Ever dream of working in aviation or becoming a pilot with type 1 diabetes, but think maybe it's not possible?

Today we're thrilled to introduce Angela Lautner, a longtime type 1 in Kentucky who's bucking that trend; she holds a private pilot's license and works in the aviation industry, meaning she has insider knowledge about navigating the skies with diabetes both personally and professionally. We've reported in the past on how the United States is behind many other countries that allow T1's to hold a commercial pilot's license. A federal lawsuit continues pushing for this certification for American pilots with diabetes, but it remains prohibited for now.

Here's what Angela has to say about that roadblock, and how she manages her own diabetes while being able to pilot smaller private planes...

On Aviation Careers and Becoming a Pilot with T1D, by Angela Lautner

For as long as I can remember, I have always looked up to the sky with wonder and joy. It might have been a quick glance at an airplane moving overhead, or stopping everything to happily watch as a rocket launched into space.

For those of us who have our hearts in the sky, we know that there is nothing like the joy we feel when an aircraft finally tells gravity to take a hike, the tires slowly depart the runway, and flight becomes a reality.

Becoming a pilot was all I ever wanted to do. 

In the Summer of 2000, when I was a young lady in my early 20’s and an aspiring commercial airline pilot, I was working my way through flight training as a private pilot to begin my journey to the flight deck of an airliner. At that time, I worked full-time as a baggage handler and customer service agent for an airline as a way to surround myself with like-minded individuals who were all passionate about one thing: airplanes.

Then, diabetes entered the picture.

I had just returned from Memphis where I had finished a temporary duty assignment of short-term staffing for ground support operations at the airline’s hub. During this two-week assignment, I'd lost a lot of weight, noticed a significant increase in the amount of water I had to consume, and was simply fatigued. Within 48 hours of returning home, I was so weak and ill that I couldn’t leave my home. I knew that something was terribly wrong, but had no idea that I was about to be diagnosed with something that was going to forever change the path of my life.

On a Sunday afternoon, my mother drove me to an urgent care facility. Based on the symptoms I was providing the nurse, they immediately checked my blood sugar and started to inject insulin into me to lower my blood sugar. I don’t remember the exact reading, but I do remember it being close to 600 mg/dL.

That day in the urgent care, I was given a diagnosis of type 2 diabetes. But as the weeks passed, the pills I'd been given to hopefully lower my blood sugars were not helping at all. Eventually, another doctor diagnosed me with type 1.

Because I'd been working on my license to be a Private Pilot at the time, I had already reviewed the regulations and requirements to maintain an FAA flight medical requirement for all private and commercial pilots in the United States. The federal regulations define three different medical class requirements based on the type of flying you do, and recently a fourth option has been added for recreational pilots.

For someone like me, who aspired to be a commercial pilot, if you're taking any insulin at all, you are not able to obtain a Class 1 flight designation -- the highest a pilot can achieve and the designation needed to be a commercial pilot.

No more commercial piloting in my future, unfortunately.

For those with T1D wishing to be a private pilot or flight instructor, you must apply for a special flight medical designation issued by the FAA. That means you must provide documentation showing the following:

  • You haven't had more than two episodes of hypoglycemia in the past five years;
  • Have had no hypos in the preceding year that led to unconsciousness or impaired cognitive function requiring intervention;
  • Provide copies of all medical records relating to diabetes;
  • Include a completed report by your treating endocrinologist that covers all A1C lab results, insulin dosage requirements, and verification that the applicant has been educated in diabetes control and understands actions to be taken for severe hypoglycemia;
  • Provide a letter from their treating ophthalmologist regarding any complications, including neuropathy, that may occur and potentially impact flying.

If approved, the FAA gives specific guidance to blood sugar management before and during flight.

For me, the use of Continuous Glucose Monitors (CGMs) allows for much safer operation of the aircraft during the times that the FAA states we must check our blood sugars, ensuring that we aren't operating at levels that are too low or too high. It is a challenge to pull out a meter, prick yourself, and manage the safe contamination of needles and test strips in a single pilot environment. It is also a challenge with another pilot in the flight deck who can be nervous about seeing needles and blood.

Every time I am anticipating a flight with other crew members, I have to explain my situation before flight to ensure education and awareness. Not one pilot or flight instructor has ever not agreed to fly with me because of my requirements to maintain safe blood sugar levels.

Fortunately, all of that led me to obtaining my special medical issuance needed to be a private plane pilot and instructor. Even though I continued my training and received an FAA Instrument Rating and Commercial Pilot certificate, I cannot be a commercial pilot as the system is set up now.

Yes, I still plan to finish my training as a flight instructor (which doesn't fall under the same medical restrictions as commercial pilots do), as it affords me the opportunity to continue to fly airplanes while being able to make a little bit of money on the side.

Honestly, the only reason I have not yet finished that training is due to the amount of layoffs and job losses over the past several years -- largely due to mergers and volatility in the airline industry.

After being diagnosed with T1D and facing the stark realization that I was not going to be able to attain my dream to be a commercial pilot, I had quite a few pilots in my inner circle advising me about another position that may not be quite as awesome as an airline pilot, but still exciting. It's something known as a "flight dispatcher" -- the people whose job it is to plan routes and required fuel for all flights operating on behalf of an airline. These flight dispatchers have assigned flights and really have responsibilities that only the flight's captain shares -- maintaining control and awareness of each flight, even after the planning phase has finished, prior to departure and until the aircraft is parked again at its destination.

I truly enjoy working alongside the multiple groups of people it takes to just get an airplane to push back from its gate, and the people we must work alongside (and sometimes negotiate with) during the duration of flight to ensure its safe completion.

Fortunately, the FAA does not issue any medical requirements for the dispatcher position, and it would allow me to keep my heart in the flight deck of the aircraft throughout the many decisions we make daily. Being a T1D still presents challenges in my career, as it does any other career, of course -- mainly, dealing with the continuing challenge of maintaining balanced blood sugar levels with shifts that cross all hours of the clock depending on where we're flying.

I'm hoping that before long, the U.S. catches up to other places in the world allowing for pilots with T1D to get commercial pilot licenses. As of Fall 2016, that's allowed in Canada and the UK and it's being fought for here in the U.S.

The American Diabetes Association (ADA) is one organization working with both the Aircraft Owners and Pilots Association (AOPA) and American Airline’s Allied Pilots Union, to get updated FAA guidance for pilots with diabetes and also present legal arguments in lawsuits relating to commercial pilots with diabetes. Specifically, the AA is currently involved in the case of former commercial airline pilot Eric Friedman, who has T1D and sued the FAA regarding denial of his request to maintain a flight medical status as a commercial pilot. In 2016, he took his case to the U.S. Circuit Court of Appeals in Washington D.C., and that lawsuit continues pending (updates on that case are online at the ADA's "pilots and diabetes discrimination" website).

From my own personal experience, it takes a long time for things to change in aviation. But the continued fight may help our next generation with T1D realize a dream that I was not able to.

For now, even with the restrictions on commercial flight for those using insulin, I fully believe it's important for pilots with diabetes to share their stories. Never give up on your dreams. Just because the answer may be no at the moment, it doesn't mean it will always be that way. And even if it remains the same, there are opportunities to find a way to let your passion shine through, make the best of it and set your sights on the skies where you heart is.


Thanks for sharing your story, Angela! Glad you found a related career path to keep you involved in aviation, and we'll look forward to a day when D-peeps using insulin can actually become commercial pilots.