I have a special issuance for type II oral medication in use. Very minimum dosage. The special issuance is good for 6 years, that just means you don't need a full FAA med board eval every year, you still must submit blood work to the FAA every six months for your 1st class. In my case they deferred my medical for 60 days to show like the above poster stated, no side effects and control of the situation. At that point my 1st class was issued and its really been a non issue. I am in the third year of my special issuance. In fact my blood sugars are now lower than they have been in probably 15 years. Its not the end of the world..... at least not in the US.