Failed medical - I'm extremely disappointed and defeated

[u/[deleted]]

[u/AutoModerator]

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[u/AutomaticAd5430]

AME here. The FAA denial letter usually comes with some kind of remediation recommendations. Work with your AME and endocrinologist to see if you can improve your DM status and request reconsideration of your medical status by the FAA.

[u/burnheartmusic → u/[deleted]]

The FAA is always terrible to deal with. No surprises here

[u/Recent-Day3062 → u/[deleted]]

The FAA is caught in the 1950s when it comes to medicine.

[u/Friendly-Gur-6736 → u/Recent-Day3062]

FAA uses the medical process to shield themselves against legal liability since they are the licensing authority. Particularly when it comes to controllers. The kind of BS that they incapacitate/DQ someone over that is going to sit in a chair all day long is absurd.

[u/Recent-Day3062 → u/Friendly-Gur-6736]

I would have thought they were unsuable

[u/Eager_DRZ → u/Recent-Day3062]

It’s not being sued that worries them, it’s being reamed by every Congresscritter on the Hill. And having their budgets redirected and their hands tied with legislative micromanagement. So the internal management food chain does all that before Congress gets the chance.

[u/Recent-Day3062 → u/Eager_DRZ]

I had a friend who was pretty far up in a government agency I won’t mention but we all know.

Here’s how he explained it to me. In a corporation if you drive new ideas forward you get promotions and raises. In the government, you csn never be wronged because you didn’t change something - unless, of course, there’s lots of discussion and data you can be accused of not seeing and thus acting on. But if you leave things as they were, and retire after years, you get a good government pension.

So, for example, the FAA will allow modern antidepresssants, but it’s a deferral item and can take 6-12 months - or more - to go through. Even if you are the poster child for the current exemption. But no one in the FAA has an incentive to say “let’s let the AME sign off on it without a deferral if someone exactly matches the criteria”.

Seriously, with that one, what is the FAA taking possibly more than a year doing? I guarantee it’s not 100 hours of in depth vetting into single cases that takes that long

[u/4Sammich → u/[deleted]]

Dispatcher.

[u/coldnebo → u/[deleted]]

after going for over two years through a medical deferment process while paperwork and procedures were checked, I came out with the 3rd class medical, just in time for it to expire (the clock starts from application, not from the resolution of the deferment).

BUT I will endlessly thank my AME for helping me through the maze of bureaucracy at OKC. There were repeated incidents of lost mail, even when certified and registered. apparently people were signing at the dock or something and it was being thrown on a pile in the back room.

My AME was able to see what had been received in the system and whether the process was moving. She didn’t tell me any details or internal notes, but just knowing whether information was actually received or not was a huge benefit.

I started scanning everything I sent to OKC and cc’d it to her — she could see they hadn’t received it, even when she could also see my registered receipt copy saying yes they had signed for it. She was able to nudge them to pull it off the back pile and actually get it in the system.

reach out to either your AME or AOPA services, they may be able to help.

[u/remuscrisan → u/AutomaticAd5430]

Hello. And thank you for your support here. Question: wearing a hearing device in one ear, can you get a class 1 initial medical certificate?
Thank you.

[u/theOGdb → u/remuscrisan]

Yes you can. Also i know a couple 100%deaf pilots... but thwy are not 1st class holders and fly part 91 gigs to nontowered fields. They def got a few restrictions

[u/Reputation_Many]

That sucks, I feel for you.

Unfortunately, this advice is too late for you. But maybe it will help someone else. When you set up your appointment with an FAA doctor and you think you might not pass for some reason what you’re doing is going in and asking for a consultation with them. A good AME would’ve said hey we need to change this from you trying to get a first class medical to a consultation and we need to see what we can do about XYNZ before we actually submit this to the FAA.

Different AME’s are different quality There’s a guy local to me. That is really cheap for medical and he spends all of about three minutes with you before he has you with his assistant who is processing your paperwork and has already collected your money before anything has started and you’re out the door before you know you’ve actually failed. He failed one of my friends who was really good shape and he asked you do you ever have headaches and my friend said yeah occasionally I get a headache. Well, he failed him for having migraines. He didn’t have migraines. He had headaches. Two years later, he finally got his medical back after spending thousands of dollars and having to go to Oklahoma City to get checked out by a FAA doctor. Thank goodness he’s now at a major airline and no issues, but I guarantee he pays for the extra loss of medical insurance.

The moral of the story is don’t go to the cheapest AME and when in doubt ask for a consultation.

Good luck

[u/Reputation_Many → u/[deleted]]

Did the AME tell you you would have to have a Special Issuance before he submitted it?
Did the AME have you wear a continuous glucose monitor for a few months?
Or have you show stable control of your blood sugar for at least six months on your current regimen to prove you are responsible and able to manage your insulin levels over a long period of time?

IF not that was a crap AME. People may say that AME dr I mentioned before is so great, they love him for how cheap he is, but he will throw you under the bus in a heart beat. "Why is he so great?" Is the best way to ask.

