The Medical Review Board for the FMCSA has just published its recommendations on how to deal with the issue of medical certification for diabetic truck drivers – and it could be a huge deal.
Theoretically, if the FMCSA follows the MRB recommendations, the changes made by a new rule could allow more diabetic drivers who have their condition under control to remain behind the wheel.
The MRB recommendations concern only drivers with insulin-treated diabetes mellitus (ITDM). A new rule based off of the recommendations would require drivers with ITDM to be certified as medically fit to drive at least once per year. Additionally, according to the recommendations, drivers must meet the following requirements:
- The driver must provide an FMCSA Drivers With Insulin Treated Diabetes Mellitus Assessment Form (set out in the recommendations) to a medical examiner that has been completed and signed by the treating clinician. The treating clinician must be a Doctor of Medicine, a Doctor of Osteopathy, a Nurse Practitioner or a Physician’s Assistant who prescribed insulin to the driver and is knowledgeable regarding the treatment of diabetes.
- The driver must receive a complete ophthalmology or optometry exam, including dilated retinal exam, at least every 2 years documenting the presence or absence of retinopathy/macular edema and the degree of retinopathy and/or macular edema if present (using the International Classification of Diabetic Retinopathy and Diabetic Macular Edema).
In addition to the above requirements, drivers would be disqualified for any of the following:
- Any episode of severe hypoglycemia within the previous 6 months.
- Blood sugar less than 60 milligrams per deciliter (mg/dL) demonstrated in current glucose logs.
- Hypoglycemia appearing in the absence of warning symptoms (i.e., hypoglycemic unawareness).
- An episode of severe hypoglycemia, blood sugar less than 60 mg/dl, or hypoglycemic unawareness within the previous 6 months; the driver should be medically disqualified and must remain disqualified for at least 6 months.
- Uncontrolled diabetes, as evidenced by Hemoglobin A1c (HbA1c) level greater than 10 percent. A driver could be reinstated when HbA1c level is less than or equal to 10 percent.
- Stage 3 or 4 diabetic retinopathy; a driver should be permanently disqualified.
- Signs of target organ damage; a driver should be disqualified until the matter is resolved by treatment, if possible.
- Inadequate record of self-monitoring of blood glucose; a driver should be disqualified for inadequate records until the driver can demonstrate adequate evidence of glucose records (minimum 1 month).
If the driver is disqualified for any of the above they would be unable to be recertified for at least 6 months.
Source: gobytrucknews, truckinginfo, overdrive
Jay says
Sad,we live in an era when food makes it ever so easy to become db, our career choice is designed to help make it easy to getting db,our food choices are so poor,(fruit cups are not healthy)when found they are overpriced,good,safe places to exercise are few if any.
Take care of your health drivers,stay away from extra junk food…if you can.
acajoe says
Walking is good exercise, That is widely available .
Lump your own freight, for exercise, and profit.
Change your own tires, for exercise and savings $
Eat less.
Simple really.
Lorin Crosby says
Change our own tires??? Are you nuts!! The answer to my question is a resounding YES!!! YOU ARE NUTS!!
Kevin Dowden says
I a Driver with type 1 and on a Pump. Every 3 months I jump thru the hoops to keep my exemption. The other post is right, truckstops offer very few if any healthy food, like pilot that has Pizza with about a loaf of bread in one piece of crust. And companies have you on in such tight schedules it’s hard to exercise. And then you see the 300 to 400 lb. Drivers who belly up to the buffet and have a hard time climbing into their truck and don’t have justify anything with a doctor. It’s so unfair..
Kevin says
@Jay….Sad, Poor Choices..??.. Am 64 years old driving 30 plus years. 6ft tall 180 lbs. Same as in High School. I do not eat junk food, exercise on the road, sit ups, push ups in my truck. Walk when I can unloading or loading or at a truck stop. Carry 20 lb dumbells in my truck. So anyone “NOT” staying in shape is making that “Choice” because they want too and are too lazy to stay fit..!!
