What happened
The US Federal Aviation Administration (FAA) has proposed a change to its medical rules that would let many pilots with type 2 diabetes get their medical certificate in the doctor's office, instead of waiting for a separate FAA review. The notice of proposed rulemaking, "Modernizing Medical Standards for Non-Insulin Dependent Diabetes Mellitus Cases" (docket FAA-2026-10990), was published in the Federal Register on 4 September 2026. The comment period closed on 5 October 2026.
What the rule would change
Today, under 14 CFR Part 67, diabetes that needs insulin "or any other hypoglycemic drug" to control it is a specifically disqualifying condition. That means every applicant on diabetes medication has to go through the FAA's Special Issuance process, where the Aviation Medical Examiner (AME) defers the application to the FAA for extra review.
The FAA proposes to remove the words "or any other hypoglycemic drug" from the first-, second- and third-class medical standards. If the rule is finalised as proposed:
- Applicants whose diabetes is controlled without insulin, and who meet every other medical standard, could be issued a certificate by their AME at the time of the examination.
- Diabetes that needs insulin would still be disqualifying and would still go through Special Issuance.
- All other medical standards stay the same.
In its notice, the FAA says non-insulin diabetes "is routinely managed by primary care physicians today using a variety of treatments", and that newer medicines have made the condition much easier to control than when the current wording was adopted in 1959.
The numbers behind it
The FAA estimates that the change would save applicants between $39.7 million and $80.19 million in labour hours over five years, according to the notice and AOPA's report. AOPA also reports that an FAA review of fatal accidents between 2008 and 2025 found 51 involving pilots diagnosed with non-insulin diabetes. In 50 of them, the FAA judged pilot incapacitation from diabetes "improbable"; one investigation was still open.
Who supports it
On 5 October, thirteen US aviation organisations filed joint comments in support, including AOPA, EAA, NBAA, GAMA, the National Association of Flight Instructors and the Allied Pilots Association. They called non-insulin diabetes "a prime example of a condition that AMEs can be entrusted to certify", and asked the FAA to look for other conditions that could be handled the same way.
This is still a proposal. The FAA now has to consider the comments before publishing any final rule, and it has not given a date for that.
What this means if you're training
If you're training in the US and you manage type 2 diabetes with tablets or non-insulin injections, this could make getting and renewing your medical faster and simpler in future. For now, nothing has changed: the current Special Issuance process still applies, so talk to an AME early and bring recent reports from your own doctor.
If you're training under EASA or UK CAA rules, this proposal doesn't apply to you. European and UK medical assessments follow their own rules, so ask an aeromedical examiner where you live.
Sources
- Federal Register, "Modernizing Medical Standards for Non-Insulin Dependent Diabetes Mellitus Cases", proposed rule, 4 September 2026: https://www.federalregister.gov/documents/2026/09/04/2026-18162/modernizing-medical-standards-for-non-insulin-dependent-diabetes-mellitus-cases
- AOPA, "FAA proposes ending diabetes special issuance requirement", 10 September 2026: https://www.aopa.org/news-and-media/all-news/2026/september/10/faa-proposes-ending-diabetes-special-issuance-requirement
- Joint industry comments on FAA-2026-10990, 5 October 2026 (published by NBAA): https://nbaa.org/wp-content/uploads/2026/10/20261005-Joint-Comments-Non-Insulin-Dependent-Diabetes-FAA-2026-10990.pdf