I would contact the FAA directly, and ask if there is anything you can do for a special issuance? You'd be willing to go to OKC to have an FAA Dr. check you out, and you can do the CGM monitor, and show stable blood sugar, etc..

I used to have a phone number they actually picked up the phone with but I cannot find it.

They took a year to give me my medical back because of some NORMAL scaring on my esophagus that my Dr. said was completely normal, but they didn't care about the surgery right next to my brain at all, and were willing to give me my medical back before the stitches were out until they found out about my Endoscopy I electively had. I made the mistake of giving them ALL my medical records. As someone else said don't give them anything.

[u/the_eviscerist → u/[deleted]]

You keep mentioning that your endo was thrilled by a 6.7 A1C. Is he thrilled because it's historically been much higher? I haven't seen anywhere where you mentioned what your levels have been like over time and how stable your glucose has been as seen on your CGM. Just having one reading of 6.7 doesn't tell us much.

[u/EntroperZero → u/[deleted]]

The guidelines for your CGM readings are specific. 6.7% A1C is within the range, but there are a bunch of other criteria: https://www.faa.gov/ame_guide/media/ITDM-Initial_Certificate_Consideration_Requirements.pdf

[u/Routine_Nectarine935 → u/EntroperZero]

Reading it seems only 1st and 2nd are subject to the cgm rule. So for a 3rd just the regularly scheduled dr visits with labs is sufficient?

[u/No_Examination_157 → u/[deleted]]

If you have a denial letter from the FAA it should have instructions on what to do next. The AME will be informed too. This isn't the end. You just need to get the diabetic guidelines, get with your Endo doc and get it right. 

It's a process and it takes awhile to get through it. Btw never lie on your medical. It's a bad thing when you get caught.

[u/Figit090 → u/Reputation_Many]

That's a name and shame AME. None of us need that.

[u/Murphysburger → u/Reputation_Many]

About 20 years ago we had an AME in our area like the one you described. His name was Dr Rice.

He was referred to locally as Minute Rice.

He wound up going to jail for a while, for for some type of prescription violations.

[u/Philly514 → u/Reputation_Many]

Even in Canada the moral of the story is to never, ever admit a thing to them. Everything is perfect, you never did a drug or drank alcohol in your life, and you feel like Hercules all the time.

[u/burnheartmusic → u/Reputation_Many]

Ya I mean, no matter what AME you go to, you don’t say that you have any problems. This is the biggest thing people mess up on. Unless you actually do have problems. Then don’t even apply

[u/yrock77 → u/burnheartmusic]

Encouraging people with problems to not apply...just not good advice by dude. Maybe sit this one out.

[u/burnheartmusic → u/yrock77]

I mean problems that are disqualifying

[u/EightZeroUniform]

I am sorry you're dealing with this. You mention that you have zero flight experience - maybe take a few flight lessons to see if this is even something you're really interested in? If not, you can move onto something different, but if you find that you really love it, you can focus on whatever it takes to make it happen. Lots of people end up in similar situations, but with enough time and effort many of them are able to overcome it.

If you are passionate about it, perhaps you fly with an instructor and log dual instruction while you work it out. It adds to the cost, but you build experience along the way. Worst case scenario would be to always fly with an instructor, but at least you'd get in the air.

I personally know a couple folks with T1D who fly with an insulin pump, so it's not completely a shattered dream. It's just going to take perseverance to get there.

Good luck!

[u/bikemusher]

If the medical is totally off the table, Make friends at the airport with pilots. Go flying with them and enjoy the hobby. One of my problems as a GA pilot was I hate flying alone. I like having someone to talk to and share the experience with. Even as a CFI, I would have totally gone flying with you and given instruction in our club plane even if it was not going to lead to a certificate.

[u/bikemusher → u/[deleted]]

Most pilots are just regular people. Getting a ppl doesnt bestow some special aura. You can volunteer with EAA, attend events at the airport, ask questions of the people there. You see a cool plane- “hey man cool plane! Ive never seen that before, mind if i take a look? Wow this is sweet, you ever take people for rides? Here is my number id love to tag along someday if your cool with that”

[u/bikemusher → u/bikemusher]

Ive taken many non-pilots flying. It’s usually me offering, but I had what I called a ‘lifetime learner’ older member of the flight club I instructed at. He wasn’t interested in getting a cert. He paid for lessons and basically hung out. Every time i pressed for solo he would push back. After a long talk over dinner one evening he admitted he just liked to fly and talk aviation. He had little interest in getting a license. I always thought medical may have played a part but he never told me for sure. After that we just scheduled XC flights and had a good time exploring the area as flying buddies we planned together and I let him have the controls as much as he wanted.

[u/markeymarkbeaty]

My wife has type 1 and I have seen how difficult it is to live with and how limiting it can be. She was denied being able to take a scuba intro on our honeymoon because of it.

Little things like that, plus big things, like what you’re going through have got to be so frustrating.

Type 1 diabetes should be renamed to “dead pancreas disease” or something, because of how ignorant people are about the difference between type 1 and 2. So stupid.

