Special-Issuance Medical Certification: Diabetes Protocol for Applicants Seeking to Exercise Airline Transport, Commercial, or Private Pilot Privileges

Filed on regulations.gov — full text not in the inline record.

Ive commented before but I realized I left out a FUNDAMENTAL PIECE OF THE PUZZLE, unknown carb content. Even without being away on a trip there are times where I am required, if I am not going to starve, to eat foods of unknown carb content. Obviously, to manage this disease you need to INJECT INSULIN BASED ON A CARB RATIO THAT YOUR BODY RESPONDS TO. If you dont know the carb content (MUCH more often than not considering the mystery crew meals and eating out in general) you are GUESSING AT THE CARB CONTENT TO DETERMINE YOUR BOLUS. That leads to a lot of trial and ERROR. That guess often starts a ROLLERCOASTER OF HIGHS AND/OR LOWS BASED ON THE INCORRECT GUESS. At home, carb contents are mostly controlled. On the road, far from it. I cant imagine being responsible for passenger safety when I struggle to manage my own. Maybe a slightly more modern CGM will help with accuracy (I am requesting a Dexcom 6 next week at my quarterly Endocrinologist appointment) but Im not sure HOW IT CAN HELP WITH THE ACCURACY OF THE GUESS. The 10% margin of error is a gross overestimate of its accuracy. When I put the every 12 hour calibrations in, it is CORRECT WITHIN 10% MAYBE 10% OF THE TIME! I often add or subtract 50-150 points. Over the last 3 years of this disease it most certainly has become more controllable but there are STILL THE HIGH AND LOW SURPRISES (AND ROLLERCOASTER RESPONSES) that come with 'GUESSING' or INACCURATE or UNKNOWN CARB CONTENTS.