TP 13312

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

Appendix 4 - Selected ITDM Applicants who Meet Category 4 R.P.P, Student Pilot & Category 1R Airline Transport Pilot Licence (ATPL) (Aeroplane) Medical Certification Conditions

Blood Glucose Management Prior to and During Flight

Note: Blood Glucose levels will be required to be maintained at higher than optimal values prior to and during flight, in order to minimize the risk of hypoglycemia. This may have an effect on the long term health of the individual. The applicant must be made fully aware of this.

1. Individuals with ITDM shall maintain the appropriate supplies for blood glucose management, which shall include:
    
   1. A reliable calibrated glucose meter with memory chip and appropriate blood sampling equipment.
        
   2. A supply of 10 gm. portions of readily absorbable carbohydrate, appropriate to the duration of flight.
        
2. Prior to flight blood glucose must be greater than 6.0 mmol/L. Blood glucoses must be monitored every 30 minutes during flight. If the blood glucose falls below 6.0 mmol/L then 10 gms. carbohydrate should be ingested.
      
3. If, for operational reasons, the in-flight 30 minute blood glucose measurement cannot be done, then 10 gms. carbohydrate must be ingested, however, this shall not be done on two consecutive 30 minute occasions without a blood glucose measurement.
     
4. The blood glucose should be measured 30 minutes prior to landing and if below 6.0 mmol/L then 10 gms. carbohydrate must be ingested.
     
5. If the blood glucose should exceed 15 mmol/L then the individual should land as soon as possible and take corrective therapeutic measures.