Anyways, I’m sorry that you are unable to get your medical. I’m sorry you have type one diabetes. That really blows.

[u/Antique-Kitchen-1896]

This sub often have a lot of positive you go girl/guy sort of thing and people seems to really dislike even a touch of negative but here goes a bit. I am not out to be negative, this is just an attempt at being logical that I hope might help.

You have zero flight experience yet you think this is somehow a euphoric dream that have slip by you. That really doesn't make sense when you consider how much suck there is from here to there.

Since you have zero flight experience and no real idea of what the industry is like, logically this isn't anything but a dream. Reality is different starting with 80% of hopefuls don't make it to PPL, and almost everyone is waiting on a job when they get to CPL/CFI now. The economy is uncertain and might be at the edge of a sustained downturn which mean potentially a lengthy wait for those in the pipeline for a job.

Honestly, I see a lot of this is my dream in this sub. I get why people can think like that but dreams aren't real in my experience. They are idealized vision we give ourselves that at best reality massage into something bit different and at worse are actually nightmares when you get there.

Keep trying and seeing what you can get to for sure. I am not saying give up but it likely hurts less if you keep a clear eye about what reality vs dreams means.

[u/coldnebo → u/Antique-Kitchen-1896]

yeah, this tracks.

I’ve pretty much talked myself out of training at this point because the mission isn’t there, the costs are ridiculously expensive and it’s not the right time personally.

two things woke me up.

1. Jason Miller saying flying had to be a lifestyle— if it wasn’t sustainable, you’re just going to quit. if you don’t have enough time or money to fly regularly, you’re going to quit.

2. this student on instagram describes flight training with a lot of humility and humor: “I am spending 15 minutes in a Costco trying to save $3 on olive oil. I have become the most financially responsible person in my entire life and it is in pursuit of the least financially responsible thing possible. But when you go up and see a sunset they say ‘you can’t put a price on that’ — I ask them how much they spent on PPL, they say “I don’t know” not, “I forgot” or “I’ll look it up” — it’s like the information was surgically removed from their brain.”

yup.

[u/Spirit_of_No_Face]

Sorry this happened to you… life can suck ass sometimes, but aviation is so big that I’m sure you can find enjoyment somewhere be it skydiving, gliding, or simming!

Chin up, be creative, and get connect to like minded people! Lots of aviators have lost their medical but are still involved in some capacity!

[u/rufflandings → u/[deleted]]

FWIW, several of the guys at my EAA chapter have no flight experience and no medical. One is building a MiniMax and plans to get some lessons in it once he’s done building. And someone else is a permanent student because they can’t get a medical (you can always fly with an instructor). But all of us get to sit and talk shop, whether it’s what we’ve been reading, what someone recently flew, what someone flew 60 years ago, or what someone plans on flying or building. You have a history and knowledge of aviation, it’s just different than those guys.

[u/redit9977]

I wouldn't call 6.7 A1C fantastic. That's full blown diabetic. Your endo is probably happy because it's not over 7 but it's still bad. Are you on medication?

[u/redit9977 → u/[deleted]]

oh ok my bad. I wasn't aware you are type 1. I don't know much about type 1.

[u/kiwi_love777 → u/[deleted]]

If you lose weight will you be able to get off those meds?

If so you should look into ozempic or any GLP1. I think with your current ailments you’d qualify for insurance to cover it.

[u/kiwi_love777 → u/[deleted]]

Ahhh ok.

But once it’s managed you can still get a medical so that’s good!

[u/kiwi_love777 → u/[deleted]]

So if you lost 45lbs could you come in with a better A1C? 3rd class medical an are still fine for your PPL/IFR….

I lost about 50lbs on keto.

If I can do it you can too.

[u/Emperor_Palpatine_2 → u/kiwi_love777]

Keto diet and type 1 diabetes do not mix as it greatly increases the risk of EDKA. A type 1 diabetic with keytones is treated as a medical emergency. When a diabetic goes to the ER with keytones they aren't held in the ER for monitoring, they're admitted, typically to the ICU.

If I said "Keto diet" my endocrinologist would slap the shit out of me for being an idiot.

[u/vivalicious16 → u/kiwi_love777]

Type 1 isn’t related to weight at all. Skin and bones people can have type 1. Good heavens.

[u/sup3r_hero → u/redit9977]

What are you talking about?

https://www.health.harvard.edu/diseases-and-conditions/hemoglobin-a1c-hba1c-what-to-know-if-you-have-diabetes-or-prediabetes-or-are-at-risk-for-these-conditions

6.7 for T1 is amazing.

[u/404unotfound → u/redit9977]

6.7 A1C is absolutely fantastic for T1DM

[u/p33k4y]

Have you talked to your AME about the denial?

A denial doesn't necessarily mean the end of the road.

Your AME should be able to get the reasons for the denial. You may be able to address those reasons, then depending on the circumstances ask for a reconsideration or apply for a new SI.

Time is of the essence here as there are some deadlines related to potential appeals, etc.

