Type 1 diabetic class 1 medical
Like everything it's probably a policy based on 'rather safe than sorry', although like radgirl, I agree the frequency appears a bit OTT IMHO.
Well done to those of you who've managed to get your class 1's with T1DM, let's hope your fingers are still intact by the time the CAA decides on a slightly more lenient testing regime!
Well done to those of you who've managed to get your class 1's with T1DM, let's hope your fingers are still intact by the time the CAA decides on a slightly more lenient testing regime!
The Bird
By we I mean the medical fraternity
You make my argument better than me by pointing out that on non flying days you only test 2 or 3 times. This is presumably what your diabetologist considers necessary.....I suspect your blood sugars vary more not less on non flying days
I am afraid I do not consider very frequent testing is better safe or indeed better. As doctors, nurses and radiographers we are told from day one that everything we do, especially an invasive procedure, must be necessary. If we do it to gather data for the common good but not the individual it is research and requires specific consent. In most countries you cannot be penalised for refusing to participate.
By we I mean the medical fraternity
You make my argument better than me by pointing out that on non flying days you only test 2 or 3 times. This is presumably what your diabetologist considers necessary.....I suspect your blood sugars vary more not less on non flying days
I am afraid I do not consider very frequent testing is better safe or indeed better. As doctors, nurses and radiographers we are told from day one that everything we do, especially an invasive procedure, must be necessary. If we do it to gather data for the common good but not the individual it is research and requires specific consent. In most countries you cannot be penalised for refusing to participate.
Join Date: Aug 2013
Location: long Left base for 23R
Age: 78
Posts: 121
Likes: 0
Received 0 Likes
on
0 Posts
Like everything it's probably a policy based on 'rather safe than sorry'
The confidence of the travelling public needs to be considered too. Just try suggesting to your average Ibiza-goer that one of the guys driving him there is an insulin-dependent diabetic who might go unconscious at any time.
For many years reasoning exactly like those totally excluded type 1 diabetics from a career as a pilot. I, for one, welcome the fact that that is now changing, but the change must not be at the cost of reduced flight safety for all. It's a very steep learning curve for all concerned, not least the CAA whose task it is to regulate the process.
Radgirl's comments about the "research" aspects of this are a little harsh. It certainly is research - it has to be to learn, in order to make better decisions in the future, for upcoming generations. But reasonable people will be happy to contribute to that research, while being able to fulfil their own long-aspired career ambitions. The Bird exemplifies that approach just about perfectly - long may he continue flying safely !
Join Date: Jul 2003
Location: UK
Posts: 115
Likes: 0
Received 0 Likes
on
0 Posts
There is quite a bit of info on the website if you know where to look 
http://www.caa.co.uk/docs/2499/20140...tJan2014v3.pdf
http://www.caa.co.uk/docs/2499/20140...nceApr2014.pdf
http://www.caa.co.uk/docs/2499/025%2...%20REPORTS.pdf
http://www.caa.co.uk/docs/2499/20141...es(Online).pdf
http://www.caa.co.uk/docs/2499/20140...tJan2014v3.pdf
http://www.caa.co.uk/docs/2499/20140...nceApr2014.pdf
http://www.caa.co.uk/docs/2499/025%2...%20REPORTS.pdf
http://www.caa.co.uk/docs/2499/20141...es(Online).pdf
Join Date: Dec 2013
Location: Aberdeenshire
Age: 34
Posts: 36
Likes: 0
Received 0 Likes
on
0 Posts
Hi,
I myself have had type 1 diabetes since I was 10. I'll be 26 this year and I've held my Class 2 medical for nearly 2 years now, with the intent of obtaining a Class 1 and applying to an FTC. What the CAA are doing are moving into the 21st century. I've seen a fair amount of changes over the years regarding insulin, glucose monitoring, retinal checks, so on.... The phrase, "I'm a diabetic" means something different to what it meant in 2000. I'm currently awaiting for my new Omni Pod. It's a device that sticks to my stomach or under my arm. It sends a constant signal to the app which I'll have on my iPhone. It constantly (every 5 seconds) updates the glucose result on the app. With that, there's an insulin pump device coming out in the near future which will work together with Omni Pod delivering insulin to counteract the glucose. What the electronic devices do and a working human pancreas does are exactly the same thing. In fact, I'd bet if in decades to come scientists looked at the glucose trends of someone with the electronics and someone with a working pancreas, the one wired up will have a far more stable trend in glucose levels. Medical technology is moving forward at an exponential rate, thus reducing complications with diabetes for a lot of people. I remember one of the specialists from a few years ago and he said, "I don't like the term, I have diabetes." He's right, you can't really say, they're diabetic. Really, some peoples pancreas are part of their liver. Mines at the moment is in a pen.
