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Assessment of Pancreas Function
Type 2 diabetes occurs from a combination of pancreatic beta cell impairment and peripheral cellular insulin resistance. Likely root causes are: 2 or more decades of poor diet associated with consumption of high glycemic index foods [processed foods with fiber, enzyme and mineral content removed], a sedentary lifestyle and obesity. In many cases of diabetes, the person or driver will have diabetes mellitus or elevated blood sugar controlled by a combination of diet, pills, insulin.
Certification of a driver with diabetes is recommended only for a length of 1 year : if and only if they: meets all other physical qualification standards of the DOT examination, as well as having an active and effective treatment plan prescribed by a medical doctor that manages the disease: [must not include use of insulin, or interfere with safe driving].
Long term uncontrolled consequences of diabetes mellitus are pretty severe. This list is a partial one: cardiovascular disease [ischemic heart disease and stroke], lower limb amputations due to poor circulation, diabetic neuropathy [changes to vision], blindness, progressive kidney leading to failure, cognitive [brain] dysfunction, higher risk of infections, increased rates of hospitalizations.
A commercial driver may not be by allowed to drive if: if taking insulin, if they have had a hypoglycemic reaction involving: [seizure or loss of consciousness or need of assistance from another person] or experience unexpected period of impaired cognition, if suffers loss of sensation in the arms of legs, losses of brake pedal sensation, has resting tachycardia, has orthostatic hypotension [low blood pressure when changing from sitting to standing], has diagnosis of peripheral neuropathy interfering with safe driving or has a diagnosis of proliferative retinopathy interfering with vision.
Insulin Diabetic Prescriptions: Apidra : (insulin gluisine): fast acting insulin, Humalog: (insulin Lispro): fast-acting, Iletin Lente: (insulin zinc): fastacting, Velosulin BR: (insulin regular): fast acting, NovoLog: (insulin aspart): medium and fast acting combo,Levemir: (insulin detemir) long acting form of insulin, Lantus: (insulin glargine) long acting form of insulin, Novolin N Innolet: (insulin isophane): long acting form of insulin
Non-Insulin Diabetic Prescriptions: Sulfonylureas : stimulates insulin release from pancreas [Glucotrol {glipizide}, Diabeta {glyburide}, Biguanides: helps move insulin into the cells {metformin/Glucophage, Thiazolidinediones: improves insulin’s efficiency in muscle and in fat tissue, lowers the amount of sugar released by the liver: {actos/piogliyazone), Avanda (rosiglitazone), Alpha-glucosidase Inhibitors: block enzymes that help digest starches:[Precose/acrabose, Glyset/migitol, Meglitinides: stimulates insulin release from pancreas: Prandin/repaglinide, Starlix/nateglinide, Dipeptidyl peptidase IV inhibitor: increase insulin secretion from the pancreas and reduce sugar production: Januvia/sitagliptin, Onglyza/saxagliptin, Tradjenta/linagliptin
Diabetic Waiver : Waivers are available for certain individuals who are using insulin to manage their diabetes. The process can be very detailed and involved and not all diabetics will qualify. Even though a person is taking insulin, he may apply for a waiver.
Download this document to apply for waiver: Diabetes_Exemption_Package0706.pdf. If the driver wishes to apply for a waiver he must complete this form, meets all other DOT standards but requires periodic monitoring due to insulin treatment for diabetes.
The driver may then be certified to drive commercially for 1 year, accompanied by a federal diabetes waiver/exemption. If a driver has a diabetic waiver, they must carry a source of rescue glucose in the truck. Annual specialist evaluation are required, such as by optometrists or ophthalmologists as well as regular follow-up with a treating medical doctor.
Please contact us if you would like to arrange a Home or Office visit for your DOT Examination. We perform DOT physicals for drivers living in or passing through St. Paul and Minneapolis, as well as all surrounding suburbs.
Call 952-217-9587 or 651-699-3366 Today!