Insulin : Rules for Pilots

FAA Policies on Pharmaceuticals for Airmen

Apr 2014

Guidance is compiled and interpreted by professional pilots and physicians at from the 2014 AME Guide, FAA and FDA web data ( &, instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).


  1. Code of Federal Regulations: Legal Extract

  2. 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 are disqualifying. The AME can help expedite the FAA review by assisting the applicant in gathering medical records and submitting a current specialty report.

  3. Aeromedical Decision Considerations: See Item 48, General Systemic Aerospace Medical Disposition grid.

    The FAA has established a policy that permits the special issuance medical certification of insulin treated applicants for third class medical certification only. Consideration will be given only to those individuals who have been clinically stable on their current treatment regimen for a period of 6-months or more.

  4. Protocol: See Diabetes Mellitus Type I or Type II - Insulin treated
  5. Pharmaceutical Considerations:

    • Insulin pumps are an acceptable form of treatment.
    • Combination of insulin with beta-bockers is not permitted.
    • Combination of insulin with other anti-diabetes medication(s): not all combinations of DM medications are allowed by the FAA, even if each medication within the combination is acceptable as monotherapy. Contact the Regional Flight SurgeonRegional Flight Surgeon's office or AMCD.

Summary: This page reviewed the medical and legal aviation aspects of Insulin compiled from recent FAA and FDA reports.

This page discussed Insulin : Rules for Pilots

Reminder: use to familiarize yourself with aviation medical regulations and guidelines, but always discuss your specific situation with one or more AMEs before dedicating resources toward expensive clinical workups. Find an AME now