Old 11-02-2019, 02:21 PM
  #5  
Excargodog
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Originally Posted by AirBear View Post
Thanks for posting that link. I'm in exactly that situation so I found it very interesting. I was diagnosed with T2 diabetes 15 years ago (strong family history of it). I've been unable to get my A1C below the diabetic threshold of 7.0, although I've come close. My Diabetes Doc has said that after 15 years my pancreas is running on empty, you can only squeeze it chemically for so long. Unless I show a marked improvement in A1C I'll be starting insulin after my next visit in late November. I wear a Continuous Glucose Monitor which enables me to print out comprehensive charts on my sugar levels, based that those the Doc plans to put me on short acting mealtime insulin. That type would be a major PITA to use while flying as it needs to be temp controlled once the multi-use injector pen is used, and refrigerated until it's opened. That's why I'm doubtful the FAA will approve pilots on that type of insulin. Now an insulin pump might be a different story, I'm not sure how much care and feeding those things need.
That’s not necessarily the best way to treat type 2 with insulin. If your doctor’s an endocrinologist and you have confidence in him, go with that. But you might at least discuss this with him:


The “treat-to-target” clinical trials established that the addition of basal insulin to existing oral glucose-lowering therapy achieves good glycemic control in the majority of patients with type 2 diabetes (27–29). According to the ADA/EASD algorithm for the management of type 2 diabetes, insulin could be initiated with either once-daily NPH insulin or a long-acting insulin analog
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811456/


Often, people with type 2 diabetes start using insulin with one long-acting shot at night, such as insulin glargine (Lantus) or insulin detemir (Levemir). Discuss the pros and cons of different drugs with your doctor. Together you can decide which medication is best for you after considering many factors, including costs and other aspects of your health.

https://www.mayoclinic.org/diseases-...t/drc-20351199

As I said, talk it over with your doc and maybe your AME, but a smaller dose of long acting backed up by oral agents might be an easier sell to the FAA.
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