Insulin treatment has normally been disqualifying for pilots’ medical certification in most States to date. However, treatment protocols and blood glucose monitoring have advanced considerably within the last decades. Experience from the U.K. has shown that, with a strict protocol, even Class I Medical certificate holders have been flying commercially safely with insulin treatment.
IFALPA’s position is that insulin treatment should be accepted for medical certification with the requirement of a strict protocol controlling blood glucose levels
Currently, ICAO and most of the regulators do not allow those undergoing insulin treatment to fly commercial aircraft. Here below in this IFALPA paper you can find a summary of regulations in various jurisdictions as well as experiences of flying with insulin treatment.
Insulin Treatment and Flying
IFALPA / The global Voice of Pilots
19POS05 /3 June 2019