FAA May Allow Pilots with Insulin-Treated Diabetes to Fly Commercial Airplanes

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By : Suvarna Sheth

CNN reported last week that the Federal Aviation Administration (FAA) may allow pilots with insulin-treated diabetes to fly commercial airplanes.

If the changes take-off, it would allow pilots using insulin to treat their diabetes to apply for a first- or second-class medical certificate, which is required to fly commercially.

Currently, U.S. pilots with insulin-treated diabetes have only been issued a Special Issuance Class 3 Medical Certification, allowing them to be a pilot-in-command of private airplanes — they cannot be pilots on paid commercial flights.

According to the FAA, medical certificates issued by an FAA-authorized aviation medical examiner are designated as Class 1, Class 2, or Class 3.

First-class is designed for scheduled airline transport pilot; second-class for the commercial pilot; and third-class for the student, recreational and private pilot.

Aviation Medical Services (AMS), an aeromedical service-based in Anchorage, AK, says not every insulin-dependent diabetic gets favorable reviews by the FAA, only what they call the “cream of the crop diabetics.”

These, the organization states on their website, are pilots who have “demonstrated excellent control of their diabetes, are meticulous in their insulin and dietary management, have no episodes of hypoglycemia and have no other significant medical problems that would interfere with their disease management.”

The FAA has now authorized approximately 500 insulin-treated diabetes pilots for third-class medical certification.

The FAA has maintained its position on insulin-treated diabetes for pilots even though other countries like the United Kingdom and Canada allow pilots with diabetes to fly commercially, provided there is a second pilot in the cockpit.

The Aircraft Owners and Pilots Association (AOPA), the world’s largest community of pilots and aviation enthusiasts, supports the decision if it comes to fruition.

“Many private pilots who are insulin-dependent have been flying safely since 1996,” Jim Coon, AOPA’s senior vice president of government affairs told CNN.

“With medical advancements, such as continuous glucose monitoring along with proper protocols, the FAA’s impending proposal should help many highly qualified pilots fly commercially,” he added.

Angela Lautner, an international flight dispatcher at global cargo airline, who is also the chapter leader @KYinsulin4all, says she’s ecstatic and excited at this surprise news, and she’s not alone.

“It opens up a set of doors that I thought were closed to me for the rest of my career, and I assumed that any advocating I did on the issue would only help those following in my footsteps,” she tells dLife.

Lautner was diagnosed with Type 1 diabetes when she was in flight school. The diagnosis meant that she was no longer allowed to become a commercial airline pilot in the U.S. — her lifelong dream.

Until now, she explains pilots who are insulin-dependent are limited to a Special Issuance Class 3 Medical certification that restricts them to private pilot operations, regardless of whether or not they hold commercial pilot certificates.

“With this news, the Class 1 and 2 certifications will now be available to people with diabetes with a specific set of protocols,” Lautner says.

According to one of Lautner’s sources, the new protocols and updated Aviation Medical Examiners Guidelines will be published to the Federal Register and the FAA website on Thursday, Nov 7, 2019.

“This decision was long past due with some pilots left hanging without any decision by the FAA on their medical certification status, and without cause, while some of us were still holding Special Issuance Class 3 Medicals under current protocols as pilots with Type 1 diabetes,” Lautner explains.

“It resulted in a recent lawsuit by the American Diabetes Association with all of the pilots who were never given cause to why they couldn’t be issued the standard special medical certification, as insulin-dependent diabetics or how to move forward,” she adds.

Lautner and her fellow pilots with Type 1 diabetes eagerly await the new protocols to see what exactly will be required of them when acting as a commercial pilot. Until then, they won’t know if they will be required to use any technology, such as insulin pumps or CGM’s.

“As for me, I am excited to get back into an airplane soon,” Lautner says. “My heart has always belonged in the skies.”

This story was updated on Nov. 8, 2019.


1.  Liebermann, Oren. (2019, October 31). FAA to allow pilots with diabetes to fly commercial jets. CNN. Retrieved November 4, 2019, from https://www.cnn.com/2019/10/31/politics/faa-pilots-diabetes/index.html

2. Aviation Medical Services. What is Diabetes, and How Does it Affect Your Medical? Retrieved November 4, 2019, from http://www.airspacedoc.com/what-is-diabetes-and-how-does-it-affect-your-medical/

3. Federal Aviation Administration. (2015, May 27). Guide for Aviation Medical Examiners. Retrieved November 4, 2019, from https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/dec_cons/disease_prot/diabetes_med/