Jim Bore says
It is way more difficult when you are running team. I don’t understand how team can even be legal. Its unhealthy and extremely unsafe. Drivers in team don’t get the sleep that they should. So when you have a tired driver crash due to lack of sleep, tight schedule not allowing a proper stop for a healthy meal you have an un-strapped projectile going through the cab of the truck. Its all about the big buck for the companies.
Andy says
These new rules still make it virtually impossible for type 1(real diabetics) to medically certify even if their A1c is well within parameters because it only takes one low blood sugar below 60 in a year for them to be decertified. Some people don’t even have low blood sugar symptoms at 60.
This is just more bullshit regulation to keep diabetics from driving and avoid lawsuits against the FMCSA under the Americans with Disabilities act.
MrYowler says
Well, if staying fit were not inconvenient enough, in other career fields… Seriously, who needs the distraction, when you’re driving? When do we seriously have the time, unless we take the time away from either sleeping or driving?
That aside, nobody wants diabetes. But if you made four-wheelers do go through the medical testing that truck drivers have to go through, in order to be considered fit to drive on public highways, people would revolt. It’s an invasion of medical privacy, and it isn’t really even effective, unless *everyone* on the road, has to do it. Anything less, and it’s just a way to ensure that truckers provide revenue to medical practitioners. Do we have too many physician’s assistants, who need something to do? Trucker medical certifications are already a cottage industry, providing an easy path into private practice, with little need to purchase equipment in order to do so – what will qualify as “knowledgeable regarding the treatment of diabetes”? Will they have to take a special class, to be certified for this?
I’m sick to death of being accused of having sleep apnea, because I’m a fat guy. Nobody else, in any other job, no matter how dangerous or how important, has to buy and/or wear a vacuum cleaner in their mouth, when they sleep, in order to keep their jobs.I don’t want my surgeon to lose concentration, either, but nobody monitors him while he sleeps, to ensure compliance with the vacuum cleaner thing.
Nobody wants diabetes, but to a large extent, whether or not you have it is a matter of opinion. Once you start taking medication to treat it, however, you change the way that your body handles blood sugar – Insulin in particular, is regulated and produced by your body. When you start taking it, your body adapts it’s production, and generally loses it’s ability to regulate, since the system that does so is not set up to regulate what you take in pill for or by injection.
This is why medical treatment is supposed to be up to the patient. At some point, taking insulin becomes the right thing to do, for the health of the patient. While medical practitioners are supposed to be there to advise, they also have a stake in the decision, since it establishes an on-going dependence on further treatment. The last thing that we need, is the government getting involved, and dictating to people when they must make the choice to become insulin-dependent, or why. My metabolism does not belong to the government, unless everyone else’s does, too. What goes on in my bedroom, at night, should not be dictated to me by the government. No one should be required to put something in their mouth, in order to keep their job. Why not up their bum, while we’re at it? Health monitoring is an excuse. If there were any serious health/safety argument to be made, here, the rule would apply to *everyone*, and not just truck drivers.
If we put *all* drivers through this, there would be a revolt. Whether or not doing so might (or might not) make the roads safer…
patrick says
@ kevin. you do realize that every persons metabolism is different right? you do know that there are medical conditions that exist that will create any person, not just drivers, to become obese right?> apparently not. do some research first before running your pie hole
acajoe says
While driving , you reach for coffee *black* no calories, or Gummi bears.
You make the choice, not me
Reno Blues says
6’1″ went from 220lbs to 205 just cutting out soda. Fitness is a choice.
will says
Type 1 diabetics need insulin because they don’t manufacturer it in their bodies unlike type 2 diabetics who can reduce their dependance on insulin with weight loss and diet. I do agree the rules are rather strict. Wonder how many 4 wheelers would lose their license if they had to follow those rules.
John says
If you are aware diabetes is a hereditary thing as well so eat gummies, toast exercise or what you may guess what you are still diabetic.