I have to ask: Are you a doctor? An AME?


Mxsmanic wrote:
EFIS2 writes:

I am a person with reactive hypoglycemia (gets weak/confused if does
not eat healthy snacks/meals regularly) - I'm sure there is not much
chance of being certified to get a PPL or go onto being an airline
pilot - I just thought I'd ask if anybody knows what the deal is, or
if anybody knows about this problem.

Hypoglycemia is not unconditionally disqualifying, but the FAA must render a
decision in each individual case. You'd have to submit all the documentation
you can describing your condition and its causes, and then they would decide
whether to grant or deny. So it doesn't necessarily exclude you from getting
a license.

Reactive hypoglycemia is a form of glucose intolerance. It is closely related
to diabetes mellitus, even though the effect on blood glucose is the opposite.

Some people underreact to prandial glucose loads, and they become temporarily
hyperglycemic, sometimes markedly so. If the hyperglycemia becomes chronic
even while fasting, they are said to have diabetes mellitus. Temporary
hyperglycemia is usually harmless if it is not too acute, although it may
indicate a predisposition to DM. The hyperglycemia comes from inadequate
response to insulin (called Type II DM or NIDDM if chronic), or inadequate
production of insulin (called Type I DM or IDDM if chronic).

Hypoglycemia, both postprandial (reactive) and fasting, is much rarer than
hyperglycemia. There are a number of possible causes. Definitive treatment
requires treatment of the underlying cause. Treatment of the hypoglycemia
itself requires taking in food or glucose. In some cases, reactive
hypoglycemia may be associated with a predisposition to development of
hyperglycemia and DM.

Most hypoglycemia is asymptomatic, and most of the symptoms of hypoglycemia
can have other causes. It is essential to actually verify blood glucose
levels when the symptoms occur, to see if blood glucose really is abnormally
low.

Postprandial hyperglycemia is harmless if not too severe, although it may
indicate a prediposition to DM. Chronic hyperglycemia (diabetes mellitus) can
produce a constellation of severe complications over a period of years or
decades. Hypoglycemia is harmless if mild, even when chronic. Severe acute
hypoglycemia is life-threatening, though. However, severe hypoglycemia of
this type is almost always seen only in insulin overdoses among diabetics, and
in some types of poisoning (e.g., alcohol poisoning).

In the case of aviation, the FAA's concern seems to be incapacitation. DM is
a problem because an uncontrolled diabetic could enter a diabetic (DKA) coma,
and a controlled diabetic taking insulin or medication could enter insulin
shock. DM that does not require insulin or medication does not present a
significant risk of incapacitation.

Hypoglycemia can result in incapacitation if it drops very low, but this is
extremely rare even among people with chronic hypoglycemia (which is rare in
itself). The risk is very small.

I also have bad eye floaters, I'm sure that would be a problem too.

Only if it makes it impossible to see clearly enough to fly even with
correction. The mere presence of floaters is not disqualifying.

I'm not really optimistic given
that the condition often causes weakness and lack of awareness if I do
not keep my blood sugar up.

The FAA is unnecessarily strict and arbitrary in its requirements, so I tend
to agree with you, even though, in reality, your condition should not be an
obstacle to flying. While the underlying concern is incapacitation, the FAA
works in terms of disqualifying conditions, and not in terms of a general
assessment of the risk of incapacitation. If this latter risk can be
certified as acceptably low, however, you could still get a medical, and in
any case, your hypoglycemia and floaters are not absolute barriers to getting
one (particularly the latter).