I'm not saying everyone injecting insulin is as thorough and careful as others. Believe me, I wish they were but for us that want to embrace it, live with it and not let it affect us, what's the problem? Let's keep moving forward with flight. Hopefully very soon, the rest of the world will move out of the 20th century and adopt what the Drs and the rest of the medical professionals here in the UK have done.
I myself have had type 1 diabetes since I was 10. I'll be 26 this year and I've held my Class 2 medical for nearly 2 years now, with the intent of obtaining a Class 1 and applying to an FTC. What the CAA are doing are moving into the 21st century. I've seen a fair amount of changes over the years regarding insulin, glucose monitoring, retinal checks, so on.... The phrase, "I'm a diabetic" means something different to what it meant in 2000. I'm currently awaiting for my new Omni Pod. It's a device that sticks to my stomach or under my arm. It sends a constant signal to the app which I'll have on my iPhone. It constantly (every 5 seconds) updates the glucose result on the app. With that, there's an insulin pump device coming out in the near future which will work together with Omni Pod delivering insulin to counteract the glucose. What the electronic devices do and a working human pancreas does are exactly the same thing. In fact, I'd bet if in decades to come scientists looked at the glucose trends of someone with the electronics and someone with a working pancreas, the one wired up will have a far more stable trend in glucose levels. Medical technology is moving forward at an exponential rate, thus reducing complications with diabetes for a lot of people. I remember one of the specialists from a few years ago and he said, "I don't like the term, I have diabetes." He's right, you can't really say, they're diabetic. Really, some peoples pancreas are part of their liver. Mines at the moment is in a pen.
I'm not saying everyone injecting insulin is as thorough and careful as others. Believe me, I wish they were but for us that want to embrace it, live with it and not let it affect us, what's the problem? Let's keep moving forward with flight. Hopefully very soon, the rest of the world will move out of the 20th century and adopt what the Drs and the rest of the medical professionals here in the UK have done.
Join Date: Aug 2007
Location: West Yorkshire
Posts: 635
Likes: 0
Received 0 Likes
on
0 Posts
Rontome
I wish you well and hope you get the pod asap...However I`m, afraid that the UK is as always, miles behind the curve. I too am affected by this condition and have spoken to my pharmacist who says that the NICE committee are refusing to allow it for general use, even though it would transform lives and long term save the NHS a forture, due to its present cost..Also the big boys of the pharmacutical world are fighting its introduction as hard as they can.It would of course affect their market share and profits, which is all they care about
They are allowing it for those in certain occupations, like yourself and for children and those with a documented phobia of needles etc..Keep us informed and I`m sure it will be great for you
Apparantly the latest thinking is that this treatment is years away, for general use, in the UK
I wish you well and hope you get the pod asap...However I`m, afraid that the UK is as always, miles behind the curve. I too am affected by this condition and have spoken to my pharmacist who says that the NICE committee are refusing to allow it for general use, even though it would transform lives and long term save the NHS a forture, due to its present cost..Also the big boys of the pharmacutical world are fighting its introduction as hard as they can.It would of course affect their market share and profits, which is all they care about
They are allowing it for those in certain occupations, like yourself and for children and those with a documented phobia of needles etc..Keep us informed and I`m sure it will be great for you
Apparantly the latest thinking is that this treatment is years away, for general use, in the UK
Join Date: Oct 2016
Location: England
Posts: 1
Likes: 0
Received 0 Likes
on
0 Posts
Type 1 diabetes & medicals
Hello,
I just wanted to gain some more information on the rules and restrictions
regarding class 1 medicals and type 1 diabetes. I understand that due to
changes in recent years pilots can obtain class 1 medicals if they have
been diagnosed while flying commercially, but I am unsure if you can obtain
one for the first time to enable you start commercial pilot training if you
suffer from this condition. The information online is limited so any help
would be deeply appreciated. Kind regards, Jared.
