DOT Physical Diabetes Rules: Insulin, A1C, and Certification in Charlotte, NC

DOT Physical Diabetes Rules

FMCSA Diabetes Rules: The Current Standard (2018-Present)

The Department of Transportation (DOT) and the Federal Motor Carrier Safety Administration (FMCSA) no longer require drivers with Insulin-Treated Diabetes Mellitus (ITDM) to apply for a complex waiver program. Effective November 19, 2018, the process was streamlined to focus on two core safety principles:

1. The treating clinician must certify the diabetes is stable and well-controlled.
2. The driver must not have had any severe hypoglycemic episodes (requiring assistance) within the past year.

This regulation is part of the general medical guidelines that diabetic truck drivers must meet to obtain an interstate Commercial Driver’s License (CDL).

The Critical Form: MCSA-5870 Assessment

For any driver using insulin to control their diabetes, the Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870) is the most crucial piece of documentation. Without it, the medical examiner cannot issue a medical card.

Required Documentation for Insulin Users

Bring the following to your DOT physical examination:

• The completed and signed MCSA-5870 form (dated within 45 days of the exam).
• A detailed log of current blood sugar levels (at least the preceding 3 months) showing consistent monitoring.
• Any reports detailing recent vision assessment (required for all diabetic drivers).

A1C Requirements and Acceptable Blood Sugar Levels

While the FMCSA allows the certified medical examiner to make the final determination based on the MCSA-5870, the A1C (Glycated Hemoglobin) test remains a key indicator of long-term control.

When Does Diabetes Disqualify a Driver?

A driver is medically disqualified if the diabetes is considered uncontrolled or if there is evidence of organ damage due to the progressive nature of the disease. Disqualification is temporary if due to poor control, but permanent if due to severe organ damage.

Disqualifying Events and Conditions

• Hypoglycemic Episodes: More than one severe hypoglycemic reaction (requiring assistance from another person) in the last 12 months or more than two in the last 5 years.
• Organ Damage: Evidence of organ damage due to diabetes, including:
  • Profound Vision Impairment (e.g., advanced Proliferative Diabetic Retinopathy).
  • Peripheral Neuropathy (loss of sensation that significantly interferes with vehicle operation).
  • Active Cardiovascular Disease related to diabetes (e.g., congestive heart failure, severe vascular disease).

Your Action Plan to Pass in Charlotte, NC

To ensure a smooth certification process with Dr. Byrd at Charlotte DOT Exam Center, follow these steps:

1. Download & Complete MCSA-5870: Have your treating physician complete the Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870) and sign it within 45 days of your exam date.
2. Verify A1C: Ensure your most recent A1C reading is documented on the MCSA-5870 and reflects stable control.
3. Gather Logs: Prepare a log of your blood sugar readings for the last 3 months.
4. Schedule Your Exam: Call us to schedule your appointment, ensuring you bring all required documentation with you.