has no established medical history or clinical diagnosis of Diabetes If mild diabetes is noted at tie time of examination and it …
APPENDIX C
State Materials Used in the Process to Permit Some Individuals with ITDM to Operate CMVs in: Utah Michigan Deleware
Materials Used By Utah
CATEGORY A: DIABETES MELLITUS AND OTHER METABOLIC CONDITIONS
Profile Level Diabetes Mellitus Thyroid Parathyroid, Pituitary and Other Metabolic Conditions No history of metobolic condition Interval for Review
License Class and Restrictions
1
No history of diabetes mellitus or elevated blood sugar
2 Years
Commercial Unlimited Private Vehicles Commercial Unlimited Private Vehicles
NIA
2
History of elevated blood sugar No positive diagnosis of diabetes Any diabetes stable on diet; adult onset of diabetes stable on oral agents
Abnormal laboratory findings No diagnosis made
2 Years
Upon Renewal
3
Stabilized under treatment or recovered after surgery without symptoms for one month Stabilized under treatment with minimal symptoms not affecting driving
1 Year a
Commercial Unlimited Private Vehicles
1 Year a
4
Stabilized diabetes with with no episodes of ketosis or altered consciousness for 1 yr c
6 Months
Commercial Intrastate may be issued for diabetes only if special qualifications listed in Appendix III are met Health
care professional approval required Private Vehicles
1 Year a
SPECIAL QUALIFICATIONS FOR PERSONS WITH DIABETES MELLITUS FOR COMMERCIAL DRIVER LICENSES
Current federal commercial driver qualification requirements read:
A person is physically qualified to drive a motor vehicle if that person has no established medical history or clinical diagnosis of Diabetes Mellitus currently requiring insulin for control If insulin is necessary to control a diabetic condition, the driver is not qualified to operate a motor vehicle If mild diabetes is noted at tie time of examination and it is stabilized by use of a hypoglycemia drug and a diet that can be obtained while the driver is on duty it should not be considered disqualifying However, the driver must remain under adequate medical supervision
Some insulin taking diabetic individuals are clearly at minimal risk of severe hypoglycemia These individuals are characterized by the following: 1 2 3 Easy recognition of hypoglycemic spells; Willingness and ability to self blood glucose monitor on a frequent basis: Trained in the management of their diabetes with an understanding of the balance of insulin, food, exercise and stress
Physical
qualifications for drivers: A person is physically qualified to drive a commercial motor vehicle if thet person has no established medical history or clinical diagnosis of Diabetes Mellitus likely to interfere with that persons ability to safely operate a commercial motor vehide and provided a parson who requires insulin for control of the disease: a Has within the last five years 1 An absence of a hypoglycemic reaction that resulted in loss of consciousness or seizure 2 An absence of seizure or coma without antecedent prodromal symptoms of hypoglycemia nonketotic coma
3 An absence of recurrent diabetic ketoacidosis or hyperosmolar
b Provides the following information as a minimum to the endocrinologist or internist who examines them: 1 A complete medical history including all hospitalization, consultation notes, diagnostic examinations, special studies and follow-up reports
APPENDIX III Page 2 Special Qualifications For Persons With Diabetes Mellitus For Commercial Driver Licenses
2 3 4
A complete drivers record as reported by the State Licensing Agency which issued the person a drivers license as may be available Complete information regarding any motor vehide or other
accidents resulting in personal injury or property damage Written signed authorization to permit the examining endocrinologist or internist to obtain information from employers, work associates, health care professionals, or other health care workers, relevant to the persons medical condition
c
Undergoes a complete medical evaluation by an endocrinologist or internist who will assess the results of the following procedures prior to determining whether the person is qualified to operate a commercial motor vehicle: 1 At least two results of glycolysated hemoglobins during the last 6 months, a lipid profile,urinalysis and CBC Blood pressure readings at rest, sitting and standing Elevated blood pressure, medication for hypertension or other evidence of any cardiovascular abnormality will require a maximal exercise stress EKG Ophthalmologic confirmation of absence of visually significant retinal disease Examination and tests to detect peripheral neuropathy and/or circulatory deficiencies of the extremities A detailed evaluation of insulin dosages and types, diet utilized for control and any significant lifestyle factors, such as smoking, alcohol use and other medications or drugs