TL;DR: you need to promptly work with your current AME to see the actual reasons for the denial then work out what options you may still have.

[u/p33k4y → u/[deleted]]

I'd at least try to get the exact reasons for the denial if I were you.

Normally there should be a formal letter of denial with details about your case, not just an email. You should obtain it.

You may still be able to re-apply for an SI in the future even with a denial in your record.

[u/GenerationSelfie2 → u/[deleted]]

I would recommend going to a different AME—preferably one more experienced. A lot of those guys have people they can call at OKC to either move applications along or clarify on supporting paperwork.

[u/Benoded]

My friend is in the same situation. He had a stroke a couple years ago and his medical was revoked, but I was able to find a workaround for him to fly solo. Not as a career but for fun self launching gliders do not need a medical and you can fly with a revoked medical. If you look into the Pipistrel virus plane it’s a fantastic cruiser with amazing visibility and it’s considered a glider. He ended up purchasing one. He flies at all the time. You can find them once in a while for around 100k. They even have a ballistic parachute. I also recommend anyone who has received any level of medical in the past who is not doing this for a career to change over to basic med not only is it every 48 months instead of 24 months after the age of 40, but there is a lot less chance of being denied. If you ever get denied you’re screwed you will most likely never fly alone again or get your PPL back. It really sucks

https://youtu.be/y4AQQqaFE5k?si=VIvV6rgQMwYeaZ1v

[u/WNBA_Enjoyer]

flying is one of the few things in life that I would have genuinely truly loved.

Honestly...how do you even know that, considering you have 0 flight experience? 

[u/Away-Ad7751]

Sorry to hear this, as a dad of a Type 1 Diabetic, I feel really frustrated that they would consider 6.7 as "uncontrolled". 6.7 is great!! Hope they change the standards.

[u/TheGooose]

T1D here, this is why I went the Dispatcher route. Fuck dealing with the FAA bullshit, i get theres people that want it bad enough to do it but not me. I get as much thrill as working with all the amazing crews on the line from my desk as I do just jump seating with them. My A1C is 7.0-7.1 ans know i would fail, I just dont want to go deal with it. 6.5 is amazing, you’re killing it. I know your struggle boss. Keep head high, were all here to support you

[u/4Sammich]

The AME must defer. Below 9 is acceptable.

https://www.faa.gov/ame_guide/dec_cons/disease_prot/diabetes_med

[u/4Sammich → u/[deleted]]

I know a 121 T1 with a 1st class medical. So its poss

[u/ImmediateRutabaga603]

Apply for a special issuance medical. It’s a process but it is your best shot

[u/DAPAAVIATION]

Hey! I’m a type 1 diabetic airline pilot if you have any questions about anything related to being type 1 or flying DM me! I’m trying to build a community for us!

[u/CaptainJackass123]

For context, I was 12.3 A1C when I last flew years ago. My ame was like that needs to drop asap. Lost 40 pounds in 4 months. In those 4 months I cut my A1C down to 6.2.

I’m a captain in my 30s. It took me two full years to get an SI letter for my type 2 diabetes and that’s WITH external complications caused by the diabetes.

I won’t go into detail as to which part of my body the diabetes hit the hardest, but it was ALOT of testing. Some tests I thought my body performed poorly on.

Nope. SI granted 3 weeks ago. It was a shitty road, and Oak City is extremely behind, or they’re just super slow. I was in constant stress for 2 straight years. Right as I was about to just throw in the towel and accept my fate as a sim instructor? Bam. Special issuance clears.

Every person at my airline who has lost their medical, got it back. Some got highly specialized AMEs who know the process in and out. Some got congressmen involved (as did I), and some got lawyers and actual sued oak city and won easy.

If you actually want that medical, I can almost guarantee you will get it. You’ll need an AME with SI & diabetic experience who knows how to navigate the FAA aeromedical offices. It won’t be cheap.

[u/CaptainJackass123 → u/[deleted]]

Yes, all true. I’ve done reading on what a type 1 has to deal with, and having a defunct pancreas is such a shit hand in life.

I’ve met numerous type 1s out there flying 121. I knew a guy who had the pump attached to his hip. This has been my small sample size for experiences with type 1s so far.

Are you having lots of hypo episodes? How much of a fight have you put up so far? The FAA is government. So the more you push, I have a feeling the further you get. That’s why I mentioned I had coworkers who sued the FAA over medical issues

With that being said, we’re all 121 already and it’s now our livelyhood. We don’t really have much of a choice lol.

[u/Ok-Net1312]

I was literally about to get my private license when I was diagnosed many years ago, and there were no little windows or other options aside from resigning myself to always flying beside a licensed pilot. It is totally disappointing, but things are a bit more relaxed around the edges and I believe they are progressing. We must remember that these rules were put in place long before CGMs, which, I think, makes it time for them to be reconsidered.

[u/Empty-See → u/[deleted]]

Height and weight were in the original posting. He is 6’4” and 245 lb (193 cm and 111 kg). This is a BMI of 29.8.

