New Rules for Commercial Drivers with Insulin-Treated Diabetes

Published on
By : Suvarna Sheth

New rules for commercial drivers with insulin-treated diabetes have been implemented by the U.S. Department of Transportation and Federal Motor Carrier Safety Administration (FMCSA).

FMCSA rules apply to most people who operate commercial motor vehicles – trucks, buses, construction vehicles, delivery vehicles, airport shuttles, etc. – in interstate commerce.

The old rule contained an exclusion against insulin use regardless of how well a person managed his or her diabetes.

In 2003, FMCSA began granting exemptions to individuals who could satisfy safety criteria and wait out a cumbersome application process. The application process involved a period of many months during which the individual could not drive a commercial vehicle.

The new rule, published in the Federal Register earlier this month, changes the rules that govern the way commercial drivers with insulin-treated diabetes are certified to operate commercial motor vehicles in interstate commerce.

Recognizing the discrimination that results when people are deemed unsafe simply because of how they treat their diabetes, the American Diabetes Association insisted on more fair rules.

The new rule allows individuals on a stable insulin regimen to operate commercial vehicles without needing to obtain an exemption from the government. It provides for an appropriate assessment of diabetes by the individual’s treating clinician, followed by examination and certification from a certified medical examiner.

“This rule eliminates a longstanding barrier that prevented people with diabetes from fully realizing their potential in the workforce,” said Katie Hathaway, JD, vice president of legal advocacy for the American Diabetes Association in a press release. “I’m proud of ADA’s commitment to this issue and to lead the fight for what’s right for people with diabetes. We are so pleased to celebrate this victory alongside those affected by the outdated rule.”

The final rule draws on data presented in the ADA’s position statement “Diabetes and Driving,” published in ADA’s journal, Diabetes Care.

The final rule was posted in the Federal Register on September 19, 2018.


  1. “American Diabetes Association® Celebrates Culmination of Two Decades of Advocacy on Behalf of Commercial Drivers with Insulin-Treated Diabetes Following Final Rule,” The American Diabetes Association. September 20, 2018. Retrieved: