ATCO.MED.B.025 Metabolic and endocrine systems

                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Regulation (EU) 2015/340

(a) Applicants with metabolic, nutritional or endocrine dysfunction may be assessed as fit   subject to demonstrated stability of the condition and satisfactory aero-medical evaluation.

(b) Diabetes mellitus:

(1) Applicants with diabetes mellitus requiring insulin shall be assessed as unfit.

(2) Applicants with diabetes mellitus requiring medication other than insulin for blood sugar control shall be referred to the licensing authority. A fit assessment may be considered if it can be demonstrated that blood sugar control has been achieved and is stable.

AMC1 ATCO.MED.B.025 Metabolic and endocrine system

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     ED Decision 2015/010/R

(a)     Metabolic, nutritional or endocrine dysfunction

Applicants with metabolic, nutritional or endocrine dysfunction may be assessed as fit if the condition is asymptomatic, clinically compensated and stable with or without replacement therapy, and regularly reviewed by an appropriate specialist.

(b) Obesity

(1) Applicants with a BMI>35 may be assessed as fit only if the excess weight is not likely to interfere with the safe exercise of the privileges of the licence and satisfactory cardiovascular risk review and evaluation of the possibility of sleep apnoea syndrome has been undertaken.

(2) Functional testing in the working environment may be necessary before a fit assessment may be considered.

(c)    Thyroid dysfunction

Applicants with hyperthyroidism or hypothyroidism should attain a stable euthyroid state before a fit assessment may be considered.

(d)    Abnormal glucose metabolism

Glycosuria and abnormal blood glucose levels require investigation. A fit assessment may be considered if normal glucose tolerance is demonstrated (low renal threshold) or impaired glucose tolerance without diabetic pathology is fully controlled by diet and regularly reviewed.

(e)     Diabetes mellitus

(1) The following medication, alone and in combination, may be acceptable for control of type 2 diabetes:

(i) alpha-glucosidase inhibitors;

(ii) medication that acts on the incretin pathway;

(iii) biguanides.

(2) A fit assessment may be considered after evaluation of the operational environment, including means of glucose monitoring/management whilst performing rated duties, and with demonstrated exemplary glycaemic control.

(3) Annual follow-up by a specialist should be required including demonstration of absence of complications, good glycaemic control demonstrated by six-monthly HbA1c measurements, and a normal exercise tolerance test