Most CMV drivers are confused about the rules pertaining to insulin use. Because of past DOT regulations, many drivers think that you can not continue to drive if they are on insulin. In many cases leaving their condition untreated so they can continue to drive. This is extremely dangerous and unnecessary.
CMV drivers have diabetes mellitus (DM), specifically Type II DM, at a higher rate than the general public. This is likely rooted in the sedentary lifestyle and poor food choices many drivers make. Because of this some driver’s diabetes can be treated with simple lifestyle and diet changes. Others are required to receive oral medications or insulin.
Many years ago, the FMCSA automatically disqualified drivers if they were dependent on insulin to treat their DM. At one point, the agency began to allowed individuals with ITDM (insulin-treated Diabetes Mellitus) to drive professionally, but only after jumping through significant hoops and obtaining a federal exemption. Resulting in many drivers avoiding the process and leaving their diabetes untreated.
As of November 2018, FMCSA has streamlined the process. Drivers need only to complete the DOT medical exam with an additional form, but there is no need for a federal exemption. This also has reduced significantly the financial burden of getting cleared to drive.
The driver needs to provide form MCSA 5870 (available at fmcsa.dot.gov) to the insulin-prescribing physician and bring the completed form to their next DOT physical. Based on how well maintained the driver’s DM is on an insulin regimen, the CME can then grant a medical certificate for up to 12 months.
When performing DOT Medical Exams, I often see patients with poorly controlled DM who are on a variety of expensive and sophisticated medications. They often say, “My doctor really wants me on insulin, but I can’t drive on it.” I usually send these patients on their way with the new form and their physicians most likely start them on an insulin regimen. Most return with improved diabetic control and better health.
Drivers, don’t be afraid to start insulin if your doctor recommends it!