The Federal Motor Carrier Safety Administration has asked for public comments on a program that would allow insulin-using diabetics to operate commercial vehicles in interstate commerce.

Under current federal regulations, drivers with diabetes mellitus who require insulin to control their condition are not qualified for an interstate CDL. Many state have programs for diabetic drivers, but they are restricted to intrastate operation.
Efforts to change the federal rules go back to the early 1970s. A special conference in the late 1980s, attended by doctors, scientists and trucking representatives, recommended that insulin-using drivers be exempted from the regulations if they met certain medical and safety standards. The 1993 waiver program was initiated as a three-year study but was terminated when safety groups won a court battle to block a similar vision waiver program. Drivers already enrolled in the diabetes program were allowed to keep their waivers.
In 1998 Congress got the wheels turning again with a provision in the Transportation Equity Act of the 21st Century directing the U.S. Department of Transportation to study the feasibility of a program for diabetic drivers. FMCSA’s exemption program is based on the experience of states with similar programs, experience by other government agencies, a review of applicable studies here and in Europe, and the recommendations of a panel of experts in the treatment of diabetes.
The requirements would be strict. Applicants must have a valid intrastate CDL or a license (non-CDL) to operate a commercial motor vehicle. They must have operated a commercial vehicle as an insulin-using diabetic for the three years preceding the application.
Their driving records for those three years must be squeaky clean. No suspensions or revocations of any driving license (CDL or personal vehicle), no involvement in an accident where the applicant was cited for a moving violation in a commercial vehicle, no convictions for a disqualifying offense, no more than one serious traffic violation.
Applicants will have to provide complete medical histories and undergo thorough examinations by an endocrinologist and an ophthalmologist. They can’t have any other disqualifying conditions, including diabetes-related complications. They won’t qualify if they have had two or more hypoglycemic reactions in the past five years resulting in loss of consciousness, seizure, or impaired cognitive function which occurred without warning.
Drivers issued exemptions will be required to carry specifically prescribed medical supplies including a glucose monitor with memory. They will have to check glucose before starting to drive and every two to four hours while driving. If glucose falls above or below prescribed levels, they must stop driving and take appropriate action.
They will have to undergo annual exams by endocrinologists and ophthalmologist and will be required to provide FMCSA with records of daily glucose management. They will also be required to report any episodes of severe hypoglycemia or significant complications as well as any accidents or “adverse events,” whether or not they were diabetes related. Exemptions will be issued for two years. After that time, the drivers must re-apply.
FMCSA says it is not yet accepting applicants. Comments on the program are due Oct. 1. They can be mailed, faxed to (202) 493-2251 or submitted electronically via http://dmses.dot.gov/submit. Reference FMCSA-2001-9800. The docket, including the full proposal, can be found at http://dms.dot.gov.