I just wanted to gain some more information on the rules and restrictions
regarding class 1 medicals and type 1 diabetes. I understand that due to
changes in recent years pilots can obtain class 1 medicals if they have
been diagnosed while flying commercially, but I am unsure if you can obtain
one for the first time to enable you start commercial pilot training if you
suffer from this condition. The information online is limited so any help
would be deeply appreciated. Kind regards, Jared.
Join Date: Jun 2014
Location: UK
Posts: 11
Likes: 0
Received 0 Likes
on
0 Posts
Jared636,
I have just received my Class 1 medical having been diagnosed with Type 1 at the end of June. I did have my Class 1 already so this was a case of regaining my medical.
I spoke to my AME who just issued my revalidated medical 3 weeks prior with no signs of diabetes! Well, he didn't pick anything up anyway... He didn't know how to proceed and suggested I get my consultant doctor to write a report. I tried calling the CAA to which they said I was to speak to my AME... I called my airline and I'm the first with Type 1 within the company and so they couldn't really help me there... I emailed the CAA medical dept, not thinking anything would come of it. A couple of days later, I got a call from a senior aeromedical advisor and she told me everything that I had to do...
Provide 90 days of blood sugar readings (3 or 4 readings a day)
HBA1c value
Renal Profile
Lipids
Urine sample checking for various items (see CAA guidance material below)
Checks for any diabetic complication - retinopathy check, checking of your feet, checking of your kidneys and an ECG stress test checking for any cardiovascular disease.
All of these results were then put into a report by my diabetic consultant and sent off with my spreadsheet of 90 days blood sugar readings.
It's then checked by the chief AME and if satisfactory, you're invited to meet with the CAA diabetic consultant. If all goes okay then you'll have your medical posted out to you soon after.
Sorry I can't help from the point of getting your medical for the first time - I can only speak of my experience.
Here is the CAA guidance material on how to construct the report and the results required - https://www.caa.co.uk/WorkArea/Downl...?id=4294973794
I have just received my Class 1 medical having been diagnosed with Type 1 at the end of June. I did have my Class 1 already so this was a case of regaining my medical.
I spoke to my AME who just issued my revalidated medical 3 weeks prior with no signs of diabetes! Well, he didn't pick anything up anyway... He didn't know how to proceed and suggested I get my consultant doctor to write a report. I tried calling the CAA to which they said I was to speak to my AME... I called my airline and I'm the first with Type 1 within the company and so they couldn't really help me there... I emailed the CAA medical dept, not thinking anything would come of it. A couple of days later, I got a call from a senior aeromedical advisor and she told me everything that I had to do...
Provide 90 days of blood sugar readings (3 or 4 readings a day)
HBA1c value
Renal Profile
Lipids
Urine sample checking for various items (see CAA guidance material below)
Checks for any diabetic complication - retinopathy check, checking of your feet, checking of your kidneys and an ECG stress test checking for any cardiovascular disease.
All of these results were then put into a report by my diabetic consultant and sent off with my spreadsheet of 90 days blood sugar readings.
It's then checked by the chief AME and if satisfactory, you're invited to meet with the CAA diabetic consultant. If all goes okay then you'll have your medical posted out to you soon after.
Sorry I can't help from the point of getting your medical for the first time - I can only speak of my experience.
Here is the CAA guidance material on how to construct the report and the results required - https://www.caa.co.uk/WorkArea/Downl...?id=4294973794
Join Date: Apr 2000
Location: gone surfin'
Age: 58
Posts: 2,333
Likes: 0
Received 0 Likes
on
0 Posts
Took me three months to get my medical back when I was diagnosed with diabetes and the main part of it was proving that I cannot go into hypoglycemia, even with a doubled dose of my meds (metformin), without eating and very heavy exercise
It may give you the sh*t's in high dose though.
Interesting thread.
