Info on Diabetes

Background
Type 1 Diabetes is an autoimmune condition where the immune system attacks and destroys insulin-producing cells in the pancreas. Type 1 Diabetes is usually found in children and teenagers, hence formerly known as "juvenile diabetes. Older people can also be diagnosed with Type 1 Diabetes, but less commonly. Symptoms of undiagnosed Type 1 diabetes include lethargy, raging thirst, passing excessive amounts of water, weight-loss and blurred vision. These symptoms are often acute. After diagnosis, insulin must be injected to regulate blood sugars. Type 1 Diabetes also used to be known as “insulin dependent diabetes” because insulin injections were required as soon as diagnosis had been made.

Type 2 diabetes occurs predominantly when the body gradually utilizes insulin less efficiently – insulin resistance - and usually occurs in middle age, hence formerly known as as "mature onset diabetes. Symptoms are the same as Type 1 above, but usually less acute. The more gradual onset is why people may have Type 2 diabetes for several years before being diagnosed, and this is when internal organ damage can occur. Type 2 diabetes can be regulated with changes in diet alone (with less intake of bulk-sugar or carbohydrate in general) or if diet change alone is insufficient, or becomes insufficient, oral medication can be taken to stimulate insulin production or increase insulin efficiency. Some people with Type 2 Diabetes may eventually go on to inject insulin.

Blood Sugar Control
The aim for all people with diabetes is good blood sugar control in order to avoid long-term health complications as outlined above.

A short term risk for individuals with Type 1 Diabetes and Type 2
Diabetes on certain medications is that blood sugar levels can reduce to hypoglycaemic (or "hypo") levels which lead to a number of symptoms including sweatiness, dizziness, impaired judgement and in the worst case to loss of consciousness without warning. Regular testing of blood sugar levels can reduce the risk of going hypo.

The aim of individuals with Type 1 Diabetes and those with Type 2 Diabetes on certain medication/insulin, is to maintain blood sugars within a range which can avoid the short-term risk of low blood sugars (hypoglycemia, or "hypos") and long-term organ damage from higher than normal blood sugars (hyperglycemia).
This requires a balance of insulin, diet and exercise combined with frequent blood sugar testing and regular patient health monitoring by medical practitioners. Blood tests normally require a drop of blood being deposited on a test-strip already inserted into a battery-powered blood glucose meter. Depending on the type of blood glucose meter, an accurate sugar-level reading can be produced within as little as 5 seconds.

More on "Hypos"
Hypos can occur if a meal is delayed after injecting insulin or if an
abnormally high level of exercise is taken. Symptoms of hypos can come in many forms including sweating, light-headedness, nausea, irritability, impaired thought process and speech and in some cases a loss of consciousness, even without warning. Each individual's type and intensity of warning symptoms differ. Over time, individuals become familiar with how well their regime of diet, insulin and exercise works. Frequent blood sugar testing is extremely important in this process. While some individuals may find it difficult to control blood sugars, others can run "tight" blood sugar control while avoiding both hypoglycemia and hyperglycemia.

More on Hyperglycemia
Long term organ damage from hyperglycemia includes blindness, heart disease complications, kidney failure and nerve damage in limbs which in turn can lead to amputation. Hyperglycemia may occur if too little insulin is present in the bloodstream, larger than normal amounts of food are ingested and/or less exercise is taken. The stress of illness such as flu can increase blood sugar levels. If left neglected, shorter-term symptoms of hyperglycemia can include dehydration, blurred vision and increased levels of skin infections.

For more information:

www.diabetes.org.uk

www.diabetes.org

www.cwdfoundation.org

International Diabetes Institute (IDI)

www.jdrf.org

www.jdrf.org.uk

Flying in the US
In the US a normal Class 3 medical test is taken. Additional medical records and tests are required and results must meet requirements for an individual's history of health and diabetes (sugar) control in the US. The Class 3 medical is not valid outside the borders of the US and is valid for one year only. This in turn allows solo flying for training and exercising the privileges of a Private Pilot Licence (PPL). To ensure safe flight, the pilot must adhere to pre-flight and in-flight blood sugar testing requirements that include a test half an hour prior to flying, each hour into a flight, and half an hour prior to landing. A Type 1 Diabetic pilot must keep sugar levels within a given range and if this is not achieved, guidelines are given for subsequent action e.g. ingest a minimum amount of sugar, or land if blood levels are above a certain level.

Flying in Australia
In Australia, a normal Class 2 medical test is taken and additional tests and reports are required. Assuming that history of health and sugar control requirements are met, the licence can be issued with a restriction that a safety pilot, currently rated on the type of aircraft being flown, is present during each flight.

Flying in the UK
An exciting new "National Private Pilot Licence" (NPPL) scheme was introduced in the UK in July 2002. The applicant pilot can make a self-declaration of medical fitness which subsequently needs to be endorsed by a doctor who has access to the applicant's medical records. If there is a medical history which would prevent you from achieving a Driving and Vehicle Licencing Agency (DVLC) Group 2 standard for professional driving, you can fly solo or with another qualified pilot on type (a safety pilot). This currently applies to people with Type 1 Diabetes. The NPPL allows individuals to train for and gain ratings for single-engine piston aircraft weighing less than 2000 kgs (approximately 4,400 pounds), self launching motor gliders and microlights. Pre-flight and in-flight blood sugar testing requirements are similar to the USA.

Full details of the UK NPPL system can be found on www.nppl.uk.com

Flying in Canada
At present it is possible to gain a recreational pilot's licence and fly aircraft with up to four seats only. Background medical requirements and pre-flight and in-flight blood sugar testing requirements are similar to the USA. It is also possible to exercise commerical pilot licence privileges for two-crew operations.

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