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-   -   Diabetes and insulin in ATC (https://www.pprune.org/atc-issues/554792-diabetes-insulin-atc.html)

ferris 17th Jan 2015 06:52

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 :rolleyes:.
Does anyone have any different experience? What are the rules where you are? Is it disqualifying?

HEATHROW DIRECTOR 17th Jan 2015 06:55

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.

Brian 48nav 17th Jan 2015 09:21

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.

Vercingetorix 17th Jan 2015 10:39

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.

:ok:

confused atco 17th Jan 2015 11:21

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
We have 2 have no licence because of Diabetes.

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.

eastern wiseguy 17th Jan 2015 14:37

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.

topdrop 17th Jan 2015 23:08

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.

the Shue 18th Jan 2015 01:15

Ferris, is there a chance the fellow could continue in the training dept ?

ferris 18th Jan 2015 03:54

The reference you provide Verci offers the same,

Insulin use is disqualifying from all the classes of medical.
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.

slatch 18th Jan 2015 07:01

Current FAA guidelines

Starting on page 32

http://www.leftseat.com/ATC/FAA_Order_3930.3B_Chg_1.pdf

omaATC 19th Jan 2015 04:14

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...

Red Dragon 19th Jan 2015 07:17

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

ferris 16th Feb 2015 11:56


I've not heard of slow release insulin
Herein lies the problem. Medical advances are running ahead of the regs (and taking insulin for type 2 is quite common, especially amongst older sufferers). Slow release insulin (such as Levemir) has "no chance"* of causing hypoglycemic loss of consciousness, but as a non-oral medication, is disqualifying.

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.


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