Join Date: Apr 2000
Location: gone surfin'
Age: 58
Posts: 2,333
Likes: 0
Received 0 Likes
on
0 Posts
Gliclazides can, in theory, induce hypoglycaemia, never actually seen it happen, but our latest guidelines have a caveat in about drivers.
The main stay of diabetes control, was traditionally to try and reduce HBA1c. It's an area of rapidly changing parameters. It's likely that sorting lipids and blood pressure control out is likely more important in the long run
Probably not apt to you young pilot chappie's, but one episode of hypoglycaemia doubles your risk of early cardiovascular disease by a factor of 2.
Sorry, can't specifically answer questions about type 1, it's a fast changing field, so don't give up hope.
The main stay of diabetes control, was traditionally to try and reduce HBA1c. It's an area of rapidly changing parameters. It's likely that sorting lipids and blood pressure control out is likely more important in the long run
Probably not apt to you young pilot chappie's, but one episode of hypoglycaemia doubles your risk of early cardiovascular disease by a factor of 2.
Sorry, can't specifically answer questions about type 1, it's a fast changing field, so don't give up hope.
Join Date: May 2009
Location: Confoederatio Helvetica
Age: 68
Posts: 2,847
Likes: 0
Received 0 Likes
on
0 Posts
I can recommend the FreeStyleLibre as an alternative to finger pricks. One benefit is that it can give you an accurate estimate of your HB1c.
Join Date: Jun 2014
Location: UK
Posts: 11
Likes: 0
Received 0 Likes
on
0 Posts
I use the Freestyle Libre whilst on and off duty. As it measures interstitial and not capillary, the CAA as well as the DVLA do not accept it.
Blood testing via traditional finger prick still has to be carried out.
When I met with the diabetic specialist at the CAA, he knew from my consultant's report that I used the Libre and encouraged it's use. I also use an insulin pump - my control on pens were good but my NHS team decided to offer me the pump due to my occupation. It's great.
The A1c calculation on the Libre is very much a rough guide. It estimated mine to be approx 6.9%. When I got my bloods done, I was 5.9%. Certainly keeps you in the ball park however.
I fly purple aircraft for a well known regional airline and was swimming in the hold pool for the UK flag carrier before I was diagnosed. I told them straight away and they were more than happy to still offer me a position with them provided I could get my medical back - I start with the in the new year and that's with me having Type 1. Don't let diabetes totally rule anything out!
Blood testing via traditional finger prick still has to be carried out.
When I met with the diabetic specialist at the CAA, he knew from my consultant's report that I used the Libre and encouraged it's use. I also use an insulin pump - my control on pens were good but my NHS team decided to offer me the pump due to my occupation. It's great.
The A1c calculation on the Libre is very much a rough guide. It estimated mine to be approx 6.9%. When I got my bloods done, I was 5.9%. Certainly keeps you in the ball park however.
I fly purple aircraft for a well known regional airline and was swimming in the hold pool for the UK flag carrier before I was diagnosed. I told them straight away and they were more than happy to still offer me a position with them provided I could get my medical back - I start with the in the new year and that's with me having Type 1. Don't let diabetes totally rule anything out!
Join Date: May 2009
Location: Confoederatio Helvetica
Age: 68
Posts: 2,847
Likes: 0
Received 0 Likes
on
0 Posts
My HB1c was estimated by the FreeStyleLibre application as 6.4. The following day at Dr.s office it was 6.5.
It is an estimate, however, and inter-stitial is not glucose, but it is very helpful.
I'm impressed with 5.9 though, well done.
It is an estimate, however, and inter-stitial is not glucose, but it is very helpful.
I'm impressed with 5.9 though, well done.
Join Date: Jun 2014
Location: UK
Posts: 11
Likes: 0
Received 0 Likes
on
0 Posts
I'll need to get some tips from you, would be ideal to have a nice accurate reading before I head off for my 3 months bloods!
It's a great tool, I love it. You can head out for meals, drinks etc and just a simple swipe to let you know if things are in check. A simple swipe can indicate if you're high or low and then that'll trigger me to check my actual blood and correct as required nice an early to bring my blood sugar down or up so as to avoid a hypo - even before my body tells me I'm low with shaking and sweaty palms. Great for keeping the A1c in check.
