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Merged Diabetes Thread

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Merged Diabetes Thread

Old 19th May 2016, 00:50
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Hi airmail,

I've had my PPL for nearly three years with a class 2 medical. I've had diabetes since I was 10, I'm now 26. The CAA have an excellent team of professionals onboard that deal with the diabetic medicals. They really are leading and pushing to get EASA onboard.

There is a lot of evidence to produce, but I agree with all of it. We have to be precise and stringent about it. Good evidence and honestly will prove to EASA that diabetes is not a problem when it comes to taken control of an aircraft.

I myself am currently going through some changes with my regime. I declared myself unfit back in February because I came off of the pens and have since started with the pump. Luckily, I am in the middle of my IMC training, so I am still doing lessons with my instructor and building up evidence. I wish I'd been on the pump years ago to be honest. So much better control.

I wouldn't say it's challenging. It can be time consuming and there are a lot of points to cross, but the team at the CAA are good and they know their stuff.

All the best!
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Old 19th May 2016, 11:20
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Hi RONTOM

Many thanks for the reply and its good to hear that you have had a positive experience to date - very interesting to learn that the CAA appear to be at the forefront of supporting Diabetics as well which wasn't something that I expected. Due to the amount of time that it has been since my last properly logged flight, I'm expecting a fair few hours of dual so a delay in granting a Class 2 wouldn't be the end of the World for me!

Good luck with the pump, haven't got my head around that one just yet but will need to look at that in more detail in the coming months/years.

Cheers
airmail
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Old 20th May 2016, 09:45
  #43 (permalink)  
 
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Ozymandias

Thanks for the reply and your experiences as well. I went for the medical yesterday and much of what you say is still the case (although the Doctor checked and it looks like 90 days of blood sugar readings is now required).

As expected, if it wasn't for that pesky diabetes I would have passed the class 2 on the spot as everything else is fine. I know the additional tests that they want me to do including a treadmill ECG and as my doctor said, the more paperwork that I can supply to support my management the better as they have never rejected a medical because of too much information!

If people are interested (as there have been over 300 views of this thread already and statistically around 6000 PPRuNers will have type 1 whether they know it or not), I'd be happy to post my experiences, challenges etc as they occur.

Regards

airmail
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Old 28th May 2016, 19:56
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Same here guys,

Finished training 2008 and flying with a big airline for two years when I got diagnosed with type 1. At that point the CAA program was put on hold by EASA but after unfit for 6 months I got the medical back. Been flying on the scheme for over 3 years and I fly 800 hrs on an annual basis. Absolutely no issues and control is really good. Colleagues are very positive so I dont see any issue at all. I and a lot of fellow participants provided so much data by now that there should be enough proof to implement it on a european level. Some authorities are still being very resistant but they dont have any evidence to back it up so lets hope for once that EASA will take the responsibility to end this once and for all.
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Old 11th Apr 2017, 17:47
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Insulin and Type 2 Diabetes

I suffer from Type 2 Diabetes and have a EASA Class 2 Medical. My diabetes specialist has suggested that my Blood Glucose level might be improved if she were to prescribe a small dose of Insulin for me. Can I, as a EASA class 2 medical holder legally take this prescribed medication?
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Old 11th Apr 2017, 21:15
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You need to talk to your AME as your Diabetes is not well controlled at the moment (otherwise the need for insulin would not have arisen)

There are additional tests required for those taking potentially hypoglycaemia medication, but you may already be on that and so may already be aware of the implications of this medication.

Chapter and verse in the form of the CAA guidance can be found on their website by Googling 'CAA diabetes guidance'
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Old 12th Apr 2017, 12:19
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Look in easa part med. Insulin is a no go for class 1 and class 2 (for now) unless you have a UK medical. In that case you can only fly G reg planes.

If you are in euroland then it is loss of medical according to current regs. It is however allowed you apply for LAPL. Thats for now the only exception.
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Old 12th Apr 2017, 12:57
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..and Ireland and I believe shortly Austria.
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Old 12th Apr 2017, 15:16
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First have a proper discussion with your diabetologist. 'Poor control' to the CAA is different from 'poor control' to doctors.

Then discuss the various oral medication that is allowed and why / if insulin is better - it may be simply a particular protocol the doctor is following

If insulin is the only option, you have to be given the consequences of not taking it. Do you have any end organ complications - eyes, kidneys? Is this a potential risk for the future???

The 'allowed' drugs such as metformin do not actually lower blood sugar, they stop it rising. So they are unlikely to create a hypo. That is why you can keep flying on them - you wont become incapacitated. Insulin can produce a hypo, needs to be closely regulated, and needs adjusting in the early months. Even the enlightened CAA will not let you fly until you are stabilised on a regime and have demonstrated your blood sugars are controlled.

I am to be convinced that the benefits in a typical type 2 are justified against these difficulties for your flying BUT only your diabetologist can give you chapter and verse - we merely provide general information and I cannot advise you specifically without all your data

As always, we love to hear the outcome!
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Old 12th Apr 2017, 20:33
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Listen carefully to your GP and AME.