taken
2 3 4
The endocrinologist or internist shall: a Certify 
that drivers have been educated in diabetes and its control and thoroughly informed of and have demostrated the understanding of the procedures which must be followed to monitor and manage their diabetes and what actions should be followed if complications arise Ascertain that drivers have the ability, willingness, and equipment to properly monitor and manage their diabetes A blood glucose monitor with electronic memory is required Determine that drivers with diabetes will not adversely affect their ability to safely operate a commercial motor vehicle The methods of making that determination shall be established by the examining health care professional
b
C
APPENDIX III Page 3 Special Qualifications For Persons With Diabetes Mellitus Fur Commercial Driver
Licenses
The following monitoring and re-evaluation procedures shall be performed as a minimum by an insulinusing diabetic who drives a commercial motor vehicle These procedures may be supplemented with additional procedures and/or operational conditions by the examining health care professional: a One hour prior to driving and approximately every two hours while
driving, drivers shall lest their blood glucose concentration and record those concentrations electronically Upon request, make records of self blood glucose concentrations available to Federal or State enforcement personnel Annually, or more often as Indicated by the endocrinologist or internist, submit a complete medical reevaluation including readings of glycosylated hemoglobin to the examining endocrinologist This requires the driver to submit any new data on the drivers medical condition, driving record or accident involvement and the glucose records Use of a new examining health care professional will require the insulinusing driver to follow the procedures set forth for a naw applicant At each visit the endocrinologist or internist will verify that the insulin-using diabetic can demonstrate the accuracy of self blood glucose measurement within 20 of actual concentration Annually have ophthalmologic confirmation of the absence of visually significant retinal disease While driving, should circumstances preclude a particular blood glucose test, intake of an appropriate snack or other source of glucose is an acceptable alternative, however no two consecutive tests may be
replaced by the ingestion of glucose or food The driver must carry necessary supplies on board the vehicle including as a minimum, blood sampling lancets, personal blood glucose monitor and strips, a plentiful source of rapidly absorbable glucose, All dated materials must be within their expiration dates h It is suggested that for long distance trips a co-driver or a companion shall be
b c
d
e f
Please take this with you to the Endocrinologist or Internist performing the examination and have them complete and return: To:
Debbie Dargar, Program Ddver License Division
PO BOX 30560
Coordiior
Salt Lake City, UT 84130-0560 From Endocrinologist Date Regarding Applicants/Patients Name File Number or Internist Signature
The following conditions of Appendix III State of Utah Functional Ability i Guidelinges and Standards for Health Care Professionals have been met: Please check the a po rae column p r pi t Yes IN O Procedure to Complete Went underwent a complete medical evaluation by an endocrinologist or internist who assessed the results of me following procedures prior to determining whether the person is qualified to operate a commercial motor vehicle At least two results of
glycolysated hemoglobins during the last 6 months A lipid profile urinalysii and CBC Blood pressure readings at rest, sitting and standing Elevated Mood pressure, mediion fur hypertension or other e i e c vd n e of any cardiovascular abnormality will require a maximal exercise stress EKG 2 3 4 Ophthamdogic confirmation of absence of visually significant retinal disese peripheral neuropathy and/or circulatory
Examination and tests to detect deficiencies of the extremities
A detailed evaluation of insulin dosages and types, diet utilzed for control and any significant lifestyle factors, such as smoking, alcohol use and other medications or drugs taken The edocrinologist or internist certifes that the driver has bean educated in diabetes and its control and thoroughly informed of and has demonstrated the understanding of the procedures which must be followed to monitor and manage their diabetes and what a t n should be followed if complications ci s o arise The endocrinologist or internist ascertains that the driver has the abilty, willingness, and equipment to property monitor and manage their diabetes A
5
blood glucose monitor with electronic Wry is rwuired
Addiional Comments
Please attach a separate sheet if more space is needed:
Source:fmcsa.dot.gov
