Blood sugar levels

[Tom-D]

After 8 hours of fasting how high can the blood sugar level be and still meet the FAA requirements?

Or is there a requirement?

 

[Gary F]

After 8 hours of fasting how high can the blood sugar level be and still meet the FAA requirements?

Or is there a requirement?

Not an AME so can't give information on FAA issues. Dr Bruce was the FAA medical authority here but he left and that's a long story.

From a medical perspective:
If it is over 126 you are officially a diabetic. Hemoglobin A1c of 6.5 or higher is also consistent with diabetes. Depending on many factors you physician may try to get you to lose weight, exercise and improve your diet as the first line of treatment but more physicians are prescribing metformin before waiting for lifestyle changes to take effect. If the Hemoglobin A1c or fasting glucose are really high then multidrug therapy may be initiated.

 

[AggieMike88]

Gary's correct on the numbers. The HbA1C is the number to obtain and take note of as it's the historical "averaging" number and represents the percent of red blood cells that have been glycosated over the past 60-90 days.

Fasting Blood Glucose that is measured with a fingertip stick (or the blood draw if you're visiting your doctor) is an "instant read" and, while useful, can be manipulated or "gamed" as the current generation calls it. The A1C is the better "tell-tale"

If you wish to know your A1c, you can either schedule the blood draw with your doc, or you can purchase the Bayer "A1C Now" test to do at home. While this test is not official or acceptable by the FAA, it is close enough to the labratory reading to help monitor your situation.

It's often found online for $40 and includes two tests. But I've seen it in grocery store phamacies at $30.00

I use this kit periodically to measure my A1C and ensure I'm staying within my doctor's proscribed zone.


Now with all of the above said, the current CACI protocol (Conditions AME's Can Issue) permit the AME to issue the certificate as long as you have documented blood labs showing A1C at 6.5 or lower, a FBG at 126mg/dl or lower, are on diet/exercise control or stable on metformin, and your doctor says you are not at risk for the other big 4 items (neuro, renal, optho, cardio).

If you are higher than 6.5 and 126, then you will be put onto the Diabetes special issuance.

For anyone other than Tom reading this, and you're in the yellow arc with your blood sugars and/or high blood pressure, now is the time to take corrective action. Minor changes such as improved food choices and increasing the exercise will make a huge difference in your life, and keep you out of the "fun zone" of dealing with the Special Issuances.

EDIT: The attached chart might help some folks understand the correlation between their FBG and A1C numbers and the associated health risks.

 

[Gary F]

If someone's fasting glucose is between 100 and 126 they are considered pre-diabetic (knocking on the door) and that is when it is important to start aggressive lifestyle changes and possibly even metformin. I don't know if metformin used for this causes issues with the FAA. Damage to blood vessels starts to occur during the pre-diabetic stage.

 

[AggieMike88]

If someone's fasting glucose is between 100 and 126 they are considered pre-diabetic (knocking on the door) and that is when it is important to start aggressive lifestyle changes and possibly even metformin. I don't know if metformin used for this causes issues with the FAA.

We would have to get with Bruce for confirmation, but from what I understand when we discussed it via email, the Pre-Diabetic CACI issuance (with the 100-126 numbers you mention) is still recorded in your FAA file that you're in this zone. And taking metformin is permitted for CACI. You are still in the routine issuance cycle (2yrs when over 40).

Then it is up to the airman to remain in this CACI zone. Otherwise you're on the SI and required to send in status reports annually.

Damage to blood vessels starts to occur during the pre-diabetic stage.

Good that you reminded us of that. And slots in with the discussions about benign hyper tension we've had in the past.

 

[eaglepilot]

A good resource for in depth understanding of Diabetes and Blood Sugar etc from a layman's perspective (Google blood sugar 101) http://www.phlaunt.com/diabetes/

 

[jnmeade]

you can purchase the Bayer "A1C Now" test to do at home.

I'd heard that Bayer was stopping production by the end of last year. No?

 

[AggieMike88]

I'd heard that Bayer was stopping production by the end of last year. No?

Google search found: http://www.a1cnow.com/Our-Products/Overview.aspx which verifies your comment.

That sux. I underestand the business decision if not enough folks are purchasing it. But it was a useful product.

 

[mnewb1]

The FAA does not require a blood test for the medical. They will check urine for glucose and if present the medical will be deferred for further testing. If you have seen your PCP who has discovered an elevated blood sugar then you will need to report this, and I would suggest bringing any lab tests done and a letter from the PCP discussing any relevant diagnosis.

 

[Tom-D]

During the holidays my finger prick test has been creeping up. I normally test in the upper 90s, the last month with little exercise and the holiday goodies, it has gone up to the lower 100s, today it was 109.