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United States Department of TransportationUnited States Department of Transportation

Guide for Aviation Medical Examiners

Decision Considerations – Aerospace Medical Dispositions
Item 48. General Systemic – Diabetes, Pre-Diabetes, Metabolic Syndrome, and/or Insulin Resistance

Common Conditions and Course of Action
Disease/Condition Class Evaluation Data Disposition
Diabetes Insipidus All Submit all pertinent medical records; current status to include names and dosage of
medication(s) and side effects
Requires FAA Decision
Pre-Diabetes (Metabolic Syndrome, Impaired Fasting Glucose, Insulin Resistance, Glucose Elevation/Intolerance, and Polycystic Ovary Syndrome) All Review all pertinent medical records; current status to include names and dosage of medication(s) and side effects See CACI – Pre-Diabetes Worksheet (PDF).
If airman meets all certification criteria – Issue.

All others require FAA decision. Submit all evaluation data.
Diabetes Mellitus – Diet Controlled All See Diabetes Mellitus – Diet Controlled Protocol If no glycosuria and normal HbA1c – Issue

All others require FAA decision. Submit all evaluation data.
Diabetes Mellitus II – Medication Controlled (non insulin) All See Diabetes Mellitus II – Medication Controlled (non insulin) Protocol

See chart of Acceptable Combinations of Diabetes Medications (PDF).
Initial Special Issuance – Requires FAA Decision

Followup Special
Issuances - See AASI Protocol
Diabetes Mellitus I & II – Insulin Treated All See Diabetes Mellitus I & II – Insulin Treated Protocol

See chart of Acceptable Combinations of Diabetes Medications (PDF).
Requires FAA Decision
Diabetes Mellitus, Insulin-Treated, Non CGM – Third Class Third Class only See See Insulin-Treated Diabetes Mellitus Non CGM – Third Class Option Protocol Requires FAA Decision

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