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Merged Diabetes Thread

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Merged Diabetes Thread

Old 19th Jun 2013, 14:16
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http://www.caa.co.uk/docs/49/2013022...danceFeb13.pdf

Is the current guidance.
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Old 14th May 2014, 13:53
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Type 1 Diabetes and flying in australia

Hi guys,

I thought some people would like to know that I have been given a class 1 medical (Australia/CASA) At the moment It is with a multi-crew restriction but I hope to push for a restriction free medical in the future. As far as I can tell I am the first in Australia to have obtained a class 1 with T1D

Please PM if you would like more information.

Gordon
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Old 3rd Jun 2014, 13:36
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Congratulations Gordon

You are as far as I know the first in Australia - you must have an impeccable understanding of your diabetes - well done!
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Old 8th Jul 2014, 13:22
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Fantastic news Gordo!

A diagnosis of Type 1 all but grounded me in 2011, so it's very nice to hear of your success. There is hope indeed.

Cheers
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Old 4th Sep 2015, 22:13
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Type 2 diabetes

Has anybody had any experience with their AME and the CAA regarding being diagnosed with type 2 diabetes?
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Old 5th Sep 2015, 04:50
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Type 2 diabetes

Yes. 30 days of meds...then start the paperwork. If no medical reaction it is pretty straight forward. I used the time off to lose 40 lbs and 2.5 years later...no meds and I waivers! Motivation
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Old 6th Sep 2015, 13:01
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UK CAA rules here. http://www.caa.co.uk/docs/2499/P027%...20Guidance.pdf
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Old 6th Sep 2015, 19:11
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type 2 diabetes

Thanks for the reply.


I have read the caa guidance.


My intial HbA1c was 50 and blood sugar 5.6 the GP calls it pre diabetes,and gave me metformin.


my last blood test shows HbA1c 50 and 4.8.


caa guidance seems to show 5-15 mmol as normal, so at what point does the caa or ame regard you as being diabetic?


I am being asked to take a cardio assessment and stress test although it does not fall into the range in the caa guidance.






BMI 34
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Old 9th Sep 2015, 00:30
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The random blood sugars don't really help with the definitive diagnosis.

The HBA1c does tell of trouble along the line (slightly).

The key figure here is your BMI.
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Old 10th Sep 2015, 13:58
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Get fit, lose weight, eat low fat more vegetarian type food, get some skeletal muscle activation. There are aviation approved list of diabetes mdications, snd metformin is an ok one. The Gliptins are approved in our juristiction, sling with acarbose which is horrible to take. Sulphonylureas are not approved, and insulin is a no no for CPL level and above but in our country limited ( very specific)protocols are being trialled for insulin use for PPL's.
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Old 10th Sep 2015, 20:12
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It's difficult to comment on individual cases.

Once labeled it's a difficult thing to reverse the "diagnosis".

I'd hazard a guess that if you could reduce your BMI, your bloods will normalise.
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Old 12th Sep 2015, 20:31
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type 2 diabetes

Thanks for the replies.


There does seem to be a difference between what the NHS and the CAA regard as diabetes.


The NHS has a limit of HbA1c of 42 however the CAA has a normal range of 5 - 15 mmol/l, and an article by an AME says anything over 7.5% (old units ) which equates to 58.5 mmol/mol ( HbA1c)


so what is the point at which the CAA regards you a diabetes.
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Old 18th Sep 2015, 21:45
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diabetes type 2

Wow, thanks for the reply,
unfortunately its was too technical for me even when looking up what they mean.


Could you please explain in layman terms.
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Old 19th Sep 2015, 06:27
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I doubt it. This is a research paper which has no relevance to this thread.

Back on topic please.

