February 21, 2019 8:00 PM, EST

FMCSA Formally Ends Its Driver Diabetes Exemption Program

Diabetes exemption program endsiStock

The Federal Motor Carrier Safety Administration on Feb. 21 formally announced the immediate end of its exemption process for the medical certification of insulin-dependent truck and bus drivers.

In a Federal Register announcement, the agency said diabetic drivers who possess a medical card will need to renew, and those seeking a medical card in the future will be certified to drive only if they get a green light from an agency-certified medical examiner.

“Obtaining certification under the new standard should be much less burdensome in terms of both time and resources than the lengthy process of applying for and maintaining an exemption,” the announcement said. “FMCSA withdraws its Sept. 3, 2003, notice concerning exemptions for certain individuals with insulin-treated diabetes mellitus and its Nov. 8, 2005, revision.”

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The exemption process will remain in effect for drivers with epilepsy and seizure disorders, as well as for hearing and vision disorders, the agency said.

Diabetes impairs the body’s ability to produce or respond to the hormone insulin, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose-surge in the blood and urine.

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The revised diabetes standard, published Sept. 19, grants certified medical examiners, in consultation with a driver’s treating clinician, ability to determine whether to approve an insulin-treated individual for a medical certificate to drive a commercial motor vehicle in interstate commerce for up to 12 months.

“FMCSA has determined, therefore, that an exemption program for [treated diabetics] is no longer necessary,” the agency said.

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The new rule eliminates a typical two- or three-month delay for the estimated 4,700 diabetic drivers with medical cards to navigate a bureaucratic process requesting an exemption from FMCSA after being automatically disqualified for having the condition. While waiting for the exemption, diabetic drivers were not allowed to drive, often resulting in loss of income. Under the old rule, about 76% of drivers that apply receive an exemption.

Despite dropping the exemption process, a diabetic driver still must convince his treating clinician and medical examiner that his or her diabetes is under control. Not only are diabetic drivers required to keep blood glucose self-monitoring records for at least the preceding three months, they must detail how many times per day they test their blood glucose, reveal if they have experienced any severe hypoglycemic episodes in the past three months, and if they have taken a Hemoglobin A1C measurement test intermittently over the past 12 months.

Although the final rule outlining the requirements for diabetic exemptions technically ended the process in September, the agency still was clearing out drivers requesting exemptions until late November.

Kay Pfeiffer, vice president at diabetes management company TrueLifeCare

Kay Pfeiffer, vice president at diabetes management company TrueLifeCare, at a diabetes seminar during the 2018 Mid-America Trucking Show. (John Sommers II for Transport Topics)

Health education specialist Kay Pfeiffer said last year that many drivers are not aware of their diabetes disorder, and many who suspect they have the condition do not attempt to get treatment.

She compares diabetic professional truck drivers who are not testing their blood sugar with “driving at night without headlights — and you’re going to crash.”

Pfeiffer, a vice president at diabetes management company TrueLifeCare, said as a group the number of truck drivers in the United States with diabetes is about 50% above the national average — about one of every seven, primarily due to sedentary lifestyles and poor eating choices.

“If you choose not to manage your diabetes,” Pfeiffer said, “your diabetes will manage you.”