Just diagnosed?
Take a breath. You still have options.
If you were just told you have diabetes and one of your first thoughts was about flying — you're in the right place. This page is for the first few weeks: what's actually true, what to do now, and where to find people who have been exactly where you are. The person who built this site is one of them. Eleven months passed between his ICU admission and his return to the flight deck. This is what he'd want you to hear first.
First, what's true
Four things to hold onto.
- Diabetes is no longer an automatic no. The FAA has a published pathway — the Insulin-Treated Diabetes Mellitus CGM Option — under which insulin-treated pilots, Type 1 included, are considered for first- and second-class medical certificates. Airline careers are on the table.
- There is a process, and it's written down. Not a favor, not a loophole: a defined Special Issuance protocol with specific requirements. You can read every page of it today. That means you can plan.
- It takes time, and the clock hasn't started yet. The FAA requires a minimum of six months of stable data on a continuous glucose monitor before it will consider you. That clock starts the day you're on a compliant CGM — so the sooner you start, the sooner it ends. Six months is the floor, not a promise: the FAA's requirements sheet notes that a new diagnosis may require a longer stability period.
- You are not the first. DAPA's founder was diagnosed with Type 1 at 25, mid-career, after a DKA hospitalization with no warning. He went through the Special Issuance process and flies the A320 line today. Others have done it too. That's why this community exists.
What I wish someone had told me in the hospital
Your life isn't over, and neither is your career.
Diabetes makes things more complicated — I won't pretend otherwise. But I'm genuinely healthier today than I was before my diagnosis, because now I pay attention to what I put in my body and I move more than I ever did. Eleven months after I was admitted to the ICU, I was back in the flight deck.
Nobody told me that was possible while I was lying in that bed. So I'm telling you.
Gabriel Urdaneta · Founder, DAPA · A320 First Officer · Diagnosed February 2025
This week
Three things. In this order.
Get stable. Your health comes first.
The FAA's own first instruction to newly diagnosed pilots is "see your treating physician and get healthy." Everything else waits behind that. Work with your care team, learn your body, and give yourself the time a serious diagnosis deserves. The paperwork will still be there.
If you fly, stop — and tell your AME.
If you hold a medical certificate, 14 CFR 61.53 means you may not act as a required crewmember with a known medical deficiency. That applies now, before anyone has told you it does. Ground yourself, notify your AME, and if you're an airline pilot, talk to your chief pilot's office and union about the leave process. If you're a student or aspiring pilot who doesn't hold a medical yet, there's nothing to stop — skip to step three.
Start the clock: an endocrinologist and a compliant CGM.
The FAA requires a board-certified endocrinologist (M.D. or D.O.) and a real-time CGM that meets its feature requirements. Get both in place as early as your care team agrees it's appropriate, and turn the alarms on — the FAA wants to see them on in your reports. Every month on a compliant device is a month toward the FAA's six-month minimum.
Which CGMs qualifyThis month
Once you're steady.
Learn the process before anyone explains it to you
Read The FAA Medical on this site, then the FAA's own protocol page. You'll walk into every appointment knowing what the FAA needs from it, which is the difference between one visit and three.
Then
- Find an AME who has handled insulin-treated Special Issuances — call and ask before booking
- Ask your endocrinologist's office how they export monthly CGM reports; you'll need them separated by calendar month
- Consider an aeromedical consultation (AMAS, or your union's aeromedical office) before your package goes in
Find your people
The medical is a paperwork problem. The harder part is the 3 a.m. version of the question — whether this is still your life. That part goes better with people who've asked it.
DAPA is
- Pilots, cabin crew, controllers, and technicians managing diabetes around an aviation schedule
- A place to compare notes on AMEs, devices, duty days, and the process
- Not medical or legal advice — peers who've been through it
Two starting points
Where you are changes the order, not the destination.
If you already fly for a living
You're grounded for now. Not forever.
You'll go through the initial Special Issuance package — endocrinologist evaluation, labs, six months of CGM data, eye exam, cardiac evaluation — and your AME will defer the application to the FAA. If you already hold a Special Issuance for another condition, the FAA's FAQ says it becomes invalid with the new diagnosis; you'll need a new Authorization covering both.
Use the time. Get your numbers steady, get your routines built, and read the Life on the Line guides on how diabetes and a duty schedule actually fit together — written by someone who did exactly this. For him it was roughly eleven months, ICU to flight deck. Yours will be your own, but it is a timeline, not a wall.
If you're a student or you haven't started yet
Start the data before you start the training.
To exercise student pilot privileges in an airplane you'll need at least a third-class medical certificate (14 CFR 61.23; gliders, balloons, and sport-pilot light aircraft are the exceptions), and with insulin that means a Special Issuance. The most valuable thing you can do right now costs nothing: get on a compliant CGM with your endocrinologist and begin building the stable data the FAA will ask for — six months at minimum. Every month you bank now is a month you won't wait later.
Third-class applicants can use either the CGM protocol or the FAA's older non-CGM option; if a professional career is the goal, build for the CGM protocol from day one so the data carries forward.
Things you'll hear
Three that aren't true, and one that is.
"Diabetics can't be pilots."
Outdated. This was true for first- and second-class medical certificates until the FAA's CGM Option opened them to insulin-treated applicants. People repeating it — including some doctors and some pilots — are working from old information. Point them at the FAA's own protocol page.
"My endocrinologist says I'm fine, so the FAA will too."
Not necessarily, and the FAA says so directly. Its FAQ notes that your physicians "may not be familiar with the additional challenges of the demanding aviation environment" and that FAA guidance addresses aviation-specific concerns. The FAA evaluates you against its own published targets and its own list of required evaluations. Your endocrinologist's support is essential; it is not the decision.
"I test my sugar all the time. I don't need a CGM."
For a first- or second-class medical, you do. The FAA's pathway is built on CGM data and it explains why: a CGM works independently of your actions, gives predictive warnings, and lets the FAA see your control both on the ground and in flight. Fingersticks alone will not get you a first- or second-class medical under this protocol.
"This is going to take a while."
True. Six months of data at minimum, plus the FAA's review, and the FAA's guidance doesn't say how long that review takes. What you control: start the CGM early, keep your numbers consistent, and submit a complete package the first time. The FAA says partial packages are not reviewed, and a file that isn't kept current stalls. People who do this well treat it like a checkride — prepare, execute, don't improvise. For DAPA's founder, the whole arc from ICU to flight deck took roughly eleven months. One data point, not a promise — but a real one.
Not a pilot? The FAA medical process above is for pilot certificates. Flight attendants and technicians generally aren't required to hold an FAA medical, and controllers have their own FAA clearance process. If that's you, a new diagnosis still changes your duty days, your travel, and your routines — and the community and the Life on the Line guides are for you too. We especially want to hear from you.
This page is not medical or legal advice. It's a peer community's summary of publicly available FAA guidance, written for the first weeks after a diagnosis. Decisions about your treatment belong with your medical team; decisions about your certification belong with your AME and the FAA. See our Disclaimer & Terms of Use.
Same sky. More possibilities.
You don't have to figure this out alone, and you don't have to figure it out this week. Join DAPA, ask the question you're afraid to ask, and hear from people who asked it too.
