Pharmaceuticals (Therapeutic Medications)
Diabetes Mellitus - Type II, Medication Controlled (Not Insulin)

  1. Code of Federal Regulations

  2. Medical History: Item 18.k. Diabetes.
    The applicant should describe the condition to include symptoms and treatment. Comment on the presence or absence of hyperglycemic and/or hypoglycemic episodes. A medical history or clinical diagnosis of diabetes mellitus requiring insulin or other hypoglycemic drugs for control is disqualifying. The Examiner can help expedite the FAA review by assisting the applicant in gathering medical records and submitting a current specialty report.

  3. Aeromedical Decision Considerations: See Item 48, Diabetes

  4. Protocol: See Diabetes Mellitus Type II - Medication Controlled

  5. Pharmaceutical Considerations:
    1. Combination of DM medications with antihypertensives:
      • Disqualifying Combinations. Certification of airmen using meglitinides or sulfonylureas, along with beta-blockers is not permitted. Commonly used meglitinides include repaglinide (Prandin) and nateglinide (Starlix). Commonly used sulfonylureas include: acetohexamide (Dymelor); chloropropamide (Diabinese); tolazamide (Tolinase); tolbutamide (Orinase); glimepiride (Amaryl); glipizide (Glucotrol, Glucotrol XL); glyburide (DiaBeta, Micronase, Glynase); glyburide plus metformin (Glucovance); glipizide plus metformin (Metaglip).
      • Allowable Combinations. Certification of airmen using the combination of a beta blocker with the following diabetes medications is permitted: alpha-glucosidase inhibitors [acarbose (Precose), miglitol (Glyset)]; biguanides [metformin (Glucophage)]; thiazolidinediones [pioglitazone (Actos)]; DDP-4 inhibitors [sitagliptin (Januvia)]; and incretin mimetics [exenatide (Byetta)].
    2. DM medication monotherapy versus combination therapy. Not all combinations of DM medications are acceptable to the FAA, even if each medication within the combination is acceptable as monotherapy. See chart of Acceptable Combinations of Diabetes Medications (PDF). Contact the Regional Flight Surgeon's office or AMCD for questions.
    * The drugs in parenthesis are examples and are not all-inclusive.