What is the recommended HbA1c target range for a pilot with type 2 diabetes treated with insulin, and why is this range chosen despite evidence that lower levels reduce diabetic complications?

The target level of HbA1c is set to 7.5–8.5%. This range is chosen for safety reasons because setting the target to normal (non-diabetic) levels would significantly increase the chance of hypoglycaemia, even though lower HbA1c levels are correlated with fewer diabetic complications.

According to the guidance, what is the specific HbA1c percentage range that is considered acceptable for a pilot with type 2 diabetes treated with insulin?

The acceptable HbA1c range is 7.5–8.5%.

Why does the guidance set the HbA1c target at 7.5–8.5% rather than at normal non-diabetic levels for pilots with type 2 diabetes on insulin?

Because setting the target to normal (non-diabetic) levels would significantly increase the chance of hypoglycaemia, which is a safety concern.

GM1 MED.B.095 Medical examination and assessment of applicants for LAPL medical certificates

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GM1 MED.B.095 Medical examination and assessment of applicants for LAPL medical certificates

ED Decision 2019/002/R

DIABETES MELLITUS TYPE 2 TREATED WITH INSULIN – GENERAL

(a) Pilots and their treating physician should be aware that if the HbA1c target level was set to normal (non-diabetic) levels, this will significantly increase the chance of hypoglycaemia. For safety reasons the target level of HbA1c is therefore set to 7,5–8,5 % even though there is evidence that lower HbA1c levels are correlated with fewer diabetic complications.

(b) The safety pilot should be briefed pre-flight on the potential condition of the pilot. The results of blood sugar testing before and during flight should be shared with the safety pilot for the acceptability of the values obtained.

Details

Source-Title: GM1 MED.B.095 Medical examination and assessment of applicants for LAPL medical certificates View latest amendments

Erulesid: ERULES-1963177438-11296 Compare versions

Domain: Aircrew

Applicabilitydate: 30 January, 2019

Entryintoforcedate: 29 January, 2019

Regulatorysource: ED Decision 2019/002/R Navigate

Regulatorysubject: Part-MED

Typeofcontent: GM to IR (Guidance material to implementing rule)

Parentir: MED.B.095 Medical examination and assessment of applicants for LAPL medical certificates

Origin: EASA

Category: EAR