Sep 18, 2018

Scheduled to be published in Federal Register 9/19 - Elimination of Insulin Exemption

FMCSA plans to publish in tomorrow's Federal Register the announcement that " individuals with a stable insulin regimen and properly controlled insulin-treated diabetes mellitus (ITDM) to be qualified to operate commercial motor vehicles (CMVs) in interstate commerce"  This will put the responsibility on the examiners, essentially relying on the information provided by the treating clinician on the  Insulin-Treated Diabetes Mellitus Assessment Form (ITDM Assessment Form), MCSA-5870.   

The Treating Clinician is defined as the  health care provider who manages and prescribes insulin for the individual. The TC is to review 3 months of glucose logs and attests that the individual maintains a stable insulin regimen and proper control of his or her diabetes on the form which the examiner reviews and then performs an exam. 

The driver would be disqualified if they experience a severe hypoglycemic episode - defined as severe hypoglycemic episode as one requiring the assistance of others, or resulting in loss of consciousness, seizure, or coma. Drivers with severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy should also be disqualified.

Significant differences with current process - no exemption, no annual eye exam, no annual visit and quarterly evaluation by endocrinologist 

Pre-publication announcement at