Let me add more information to some of the good points Larry makes and
put in a mild correction.

If you're not in danger of diabetes, you might want to skip this
discussion. We're about to get into stuff that is critical to diabetics
and like talking about our operations to everyone else.



Larry wrote:
> 
> As I've just gone through all the classes on this thing, I want to clear
up a couple
> of points, or at least muddy up the water a little bit.  
>
> First, the target goal for
> blood sugar is 80 to 120.  Below 80 and you are too low and run the risk
of
> headache, dizziness, and even Coma.

Though my endocrinologist agrees pretty well with the upper limit, he
adds more information for me on the lower side. Larry is VERY right that
the dangers of LOW blood sugar are much, much more critical than going
too high. I'd add to his list of low blood sugar symptoms shakiness and
diminished cognition and judgment before unconsciousness.

It is CRITICAL to avoid extreme lows.

The FAA REQUIRES that the diabetic must not have had any instances of
low blood sugar where help was required in the last x years.  In fact,
when an insulin using diabetic is allowed to fly, we/they must keep the
blood sugars between 100 and 300. If we were to slip below 100, we are
required to take glucose pills (and always have them in the plane) or
other food to quickly get above the 100 number.  In other words, when
flying, an insulin using diabetic needs to eat poorly or use less
insulin to be sure to be well in the middle of the 100-300 range.

My endocrinologist certainly doesn't want the bottom of my range to stay
above 100, but for a day once in a while it won't damage my tissues
much.

Insulin using diabetics must have a recording meter (for evidence) and
do a test before take off, once each hour during the flight, and before
landing. (There are special exceptions for dangerous flying situations
-- fly the plane first!)

Tight control is strongly encouraged by diabetes specialists. Larry's
right that 120 is the preferred upper limit, I've also heard 130 quoted.
My endocrinologist doesn't seem at all worried by my readings in the 70s
and 60s. Admittedly, I have few readings in the 60s. Perhaps he allows
me more slack because I get clear warnings of low blood sugar, but he's
never criticized my readings in the 70s and high 60s. 

When I, occasionally, eat much better quality or a lot fewer calories
than that for which my treatment is designed, and go too low, I feel it
when I get below 70.  It'll wake up out of a deep sleep if I drop below
60. The FAA requires that insulin using diabetics be able to feel the
onset of low blood glucose.



> Above 120, and you run the long term risks
> associated with Diabetes. (too many to list).

Absolutely right. Sugar is toxic in high levels and destroys tissues.
The higher you go, the higher the risks, running to MULTIPLES of the
chance non diabetics have for heart attack, stroke, blindness, and more.



> As I understand it, the FAA
> requirement to keep your Medical current is that your blood sugar is
above 150, not
> below it.  As one member so aptly put it some time ago, it's not the
Diabetes that
> keeps you from flying, it's the cure.  Even extremely high blood sugar
levels will
> not cause you to be a hazard in the air.  The hazard comes from the
overly low
> levels, in that you could pass or become disoriented in the air.

The FAA has NO requirement that we stay above 150. The rules for insulin
using diabetics are listed above. Larry's right about the high levels,
too.  Before the medical when I lost my medical, even when I was often
or usually in the 400-600 range, my thinking wasn't apparently affected.
I did challenging mental work that year in between trips to the drinking
fountain and the rest room. However, I think I've heard that at very
high levels, cognition is affected some.

But diabetics aren't allowed to just go along with high blood sugars. I
know the (fuzzy and not rigorously defined) rule for insulin using
diabetics: our HbA1c should/must be less than 20% above the upper limit
of the normal range of the lab doing the test. For the lab that does my
tests, normal + 20% comes to around 9.0. The HbA1c is the test that
shows the average of the previous 6-12 weeks -- a deception (and self
deception) proof test.

Oral-medication-only diabetics aren't so tightly regulated.

-- 
Ed Burkhead
Peoria, Ill.
Ercoupe N3802H, 415-D

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