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done police work or construction while using insulin, and experienced absolutely no problems, would be barred from commercial driving.

The inclusion of a three-year requirement eliminates entire populations of otherwise eligible drivers and renders almost negligible the benefit of the proposed rule to people with insulin- treated diabetes. And, it is a requirement that is unrelated to the individual’s disease, to the individual’s control of diabetes, and to the individual’s ability to stand on the same footing as any other applicant who is otherwise qualified to drive a commercial motor vehicle. The reality of the situation is that proposed protocol continues the blanket ban against most of the individuals who would be the safest applicants: those individuals who have lived and worked as commercial truck drivers for years with diabetes and whose treatment regime now includes insulin; and those who have lived with insulin-treated diabetes for years without experiencing the problems the protocol seeks to screen out. If the three-year rule

were necessary to assure safety the fact that it excluded have to be acceptable. The simple, overriding fact supported by legitimate concerns for safety.5

most people who use insulin is that the three-year rule

would is not

Recommendations of the Expert Medical Panel Ignored

The FMCSA’s Report to Congress provides no basis for the three-year rule. Rather, the requirement runs counter to the testimony of the Expert Medical Advisory Panel convened by FMCSA to study this issue. The Report states that the Expert Medical Advisory Panel discussed the need for a period of time to adjust to insulin use before commencing commercial driving. FMCSA’s experts recommended a one or two month period for a person to adjust to insulin use before seeking to obtain a CDL (one month for someone with type 2 diabetes who is converting to insulin use; two months for a person who is newly diagnosed with type 1 diabetes). This period could be extended by the treating physician, if necessary. The four highly acclaimed physicians who served as the FMCSA’s Expert Medical Panel have submitted a comment on the proposed exemption program stating their objections to the proposed three-year requirement.

The Association, as the country’s preeminent medical association in the area of diabetes, agrees with FMCSA’s Expert Medical Panel that the proposed three-year requirement is not rooted in the modern medical practice of treating diabetes. There is simply no medical evidence to support this draconian provision, one that will make individual assessment

The proposed exemption for individuals with insulin-treated diabetes should not be treated in the same manner as the current exemption for individuals with vision impairments. Even if an individual with a vision impairment is otherwise qualified under the FMCSRs, that individual has operational limitations every minute behind the wheel that might impact that person’s perception of the road and other vehicles. On the other hand, an individual with insulin-treated diabetes who is otherwise qualified does not have those same operational limitations. Under the proposed protocol, such a driver will only be behind the wheel when his or her blood glucose level is within a safe range. There is no difference between that individual’s physical abilities – including how that individual perceives the road and other vehicles – and any other commercial driver. Except for the monitoring and maintenance requirements in the proposed protocol, which the Association supports, the operation of a commercial motor vehicle for an individual with insulin-treated diabetes is no different than for anyone else. 5


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