Many thanks. I am still in the honey moon phase and so I guess that helps. I would simply like to keep my A1c 6.5% or below and thus doing the best I can to avoid complications.
I find it easier to control my diabetes whilst flying as I'm strapped to a seat all day, it moves very little!
It's a great tool, I love it. You can head out for meals, drinks etc and just a simple swipe to let you know if things are in check. A simple swipe can indicate if you're high or low and then that'll trigger me to check my actual blood and correct as required nice an early to bring my blood sugar down or up so as to avoid a hypo - even before my body tells me I'm low with shaking and sweaty palms. Great for keeping the A1c in check.
Many thanks. I am still in the honey moon phase and so I guess that helps. I would simply like to keep my A1c 6.5% or below and thus doing the best I can to avoid complications.
I find it easier to control my diabetes whilst flying as I'm strapped to a seat all day, it moves very little!
Join Date: Apr 2000
Location: gone surfin'
Age: 58
Posts: 2,333
Likes: 0
Received 0 Likes
on
0 Posts
There are two competing perspectives here.....
HBA1c is a measure of long(er) term control. With BP, lipid and lifestyle control, it's essential for living a longer and healthy life. It's a video of the train.
Plasma glucose level is probably more relevant to a diabetic pilot who is about to pilot his passengers about......but generally only if he or she is at risk of having a hypoglycaemic attack, and thus rendering him suddenly incapable. This is usually only the case when a pilot is actually taking a medicine that would cause this.
Plasma glucose level (the usual "fingerprick" machines), take a snap shot of the train. It show's where the train is now. It doesn't show where it's been, where it's going, or how fast it's getting there.
HBA1c is a measure of long(er) term control. With BP, lipid and lifestyle control, it's essential for living a longer and healthy life. It's a video of the train.
Plasma glucose level is probably more relevant to a diabetic pilot who is about to pilot his passengers about......but generally only if he or she is at risk of having a hypoglycaemic attack, and thus rendering him suddenly incapable. This is usually only the case when a pilot is actually taking a medicine that would cause this.
Plasma glucose level (the usual "fingerprick" machines), take a snap shot of the train. It show's where the train is now. It doesn't show where it's been, where it's going, or how fast it's getting there.
Join Date: Jun 2014
Location: UK
Posts: 11
Likes: 0
Received 0 Likes
on
0 Posts
As you say, I guess the biggest issue with diabetes (insulin dependant) is the risk of incapacitation due to mis-calculating the amount of insulin taken with the amount of carbohydrate consumed. I bring my own food to work as the crew food supplied to us isn't labelled and I don't really fancy guessing carbs for the very reason of misjudging the insulin required unless it's food with standard values such as bread in a sandwich. I usually have food very low in carbs, or have zero carbs. Peanuts for example. I was telling my consultant this and he did say there is potential for the body to convert the protein to glucose if not consumed with carbohydrates?
Anyway, keeping an eye on things once I've eaten isn't a problem with the CAA testing protocol (within 30 minutes of take-off and landing and every hour during flight). I'll then use that instantaneous snap shot of my blood and couple it to the trend arrow on my Libre to get a pretty solid understanding of where my sugars are heading.
It's just finding that balance of keeping sugar levels from going low and from keeping them running high as to cause long term (and short term) issues.
Anyway, keeping an eye on things once I've eaten isn't a problem with the CAA testing protocol (within 30 minutes of take-off and landing and every hour during flight). I'll then use that instantaneous snap shot of my blood and couple it to the trend arrow on my Libre to get a pretty solid understanding of where my sugars are heading.
It's just finding that balance of keeping sugar levels from going low and from keeping them running high as to cause long term (and short term) issues.
Join Date: Mar 2017
Location: United Kingdom
Posts: 1
Likes: 0
Received 0 Likes
on
0 Posts
Can I become a commercial Airline pilot with Type 1 Diabetes
Hello! I have been a Type 1 Diabetic for 4 years now and I am turning 18 in the near future. I want to start my private pilot's license and ultimately do a commercial pilots license and become an airline pilot in the future. My question is, can I obtain a Class 1 medical in the UK from the CAA, if I already have Type 1 Diabetes and have not previously held a Class 1 medical certification? 
Thanks, Amar!
Thanks, Amar!
