JDRFNewsPilots with type 1 diabetes can safely fly commercial aircraft

Pilots with type 1 diabetes can safely fly commercial aircraft

Posted on 01 October 2020

Two pilots flying an aeroplane
UK pilots with type 1 diabetes are safely flying commercial aircraft

Strict safety measures introduced in the UK are successfully enabling people with type 1 diabetes to work as commercial airline pilots, according to a new study.

The UK now has the largest number of commercial pilots in the world with either type 1 diabetes, or insulin-treated type 2 diabetes.

The results come from a study of 49 pilots with the two conditions, tracked over the course of more than 22,000 flying hours.

During that time, almost 98 per cent of the pilots’ 38,621 blood glucose measurements fell between 5 and 15 mmol/L – the range in which a pilot is deemed safe to fly.

The researchers also found no evidence that the pilots were running their glucose levels high to avoid hypoglycaemia, which would put them at risk of later complications.

Frequent blood glucose checks

In 2012, the UK became the second country worldwide, after Canada, to allow pilots with type 1 diabetes to fly commercial aircraft.

To do so, pilots must follow a strict routine of fingerprick blood glucose checks – no more than two hours before reporting for duty, within the 30 minutes before take-off, every hour while flying, and no more than 30 minutes before landing.

If any of these blood glucose values measure lower than 4 mmol/L, or more than 20 mmol/L, the pilot must immediately hand over duties to the co-pilot.

However, this led to some concerns that pilots might run their levels higher than the NHS recommended range of 4-10 mmol/L – enabling them to fly by avoiding hypoglycaemia, but potentially risking long-term complications.

This study suggests that this has not happened. The pilots had an average HbA1c of 7.2% (55.0 mmol/mol) both before and after they were certified to fly.

The researchers suggest that similar protocols could be used to enable people with type 1 diabetes (or insulin-treated type 2 diabetes) to take on other higher-risk job roles, such as bus driving and maritime work.

Breaking down barriers

Conor McKeever, Research Communications Manager at JDRF, said: “It is great to see that advances in diabetes management are enabling more people with type 1 diabetes to do what they love.

“Type 1 diabetes should never be a barrier to a person’s career or wellbeing.”

Dr Gillian Garden, who led the research at the University of Surrey, said: “Our study showed that there were no safety concerns, and certainly no episodes of pilot incapacitation, throughout the seven and half years of the study.

“We believe that this protocol could be adopted by other aviation authorities to allow more insulin-treated pilots worldwide to fly commercial aircraft.”

The research is published in the journal Diabetes Care, and was announced at the annual meeting of the European Association for the Study of Diabetes, held virtually this year.

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