The HbA1c simply shows the average blood sugar over the past 60 days. It shows when your insulin system is wearing out. In early diabetes the level of insulin is actually high as the body can't use it, and later it falls. It is a very common problem

You do not need drugs. Oral drugs do not help the progression of the disease and are only given if the blood sugar itself is high. We need to reduce the stress or load on the insulin system so that it doesn't give up to the extent that you need insulin

Most important is reducing carbohydrate - bread, pasta, rice. Protein is super. Obviously reduce your refined sugar but this is less important. In terms of weight, unless you are truly bariatric, you merely need to reduce your waist measurement. For Caucasian males we want under 42 inches. Exercise - 20 minutes breathlessness twice a week - will help and may reverse early diabetes.

The biggest risk is heart disease so all type 2 diabetics must be assessed for hypertension and if present it must be treated. Statins are vital if tolerated

This is the medical approach. The 'NHS' definitions are simply publications often by non doctors. The CAA make their own rules. I personally think there is considerable difficulty in defining when the HbA1c shows diabetes, and prefer to monitor patients every 6-12 months. If the trend is upwards that is the time to act, not at a certain number.

My advice would be not to take drugs for your blood sugar at this stage, as that will lead to the CAA setting down requirements as posted above. The CAA are clearly using a sledgehammer as they want the tests you mention when simple blood pressure measurement is the necessary screening tool but hopefully you will be ok and then you simply need to manage your lifestyle and follow your HbA1c

Please do let us know how you get on. I am sure I am not the only one interested in whether the regulator concurs
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Old 19th Sep 2015, 08:02
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I was diagnosed with type 2 a year ago. Since then I have gone to a high fat, high protein low car diet. I also train at the gym 5 days per week. Lots of weights, cardio HIITS training and swimming. I'm doing about 6 hrs of high intensity workouts a week. My HBa1c is down to about 6.0%. BP is excellent at 120/70, given up smoking...the only issue is on paper, I look like a couch potato as I have stacked on so much muscle my BMI has gone from 36 to 39.8 while losing 3 inches round my waist.
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Old 23rd Sep 2015, 20:39
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type 2

Thanks for the advice Radgirl, very good commonsense.


I have already stopped metformin as its basically the non fasting blood sugar that is making the A1c hi.


Also increased exercising, its basically the AME following CAA guidance notes.


Will let you know what transpires.
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Old 25th Sep 2015, 14:08
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Sorry to hear this

Just to reiterate, GTT is no longer used by diabetologists. We use HbA1C. If your blood pressure is OK and there is no evidence or other organ damage (retinoscopy ok etc) then I fail to see what their issue is. Lifestyle changes as discussed in this thread may well reverse your diabetes in the early stages.

Good luck
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Old 27th Sep 2015, 21:16
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type 2 diabetes

Is it possible to go to another AME if you are not satisfied with a decision?


i.e. get a second opinion.
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Old 27th Sep 2015, 22:41
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Unfortunately, primary prevention (stopping it happening), seems to be blurring with secondary prevention (stopping complications once it's happened).

The WHO stuff on diagnosis is probably the best guide, although, obviously local authorities will have their own rules.

Random, (or indeed fasting) glucose levels aren't that helpful, as Radgirl say's, HBA1c is probably the best indicator of future problems.

I'm not sure what the stuff about histamine from Winnerhofer has to do with things, I'd be happy to help him sift through the evidence behind his assertions if he care's to post it.
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Old 18th May 2016, 16:31
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Type 1 Diabetes

Hi all

I did a search on this topic and couldn't find the answers that I am looking for so would be grateful for any advice and assistance out there. Basically after a long break from flying (due to marriage, kids, divorce), I have decided to regain my PPL and enjoy the skies again. Unfortunately about 3 years ago I was diagnosed with Type 1 Diabetes. I am aware that I wouldn't have had a chance of flying solo again up until a few years ago and I have downloaded all (I think) the relevant paperwork from the CAA website in advance of taking my medical again.

My query is more about people's experiences with Type 1 and the CAA. I'm aware that it may be a challenge and am prepared for it but any info (good and bad) would be most welcome.

Regards

airmail
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