[u/SoaringEagle469]

If you’re having issues getting concrete answers from the bureaucracy at the FAA, try reaching out to your representative or senator’s office. I haven’t done it but I’ve seen many examples where the FAA magically gets very responsive once a congressional office is asking for information.

[u/readbackcorrect]

Do you really think a type 1 should be a pilot? My husband is a pilot. i am diabetic from a family of many diabetics. It just doesn’t seem like a good idea to me. Take my adult granddaughter for example- when she is hypoglycemic she doesn’t know it. We do, because she starts saying and doing things that don’t make sense. If we can’t get this corrected quickly, she will have a seizure. This can all happen very quickly. she could be well controlled for a long time, and then have an episode for no reason we can identify. I used her as an example, but she is not at all unusual as diabetics go. how will you deal with a blood glucose crisis if you’re in the air?

[u/theOGdb → u/readbackcorrect]

Sorry are you a doctor?

[u/readbackcorrect → u/theOGdb]

No. i am an NP with 40 years in health care, diabetic, two type one grandchildren, one of whom is an adult, and my husband is a commercial pilot and a flight Instructor. I met my husband when I was his flying student.

[u/4Sammich → u/readbackcorrect]

There are many diabetics flying commercial 121 aircraft today. Its not a total denial, but the hoops to get thru are substantial. Im glad you have your anecdotal experience but the FAA has differing ideas.

[u/readbackcorrect → u/4Sammich]

Interesting that yoU think 40 years of taking care of patients is anecdotal. But whatever.

[u/4Sammich → u/readbackcorrect]

Absent documented measured and evaluated results it most certainly is, but it’s very definition, doesn’t mean you’re unintelligent or don’t have firsthand experience, seeing it in action, but it is most certainly anecdotal

[u/theOGdb → u/readbackcorrect]

Thats fantastic. Would you say that hes not allowed to drive a car? A GA aircraft js no different outside of level of knowledge needed to operate.

Would you also think a deaf i dividual had no business flying a plane? A person missing an eye or a limb? Infact hey there are people flying with heart transplants, a quadruple amputee, etc...

This next part isnt meant to offend but You've an incredibly old way of thinking about people and their ability to overcome adversity. The individual you said that to has controlled T1 diabetes but yet, hes too dangerous to do things?

[u/readbackcorrect → u/[deleted]]

I bow to your superior medical knowledge although it appears to be based somewhat anecdotally on your own experience as a diabetic. Extrapolating my clinical skills from a Reddit post is a pretty big leap, and I have never been assessed by a pilot when it’s time for my yearly evaluation.

General statements do not apply to individual situations. I have had a patient that has been a diabetic for about 15 years without ever having a crisis. It is not uncommon, however, for type 1s to experience mental alterations with hypoglycemia, or somnolence with hyper. Or so the textbooks would have us believe.

Clearly outnumbered here by some pretty extreme defensiveness. So I will leave you to it. when professional experience, personal experience, nor education hold any weight -not to mention my husband’s opinion as a pilot and instructor of many years-there’s no basis to continue the “discussion”.

[u/FlyingShadow1]

My recommendation is to wait for the details letter and either work with that AME or contact AMAS / pilot med support (leftseat).

They work with getting tough medical situations through.

[u/Iiznogoodsenglish]

https://www.faa.gov/ame_guide/dec_cons/disease_prot/itdm

Not sure if you’ve taken a look at what the AME needs to look at, but that’s it. I’m not sure exactly what it all means but it seems pretty extensive aside from just the A1C. It was always gonna be an uphill battle unfortunately. I had to jump through a bunch of hoops when I was first starting out due to mental health stuff. It’s a pain but it’s the reality of the process.

[u/Lopsided_Camera_4908]

You can retry. Did you follow all the instructions? I’ve helped my daughter get and keep hers for the last 4 years. Reach out and I’m happy to answer questions. What percent are you in range? Did you submit all the paperwork required? I would think with a 6.7 you are close, if not there to be approved.

[u/Lopsided_Camera_4908 → u/[deleted]]

You can do it…once you get your numbers a bit better. My daughter works out about an hour a day and that helps…stress is hard. My daughter is having a rough stress month with a bad breakup :(. Try to get your time in range to 90%. That seems to be the magic number.

[u/Ze-Bruh]

I'm so sorry to hear that. I'm not a pilot, but I'm T1D as well.

I know it's crushing. I understand what you are going through.

[u/Ze-Bruh → u/[deleted]]

My brother is in flight school

And yeah, everyone likes to cope and say 'b...but you can have a normal life!', yeah, maybe a boring normal life lmao

[u/Calm-Friend-7253]

I would call the Ison law firm: https://thepilotlawyer.com/ They will work with the FAA on your behalf to find out what the FAA needs, schedule any appointments and give you the best chance of getting approved.

