An Evaluation of the Safety of Pilots With Insulin-Treated Diabetes in Europe Flying Commercial and Noncommercial Aircraft
| Autor: | Graham A Roberts, Veronika Hofmann, Kenneth M. Shaw, Thomas P. Gaffney, Brian M. Frier, Julia L. Hine, David Russell-Jones, Gillian L. Garden, Simon Heller, Gerd Koehler, Stuart J Mitchell, Ewan J Hutchison |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Blood Glucose Male Diabetes duration Aircraft Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Hypoglycemia Toxicology 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Diabetes Mellitus Internal Medicine Extensive data Humans Insulin Medicine 030212 general & internal medicine Glycemic Advanced and Specialized Nursing business.industry Middle Aged medicine.disease Large cohort Europe Pilots Female business Insulin treated diabetes |
| Zdroj: | Diabetes Care. 43:2923-2929 |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | OBJECTIVE The risk of hypoglycemia in people with insulin-treated diabetes has debarred them from certain “safety-critical” occupations, including flying commercial aircraft. This report evaluates the effectiveness of a protocol enabling a large cohort of insulin-treated pilots to fly commercially. RESEARCH DESIGN AND METHODS This was an observational study of pilots with insulin-treated diabetes who were granted medical certification to fly commercial and noncommercial aircraft. Clinical details, pre- and in-flight (hourly and 30 min before landing) blood glucose values were correlated against the protocol-specified ranges: green (5–15 mmol/L), amber (low, 4–4.9 mmol/L; high, 15.1–20 mmol/L), and red (low, 20 mmol/L). RESULTS A total of 49 pilots with type 1 (84%) or type 2 (16%) diabetes who had been issued class 1 or class 2 certificates were studied. Median diabetes duration was 10.9 years. Mean HbA1c was 7.2% (55.0 mmol/mol) before certification and 7.2% (55.1 mmol/mol) after certification (P = 0.97). Blood glucose values (n = 38,621) were recorded during 22,078 flying hours. Overall, 97.69% of measurements were within the green range, 1.42% within the low amber range, and 0.75% within the high amber range. Only 0.12% of readings were within the low red range and 0.02% within the high red range. Out-of-range readings declined from 5.7% in 2013 to 1.2% in 2019. No episodes of pilot incapacitation occurred, and glycemic control did not deteriorate. CONCLUSIONS The protocol is practical to implement, and no events compromising safety were reported. This study represents what is, to our knowledge, the most extensive data set from people with insulin-treated diabetes working in a “safety-critical” occupation, which may be relevant when estimating risk in other safety-critical occupations. |
| Databáze: | OpenAIRE |
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