Foreword
Since the discovery of insulin in Toronto in 1923 by Banting & Best great progress has been made in the
treatment of diabetes mellitus. In the last ten years control of this condition has improved dramatically
with the development of patient operated computer chip glucose meters and patient education. Blood
tests to assess long term control such as Hb.A1.C. also have made it much easier to make alterations to
diet, exercise, insulin or hypoglycemic medication dosage for optimum control.
This enormous progress in the management of the disease together with an increase in the number of
insulin and oral hypoglycemic treated diabetics prompted Transport Canada’s Civil Aviation
Medicine Branch to reexamine its policies on diabetes mellitus. To this end a one day workshop
was held on April 8th 1992 in Ottawa to review the
subject in the context of the modern aviation environment.
These guidelines are based on the deliberations at that meeting. Physicians are reminded that this
document should be used as a guide only and it should not be confused with the medical standards
for aviation personnel published by Transport Canada Aviation (TP 195). Any specific questions should be
directed tothe nearest regional aviation medical office of the Civil Aviation Medicine Branch,
Transport Canada (Appendix).
To the late Dr. Gerald S. Wong, for his special assistance in the early stages and for co-chairing the
workshop, I am eternally grateful. To Dr. James Wallace, Senior Consultant, Operations
Policy and Standards and to Dr. Robert Depuis, Internal Medicine Consultant to the Aviation Medical
Review Board, who shared the task of writing and
editing the rest of this document, my gratitude for successfully completing a very difficult task.
G.Y. Takahashi, M.D., D.Av.Med.
Director, Civil Aviation Medicine Division (CAM)
Health Canada
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