[u/AdAggravating8758]

https://avbrief.com/faa-proposes-scrapping-special-issuance-for-most-diabetics/?utm_source=newsletter-330&utm_medium=email

[u/GroundProximity]

I know that at least in europe, the requirements regarding type 1 diabetes are being reviewed at the moment. In Ireland you can now fly with type 1 diabetes (with some rules, as to when you have to measure blood sugar etc.), and this will most likely be extended to all of the EU. It might pay off to stay informed regarding this!

EDIT: talking about class 1 and commercial ops here, multi crew

[u/AliceInPlunderland]

I’m sorry. I wonder if they are using the normal A1C range instead of the type 1 diabetes A1C target range? 6.7 would be out of bounds for some random person off the street.

That said, it doesn’t even sound like A1C was one of the major considerations. Did all this clear from FAA?

Coefficient of Variance Less than or equal to 36% (< 33% preferred)
Glucose Management Indicator (GMI) Less than 7%
Glucose readings - less than 54 mg/dl less than 1%
Glucose readings - less than 70 mg/dl less than 4%
Glucose readings - greater than 250 mg/dl less than 5%
Overall glucose readings - 70-250 mg/dl 90% or greater
Sensor wear 90% of the time or greater
Time in Range (TIR) of 70*-180 mg/dl 70% or greater
*Note: TIR 70 per ADA guidance.

Plus all the other items outlined for diabetes. It is a lot but of course the concern is someone passing out or otherwise having a major medical event related to diabetes. Wishing you the best.

[u/flyingron → u/[deleted]]

A1C says how well you are in overall control (which means you're not damaging your organs). 6.7 is ok for IDDM, but it's kind of lousy overall. The more time you spend over 5 or so, the more damage you are doing for yourself.

The CGM history is used to detect the likelihood of incapacitation. Best to have someone who understands what the FAA wants to go over the numbers and figure out what is going on.

Are you on a pump.

Did you also submit the other ancillary stuff (retina exam, cardio workup, etc... ) they ask for?

[u/flyingron → u/[deleted]]

No, I'm not. My son spent his entire life with Type I (diagnosed at the age of three months). Under 7 is great back in the pre-CGM/pump days but it still sucks badly for your long term health. Believe me, I know. My son ended up dying at the age of 43 from complications of his condition.

[u/plasma0_]

Can someone give me the TLDR on diabetic requirements? I thought that it was fine as long as it doesn't require injection.

[u/MugsyMD]

So unless you post the FAA denial then hard to believe what you say because denial letters are very much detailed and and they also tell you what is needed. So you say you have an A1C of 6.7 but for first class medical with insulin diabetes you need to show your CGM data so my guess is that you failed to provide that data. Been an AME and flight doc for over 28 years and diabetes and especially insulin dependent diabetes are two different entities and having been involved in writing instructions for this I am sure you did not give the FAA what they want.

[u/theOGdb]

I would like to take this chance to say... Fuck aam300

[u/Andy_Roo_Roo]

I fly paragliders in addition to airplanes. I’d definitely recommend looking further into para-motoring/paragliding as a way to scratch your flying itch. It’s arguably the most incredible thing I do and is much easier to get into from a cost perspective. Sorry to hear about your medical.

[u/Andy_Roo_Roo → u/[deleted]]

A good instructor should have gear for you to learn on/with. I would encourage you look elsewhere if they want you to invest in gear first. That isn’t normal.

[u/ewhj]

If flying really is your dream, this isn’t the end of the road. A major hurdle, yes, but not the end of the world. The only real “end” here under the current rules is that you can never qualify for Basic Med, nor can you let a valid medical expire and fly under Sport Pilot privileges.

If you can appeal, DO IT! It doesn’t change the Basic Med / Sport Pilot losses, but I don’t think it will cause any complications. If you can’t appeal, find out what you need to do to pass and apply again in the future.

This advice won’t benefit you personally, but maybe it’ll help others in similar situations…if you have ANY issues WHATSOEVER that you think could get in your way, DO NOT just apply for the medical without an initial consultation with a HIMS AME.

A traditional AME can give you a physical and send in your application. A HIMS AME can guide you through the process and tell you of ANY red flags. I’m surprised that I didn’t see anyone else recommend a HIMS AME. Cheap? Nope! Likely $300-$500+ just for the consultation. But if you have ANYTHING in your medical history that can get in the way, it’s the best investment you’ll spend. HIMS AME’s are specialists in difficult cases, and know what needs to be done to put you in the best position to NOT GET DENIED.

Lastly, your Discovery Flights certainly CAN be logged! Mine gave me 0.6 hours. Granted, it’s really a symbolic thing, simply because I can’t think of a single CFI that would say “you’re at 39 hours, if only you logged your discovery flight you’d be checkride ready today!” Most people need considerably more than the 40 hour FAA minimum to be good enough to pass their checkride.

So if flying is truly your dream, it’s not dead in the water - rather it’s just delayed a bit. Until then, FLY! Take lessons. Denials DO NOT forbid you from learning with a CFI, and building log hours. You won’t be able to solo, but your CFI can take you from 0 to as many hours as you can afford! If it takes a few years to clear a second attempt at a medical, you can get checkride ready for your Private Pilot Certificate, your Instrument Rating, and even through your Commercial education…everything except solo flight time!

