Physical Qualification Standards and Advisory Criteria - Diabetes Flashcards
What is the regulation regarding diabetes?
No established medical history or clinical diagnosis of diabetes mellitus currently requiring insulin for control
Is there an established waiting period for DM?
No
You should not certify driver until the tx has been shown to be adequate/effective, safe, and stable.
Recommend to certify a driver with DM if…
Meets all the physical qualification standards
Has a treatment plan that manages the disease and does not include the use of insulin or interfere with safe driving
Recommend not to certify a driver with DM if
Hypoglycemia in the last 12 mo resulting in seizure, LOC, need for assistance, impaired cognition w/o warning
Two or more hypoglycemic episodes in the last 5 years
Loss of position sensation
Loss of pedal sensation
Resting tachycardia
Orthostatic hypotension
Peripheral neuropathy
Proliferative retinopathy
Required monitoring/testing for drivers with DM
Urinalysis (looking for glycosuria)
If glycosuria, finger prick BG
A1C
Are incretin mimetics (ie Byetta) allowed?
Yes, so long as they aren’t on insulin, they can driver if physically qualified BUT…
Only 1 year certifications
What documentation do you need for a driver on an incretin mimetic?
Written statement from the treating provider that:
- Describes driver’s tolerance to the medicaiton
- Indicates how frequently the driver is monitored for adequate blood glucose control
- Includes efficacy of treatment
Some drivers with DM who use insulin may be medically cleared if…
Driver has or is eligible to apply for a federal diabetes exemption
Driver has an FMCSA-issued letter that states the driver may be qualified by operation of 49CFR391.64(a) (grandfathered status)
The driver with a diabetes exemption must carry…
A source of rapidly absorbable glucose while driving
Waiting period for DM
Min - 1 month if the driver with DM was previously diagnosed and on treatment that did not included insulin
Min - 2 months if the driver with DM is newly diagnosed and was not on prior treatment
Max certification period for DM?
1 year
The annual diabetes assessment package for the federal diabetes exemption should include…
Endocrinologist Annual Evaluation Checklist (must be by a board-certified/eligible endo for the exemption)
Vision Annual Evaluation Checklist (must be by ophthalmologist if driver has diabetic retinopathy)
Blood glucose levels between ___ and ___ are generally considered to be safe for commercial driving
100 and 400
Max certification for a driver with DM using oral hypoglycemics
1 year
Max certification period for a driver with a hernia
2 years
If you as the medical examiner believe that the nature and severity of the medical condition of the driver does not endanger the safety and health of the driver and the public.
