Code of Federal Regulations: Legal Extract
- First-Class Airman Medical Certificate: 67.113(a)(b)(c)
- Second-Class Airman Medical Certificate: 67.213(a)(b)(c)
- Third-Class Airman Medical Certificate: 67.313(a)(b)(c)
Medical History: Item 18.k. Diabetes.
The applicant should describe the condition to include symptoms and treatment. Comment on the presence or absence of hyperglycemic and/or hypoglycemic episodes. A medical history or clinical diagnosis of diabetes mellitus requiring insulin or other hypoglycemic drugs for control is disqualifying. The AME can help expedite the FAA review by assisting the applicant in gathering medical records and submitting a current specialty report.Aeromedical Decision Considerations: See Item 48, Diabetes
Protocol: See Diabetes Mellitus Type II - Medication Controlled
Pharmaceutical Considerations:
- Combination of DM medications with antihypertensives:
- Disqualifying Combinations. Certification of airmen using meglitinides or sulfonylureas, along with beta-blockers is not permitted. Commonly used meglitinides include repaglinide (Prandin) and nateglinide (Starlix). Commonly used sulfonylureas include: acetohexamide (Dymelor); chloropropamide (Diabinese); tolazamide (Tolinase); tolbutamide (Orinase); glimepiride (Amaryl); glipizide (Glucotrol, Glucotrol XL); glyburide (DiaBeta, Micronase, Glynase); glyburide plus metformin (Glucovance); glipizide plus metformin (Metaglip).
- Allowable Combinations. Certification of airmen using the combination of a beta blocker with the following diabetes medications is permitted: alpha-glucosidase inhibitors [acarbose (Precose), miglitol (Glyset)]; biguanides [metformin (Glucophage)]; thiazolidinediones [pioglitazone (Actos)]; DDP-4 inhibitors [sitagliptin (Januvia)]; and incretin mimetics [exenatide (Byetta)].
DM medication monotherapy versus combination therapy. Not all combinations of DM medications are acceptable to the FAA, even if each medication within the combination is acceptable as monotherapy. AMEs should contact the Regional Flight SurgeonRegional Flight Surgeon's office or AMCD for questions.
FAA Note: The drugs in parenthesis are examples and lists presented here are not all-inclusive.
- Combination of DM medications with antihypertensives:
Disclaimer: Neither the FAA nor FlightPhysical.com will attempt to publish all-inclusive references. Online guidance does not replace medical advice from your PCP and/or AME. Most doctors are not AMEs, and your regular Primary Care Provider (PCP) or specialist will know more about you and/or your specific medical condition than an AME, but is probably untrained or unfamiliar with aviation medicine. Follow 14 CFR 61.53 (duty to self-ground when ill) for your safety and that of your passengers. Don't fly after taking a new medication for the first time until 48 hours have past without side effects.
When in doubt - DO NOT FLY.
FAA AME Guide Dec 2025 version and FAA.gov