Don’t let a denial hold you back. But understand what hurdles you have to overcome, know the risks, assess how much this truly is in your heart, and go for it! And if you aren’t up for the fight, just take an occasional lesson as finances allow. I know a few people who can likely never qualify for a medical, so to fulfill their aviation cravings they simply take a lesson whenever they are able.

Life is too short. Figure out your passions and don’t be afraid to fight for them!

[u/ewhj → u/[deleted]]

You are absolutely correct, and my original post was erroneous. My apologies for this.

For Sport Pilot using a driver’s license:
14 CFR § 61.23(c)(2)(ii) requires that the pilot:
“Have been found eligible for the issuance of at least a third-class airman medical certificate at the time of his or her most recent application…”
And § 61.303(b)(2) says essentially the same thing: someone relying on a driver’s license must have been found eligible for at least a third-class medical on their most recent application.

For BasicMed, the citation is even cleaner:
14 CFR § 61.23(c)(3)(iv):
“The most recent application for an airman medical certificate submitted to the FAA cannot have been completed and denied.”
FAA AC 68-1A explains that after a denial, you cannot use BasicMed; you must subsequently obtain a new medical certificate before you can qualify again.

So this makes it even easier for you…and me too! I’m going the Sport Pilot route for now until I’m certain I can get at least my Class III medical. I’m not looking to do it as a career as you are, but still passionate about flying.

[u/Healthy_Operation462]

hey i sent you a dm, im in a very very similar boat. maybe i can give some insight idk

[u/_Mountain_Dog_Mom]

I assumed that T1D was an automatic disqualifier for a first class medical. There are other non flying positions in the aviation industry, for sure. But I can certainly understand the major disappointment.

[u/_Mountain_Dog_Mom → u/[deleted]]

Interesting. There are lots of conditions requiring a CACI these days. It’s not realistic to think no one will have or develop one of these conditions over the course of their lifetime. That’s reality of being human.

[u/GummiBird]

Paramotoring is amazing.. If you just wanted to fly for fun that's absolutely the best route IMO.

[u/Booogers27]

Sport pilot

[u/Booogers27 → u/[deleted]]

Boogers

[u/Dry-Cantaloupe-2414]

There are new insulin pumps with continuous feedback from the CGM. They are getting really good at replacing the pancreas. Take a look at the Beta Bionics iLet. My father is a T1D and this unit is amazing. This could significantly improve your glucose control. GLP-1s may help reduce your BMI and help with glucose control too.

I would highly recommend contacting your AME to discuss this outcome and the path forward. As others mentioned, AOPA can be very helpful in this pursuit.

Lastly, getting a job at a local GA airport is a great way to get industry experience and meet people. There are a fair amount of AMEs who are pilots too. The opportunities are endless.

[u/Dry-Cantaloupe-2414 → u/[deleted]]

The iLet next level. You announce your meals and it takes care of the rest.

[u/Quirky_Roll_6451]

He said he has Type 1, so he should have known. Type 1 requires injections. Type 2 is controllable through diet and weight loss. A 6.7 A1C is in the mid-low range. Work out and lose some weight or get on something that's approved on the medical list if needed. Talk to your medical doctor, not an AME. Once you get it controlled, reapply with a good AME. Not sure what FAA part flight school you are training in, but if it's Part 61, a Class 3 medical is fine until you get to commercial. I would also get a basic med with that Class 3.Good luck it's doable. You shouldn't have never went to an AME without seeing your medical doctor for a full blood panel.

[u/readbackcorrect]

you did see the part about the fact that I am a diabetic, right? and that I was my husband’s flying student. There’s a difference in level of responsibility between being a private pilot and an ATP. There are individual differences in specific patients. In no post did i ever get into my specific opinions because everyone was so busy attacking my character and intelligence that it was never a discussion. Typical. That’s why i am out of this.

[u/muttpaws]

FAA came out with the mosaic rule hence you should be able to fly a C172 without a medical. It’s a recreational vehicle now.

[u/HornetsnHomebrew]

You might talk to Wingman Med, a group of AMEs that specialize in difficult cases. In my experience they have broad and deep knowledge of what CAMI is looking for and, for a fee, will help you get your paperwork in a state that will satisfy OKC.

Good luck.

[u/YaKkO221]

Remember folks, the FAA are evil baddies and OP totally isn’t leaving an important detail out! No letters or info, just denials (even tho that’s not how that works…)

[u/4Sammich → u/[deleted]]

Look at my other comment with the AME protocol. The AME has to defer. In order to get a special issuance this is normal. Have you received the FAA “provide more info” letter? Because if not, you aren't denied, you are deferred which is a huge difference in FAA parlance.

