TP 13312

•	Foreword
•	Section 1
•	Section 2
•	Neurology
•	Cardiovascular
•	Diabetes
•	Asthma
•	Other Policies
•	Contacts
•	Alternate Formats

Appendix 3 - Selection Conditions for Insulin Treated Diabetes Applicants (ITDM)

– Cat. 4 R.P.P. & Student Pilot (Aeroplane) ITDM applicants will be considered for medical certification provided the following conditions are met:

• No recurring hypoglycemic episodes requiring the intervention of another party during the past 5 years.
    
• 1 year stable blood glucose control as measured by: 
    
  – glycated hemoglobin (A1 or A1c levels) (patient/upper level normal ratio < 2.0)
    
  – 90% blood glucose values > 5.5 mmol/L.
    
• Must demonstrate good diabetes education & understanding and have a positive attitude towards monitoring & self control.
    
• No evidence of hypoglycemia unawareness.
    
• Medical evaluation by a specialist in diabetes every 3 months, to include glycated hemoglobin (A1 or A1c levels) levels and a log of blood glucose levels.
    
• The initial medical report should include specialist reports from:

  *a) an ophthalmologist
    
  *b) a cardiologist (to include a Treadmill Exercise Test - TXT)
    
  *c) a neurologist
    
  *d) a nephrologist

All of these reports should be negative in terms of significant complications of diabetes.

• Submission of a routine civil aviation medical examination report including a resting ECG at no less than 12 monthly intervals.
    
• A report from a vision care specialist every 2 years.
    
• A report from a cardiologist (to include a TXT) every 2 years over the age of 40.

Note: All ITDM applicants who have achieved medical certification will be monitored by a single physician within the CAM organization in order to maintain consistency and an adequate data base.

* Reports a, b and c may be in the form of a comprehensive report from a specialist in internal medicine.