On The Road With Diabetes

by Holly Plude - Published: 3/08/2017
3.9 8 votes

For many years truck drivers taking insulin lost their medical certificate. No medical certificate, no CDL. Then, in 2003, the Diabetes Exemption Program was

enacted. Two years later, in 2005, a transportation bill passed, and was then signed into law by President George W. Bush, providing updates to the original exemptions.

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Diabetes is a complicated disease. Many have no real practical knowledge of the disease. Even when one takes their insulin and other medications regularly and they believe they are eating well, their blood sugar can still be high.

There are some important first steps that one can take when addressing the disease. 

First, get into your doctor. No ifs, ands or buts, make the appointment and go! Have an honest conversation with your doctor. Tell him/her if you have not been regularly taking your medications, if your eating habits are not under control, what your stress level is like, etc. If you are not honest with your physician, they cannot effectively help you.

Next, make a plan and stick to it. Easier said than done, I know. Don’t be afraid to enlist family to help you remain accountable. If eating is a downfall, think about being proactive in preparing meals rather than relying on truck stop food.
Use a smartphone app such as MyFitnessPal. Such apps allow you to keep track of all your food and liquid intake and monitor your sugars, carbs and other macros that way. This is especially helpful for truck drivers who are on the road more than home, where bad eating habits are practically expected and encouraged.

Get a good water bottle and attach it to your hip (so to speak). More often then you realize, when you are hungry, you are actually thirsty. Try drinking water first, if after 30 minutes you are still hungry, have a sensible snack.

If your doctor recommends you see a specialist and/or a nutritionist, make the appointments and attend. Knowledge is power!

There are so many tools available to help you monitor your blood sugar, track what you eat and how you sleep. Take advantage of them.

Preparing For The Doctor's Visit

As the medical examination is just the beginning of the process, you want to be fully prepared before you show up. Be sure to take the Certifying Medical Examiner Evaluation letter. The physician needs to review this prior to performing your medical exam. Also, bring a copy of your prior five-year medical history.

The FMCSA offers the following information as well, “Other than the use of insulin to treat their diabetes, any other medical problem or condition that prevents the applicant from being certified by the medical examiner must be corrected BEFORE the rest of this application is completed.Therefore, the endocrinologist and vision evaluations SHOULD NOT be completed until the medical examiner certifies the applicant.The applicant must submit copies of the completed medical examination report and medical examiner’s certificate. The certificate should indicate that the driver is certified ONLY IF the driver has a diabetes exemption. The certificate is not valid until the insulin exemption is obtained from the Federal Motor Carrier Safety Administration (FMCSA).”

In addition to the certified medical examiner, you must be examined by a board certified (or eligible) endocrinologist. Bring the Endocrinologist Checklist and your current glucose logs to the appointment. Before you leave that appointment, be certain the endocrinologist has completed all parts of the checklist. Along with the checklist you need to have the endocrinologist’s signed letterhead and any reports detailed in the checklist.

The vision exam may only be given by an ophthalmologist. Bring along the Vision Evaluation Checklist. Again, be sure it is completely filled out before leaving your appointment. Also, obtain the ophthalmologist’s signed letterhead.

Be timely about making your appointments and submitting your application for exemption. The Endocrinologist and Vision evaluations are only valid for six months.

If your application is approved for the Diabetes Exemption, then the FMCSA is required to publish this applicant request, not once, but twice, in the Federal Register. There is a 30-day period that is open to public comment and a notification of the FMCSA’s final decision. This notice will disclose your full name, age, basic information regarding your insulin use, what type of license you hold and any endorsements. Rest assured that personal information such as address, employer, medical records, or driver’s license number are not released for public information.

Frequently Asked Questions About Diabetes and Driving:

Q: Who is eligible for the Federal Diabetes and Vision Exemption Program?

A: Per the FMCSA, it is any individual who “does not currently meet the diabetes…standard and are unable to obtain a medical card.”

Q: Is my general practitioner able to do my medical exam for my medical certificate?

A: Maybe. Find out if your physician is a qualified medical examiner. The National Registry of Certified Medical Examiners provides a listing of all qualified physicians. As of May 21, 2014, only certified medical examiner listed in this registry may provide a legal medical certificate.

Q: Why is diabetes such a concern for a driver?

A: Diabetes mellitus may, on occasion, cause an individual to lose consciousness or become disoriented. Neither occurrence would be safe for a truck driver or others who share the road. With trucking jobs continuing to increase, we have to take every measure possible to ensure safe roads for all.

Q: Is my medical clearance valid in Canada or Mexico?

A: Not necessarily. Unless your exemption complies with foreign trucking regulations, you will not be clear to drive in either country. If you are not sure, speak to your dispatcher. If you are an owner/operator, take some time and research FMCSA for specifics.

Q: How will I know if I have been exempted?

A: The FMCSA will notify you either way. If you are deemed ineligible for the exemption, a letter outlining why will be sent.

Q: How long do I have to wait for a decision?

A: The FMCSA is required to complete the entire application process within 180 days of application submission.

Q: I’ve been granted an exemption. Now what?

A: First of all, congratulations! Keep in mind that the exemption is only valid for a maximum of two years. Read the conditions carefully. You may be required to receive quarterly or annual exams in order to continue the exemption. While you will be provided all the necessary forms, it will be up to you to maintain your compliance. And now that you know what to expect during the exemption process, be sure to start it a bit earlier for the next time around and save yourself a couple of points on that blood pressure!

Living with diabetes is difficult enough. Don’t let it interrupt your trucking job. There are many steps you can take to reverse diabetes. Speak with your physician and/or diabetic nutritionist about ways to change your eating and exercise habits. Often times, weight loss can significantly reduce your A1C level, which is the determining factor of whether or not you are diabetic. An A1C of about 5 is ideal.

Bottom Line

 First, if you have received a diagnosis of Diabetes Mellitus (type 2 diabetes), don’t panic! It is unfortunately common, but can be (in certain circumstances) reversible with a healthy diet and regular exercise. Even if your diabetes is not currently reversible, remember, if you are not taking insulin, your driving job is not in danger. If you are taking insulin, follow the steps listed above and get the exemption process started. With good planning, you can stay on top of this diagnosis and continue to do the trucker job that you love, and that the nation depends upon.

On the off chance that you do not receive the exemption, you have other options. While many truck drivers could never envision themselves behind a desk, you might find becoming a dispatcher, transportation supervisor, or safety and compliance officer to be very rewarding. Your company likely has options available to you should you be temporarily sidelined from driving.

And last, but by no means least, remember that your health is more important than anything else. When you risk your life, you risk the lives of everyone you share the road with. The job you do is vital to America’s economy. That being said, don’t take chances. Stay on top of your diagnosis, eat healthy, exercise, get appropriate rest and strive for less stressful days.

You will find in no time at all that you are living with your type 2 diagnosis and are stronger for the knowledge it has given you!

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