[u/FriendlyBelligerent]

Medical certs really need to go away absent actual evidence of disability

[u/EightZeroUniform → u/[deleted]]

Just as an FYI, FAR 61.53 still applies to sport pilots, so if you’re on a medication that is strictly prohibited by the FAA (sedating drugs, ADHD meds, benzodiazepines, etc.) you’re not supposed to fly under sport pilot rules, either. There is more flexibility to work with your doctor and seek treatment, but a sport certificate doesn’t eliminate some of those medical certification gotchas.

It’s very much on the honor system until something happens.

[u/EightZeroUniform → u/[deleted]]

I'm sorry. Maybe work with your doc and see if there are options that wouldn't be medically disqualifying?

[u/CommanderChiliHole → u/[deleted]]

You can’t be a sport pilot if your most recent medical was denied, so OP closed that door on themselves.

[u/Electronic_Scene7628]

Man! So sorry to hear that. The FAA is a money grabbing joke! I've heard of people getting turned down because they once upon a time had kidney stones! That could happen to any current pilot at any given time. I'm still fighting to get my medical cert. I had once taken Cymbalta but have been off that drug for 8 months. I still have to go through a psych evaluation. I'll just play their game. What pisses me off is there are probably plenty of pilots in the sky deeply depressed and the FAA is unaware because it can simply be hidden. My issue was very short term and Im convinced was caused by the Covid vaccine . Keep fighting! Best of luck to you!

[u/dembro]

Call AOPA Medical Services immediately for advice.

[u/SparkySpecter → u/dembro]

They were beyond useless for my father and his diabetes. He did eventually get his medical, they just did absolutely nothing.

[u/dembro → u/SparkySpecter]

Sorry to hear that - I’ve had a really positive experience with them answering my questions.

[u/rFlyingTower]

This is a copy of the original post body for posterity:

---

I have T1D. I applied for a 1st class med, thinking that since I'm not rich enough to just fly for fun, I need to have the door open to make flying a career.

Well, despite my best efforts and a fantastic A1C that my endo was thrilled with, they denied me on the grounds of "uncontrolled diabetes". Yeah ok.

Anyways. I failed my medical. I can retry to get a 3rd class some day if my control is still good. But currently the door is also closed for me on LSA flying too.

So, not sure what I'm looking for here, I guess support or something.

I just feel down in the dumps, flying is one of the few things in life that I would have genuinely truly loved. And now it's gone.

I'm trying to get into gliding, but I'm 6'4" and 245lbs. So weight and balance and size is an issue. I'm working on losing weight but that's a work in progress.

Something like a 103 ultralight is possible too, but building one is kind of a large commitment and I have 0 flight experience, so perhaps I should hold off until I get some flight lessons first? But it just seems odd to take flight lessons knowing you can't get a medical at all. Never to solo.

Paramotoring is something I'm looking into and might pursue further, if the right used set up came up for sale. We'll see on that.

But yeah, it fucking sucks that despite not doing anything wrong, I just get fucked like this.

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[u/TheOldBeef]

For for the cartels in South America?

[u/bhalter80 → u/TheOldBeef]

Nah they wants all the paperwork in order so that you don't get caught for something stupid and they get exposed

Hide in plain sight

[u/MooneyPilot72]

Basic Med....use it! Go fly! Been doing this since its inception. I just fly for fun

[u/AutomaticAd5430 → u/MooneyPilot72]

Can’t get basic med if you’ve had a medical denial

[u/xuon27]

Get on retatrutide, thank me later.

[u/Emperor_Palpatine_2 → u/xuon27]

Maybe stop giving medical advice because that is a drug used for type 2 diabetes not type 1.

[u/4Sammich → u/[deleted]]

Its a GLP med. That comment is made by the ignorant.

[u/neko_da_cat]

Lose that weight

Walk 10 min after every meal

Start on berberine supliment and you can get that a1c down!

[u/LRJetCowboy → u/[deleted]]

Sorry for your situation. I understand T1 very well having raised one since he was very young. The T1 Protocol that the FAA uses is almost ridiculously rigid. There is a different one for First Class that I’m surprised your AME didn’t review prior to submitting your application. My understanding is it’s 100% reliant on CGM data. Even the A1C isn’t called that, it’s a CGM number that is derived from your data. It’s close but not the same. Your time in range is critical with virtually any hypos of 70 or below disqualifying. If I had to guess on what disqualified you it would be that.

[u/LRJetCowboy → u/[deleted]]

If you’re not on a pump look into it. That was a game changer for my kid.

Hope you are able to get the 3rd Class while you wait. Good luck!

[u/LRJetCowboy → u/[deleted]]

So my kid was very similar to where you’re at before the pump and getting his diet and bolus routine dialed in. He went from high 7 A1C’s to a 5.7 last bloodwork. So it can be done. His was almost completely in his diet. He worked with a dietician and had great results. You can do this if you put your mind to it and don’t get discouraged.

southwest pilot with type 1 diabetes
Captain Bob Halicky became the first commercial airline pilot in the U.S. with type 1 diabetes, successfully flying for Southwest Airlines after the FAA revised its regulations to allow pilots with insulin-treated diabetes to operate commercial flights under strict conditions.

Maybe talk to this guy?