulin use is disqualifying from all the classes of medical.
Eastern wiseguy- those are the circumstances that this person has been operating under. Condition now requires insulin, so loss of medical.
Shue- yes, he is looking at options, but a non-op role looks like the only way to remain in the industry.
Basically, the regs are not keeping up with medical advances. Except for pilots.
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One of our colleagues at OMAA got his license suspended 2 years ago due to diabetes type 2, but after having followed a diet plan for 3 months (I believe) he got it back, so should be possible to come back. However, as far as I know, he was never prescribed insulin, so that might be a different case...
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I'm not sure what the UK CAA requirements are but here it's as follows:
Type 2 - demonstrated control through diet, exercise, medication with an Hb1ac of under 7.0. The frequency of the blood tests are at the discretion of the regulator's medical board. If it goes above 7.0 your certificate is suspended until such time as you get things back under control. Not sure how many chances you get if this happens.
Type 1 (insulin dependent) - No medical certificate.
Once you've been diagnosed with Type 1 there's usually no going back as it almost certainly means your body has stopped producing its own insulin.
I've not heard of slow release insulin and I'd say taking insulin is not usual for Type 2. The approved (AME) medication for Type 2 (Metformin) is usually aimed at helping the body to take the glucose out of the blood into where it should be. The risk of taking insulin, and hence why you can't work as an ATCO with Type 1, is that of hypoglycemia.
RD
Type 2 - demonstrated control through diet, exercise, medication with an Hb1ac of under 7.0. The frequency of the blood tests are at the discretion of the regulator's medical board. If it goes above 7.0 your certificate is suspended until such time as you get things back under control. Not sure how many chances you get if this happens.
Type 1 (insulin dependent) - No medical certificate.
Once you've been diagnosed with Type 1 there's usually no going back as it almost certainly means your body has stopped producing its own insulin.
I've not heard of slow release insulin and I'd say taking insulin is not usual for Type 2. The approved (AME) medication for Type 2 (Metformin) is usually aimed at helping the body to take the glucose out of the blood into where it should be. The risk of taking insulin, and hence why you can't work as an ATCO with Type 1, is that of hypoglycemia.
RD
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I've not heard of slow release insulin
For the record; not all type 2 sufferers are obese, lazy gits with poor diets. Often, type 2 diabetes can be controlled with changes to diet and exercise- but not always.
*as stated by the relevant endocrinologist.