"Traditional" treatment for type 2 is very unlikely to make you become suddenly incapacitated (AME's main worry.) Gliclazide and the like makes us slightly more twitchy.

Up until a few years ago, HBA1c targets (your overall diabetic control) were what we all strived to achieve. Evidence at the time suggested tighter HBA1c meant longer longevity.

The emerging evidence suggests that controlling lipids and blood pressure in a 70 year old with type 2 diabetes, is far more important than strictly controlling HBA1c (in terms of living longer and better.)

Like I say, it involves an informed discussion. Your prescribed may not realise the full impact insulin may have on your flying

Last edited by gingernut; 13th Apr 2017 at 05:56.
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Old 11th Aug 2018, 12:58
  #51 (permalink)  
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Diabetes

Years ago I held a FAA class 1 medical. I lost it due to diabetes type 2, the FAA still don't allow diabetics who inject insulin to fly. I understand the CAA (I live mainly in the UK) might. I am trying to find out the current situation for a UK/EU PPL medical (Sorry, don't know what class that is) if you inject insulin. I have emailed the CAA who only say see an AME. I would like to know before troubling an AME if possible. Anyone know the answer?
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Old 11th Aug 2018, 16:09
  #52 (permalink)  
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Google this up and perhaps you'll find the answers you seek.
It's a fifteen page PDF download.



UK CAA Policy for the Medical Certification of Pilots and ATCOs with Diabetes

Information for Pilots, ATCOs and their Instructors, Examiners and Employers
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Old 12th Aug 2018, 22:48
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You can reverse ( in early cases ) type 2 diabetes within 2 weeks with a low carb diet and intermittent fasting. In other words, with a little discipline, you should get your FAA class 1 back.. Recommend you read books by Dr. Jason Fung. He gets his patients off insulin.
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Old 13th Aug 2018, 12:35
  #54 (permalink)  
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I don't think a low carb diet will reverse an insulin injecting patient. I was diagnosed in 2004 and had my medical withdrawn same date, haven't flow since. Been advised the CAA is more tolerant of my type of treatment - hence the question do they generally allow insulin injecting diabetics to hold a licence. Also now discovered the UK has 2 types of licence; EASA-PPL and a EASA-LAPL. Am assuming a PPL is what I would require if available, but it seems to have 2 classes of medical, class 1 and class 2. Not certain yet what I require. As an aside, the medical was withdrawn as you can pass out (have a hypo episode) if you are diabetic and have low blood glucose readings. DVLA say about 3% of diabetics have low readings, the other 97% have high readings and are not likely to pass out, me included. I have never had a hypo since diagnosis. Seems to me the CAA are on the right lines.
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Old 13th Aug 2018, 18:31
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The only reason I'm bringing this up is because it's time sensitive. You absolutely CAN reverse insulin dependent type 2 diabetes if your beta cells are still intact. People do it everyday. You just need to find a doctor that is willing to go outside the standard care protocols and will work with you. It's all about getting rid of sugar. Do the research. You may be surprised! All the best to you!
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Old 13th Aug 2018, 19:20
  #56 (permalink)  
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As I said, diagnose in 2004 when I lost my medical. I don't think that now qualifies as an "early case". Also been very careful with carbs/weight loss/exercise for many years, but 1 month ago had to start insulin. I do thank you for the information though.
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Old 13th Aug 2018, 23:04
  #57 (permalink)  
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Just to clear up an anomaly, if you research
UK CAA Policy for the Medical Certification of Pilots and ATCOs with Diabetes
through the usual internet channels, you'll come straight to the link that I hoped you will find interesting. It's in PDF format though, which you have to download from the CAA's own site. Unfortunately, I don't know how to post a PDF on here. That's why the approach path has looked rather like my own in the sim.
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Old 14th Aug 2018, 13:33
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I’m Class 1 medical holder with T1 Diabetes and fly commercially. Have you looked up the CAA guidance material regarding diabetes? It can be found on the UK CAA website and sets out the requirements for holding a medical from the UK CAA.

If you have any further questions, I’m happy to help but there might be others out there with better knowledge regarding PPLs etc.
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Old 15th Aug 2018, 14:56
  #59 (permalink)  
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Driftdown,
Are you on Insulin? I know most T1 diabetics are treated with insulin. I have looked at the CAA web site, but found the information confusing - hence came here for practicle guidence.
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Old 15th Aug 2018, 15:00
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Originally Posted by Reluctant Bus Driver
You can reverse ( in early cases ) type 2 diabetes within 2 weeks with a low carb diet and intermittent fasting. In other words, with a little discipline, you should get your FAA class 1 back.. Recommend you read books by Dr. Jason Fung. He gets his patients off insulin.
that is pure bollocks, 2 weeks to reverse diabetes type 2 with any diet would be a miracle
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