Diabetes and your DOT Medical Card

Dr. Paul McLemore D.C.
National Certified Medical Examiner

Diabetes and your DOT Medical Certification

Drivers that do not use insulin can be certified unless they have a disqualifying complication, or they fail to meet one or more of the standards. OR they have been approved for the Insulin exemption waiver.

The role of the Me is to assess risk for a severe hypoglycemic episode because this is the most critical safety issue.

Glycosuria (glucose in your urine) may indicate poor glucose control. If the urine dip stick shows TOO much glucose in your urine, you may be required to see your treating doctor to re-access your meds. And then be required to get your glucose under control before receiving a DOT Medical Card. A urine dip stick is the least accurate test available and if it shows glucose to be present in your urine the Medical Examiner may elect a finger stick test for a random blood glucose test.
Bring your finger stick and glucose monitor.

The ME will certify CDL Driver Only If ::
• Meets all physical qualification standards
• Has a treatment plan that manages the Diabetes disease and does not Include the use of insulin
• The diabetes does not Interfere with safe driving
• Biennial (every two years) medical exam from their treating doctor
Certify the CDL Driver for : one year Note: Because of the progressive nature of diabetes mellitus, FMCSA believes that
1 year certification is reasonable for drivers with a diagnosis of diabetes mellitus.

Do Not Certify CDL Driver Only If ::
• Within the last 12 months, the driver has a hypoglycemic event resulting in:
• Seizure
• Loss of consciousness
• Need of assistance from another person
• Period of impaired cognitive function that occurred without warning
• In the last 5 years, has had two or more disqualifying hypoglycemic events
• Loss of position sensation
• Loss of pedal sensation
• Resting tachycardia
• Orthostatic hypotension
• Diagnosis of peripheral neuropathy (excluding temperature loss)
• Diagnosis of proliferative retinopathy (unstable proliferative or non- proliferative)

Do not certify until any treatment is shown to be adequate, effective, safe, and you are stable


Peripheral Neuropathies

Peripheral neuropathy may be a complication of diabetes mellitus. Medical Examiner should evaluate sensory modalities of pain, light touch, position and vibratory sensation in the toes, feet, fingers, and hands for signs of peripheral neuropathy

Certify CDL Driver Only If ::
• Neuropathy may be treatable or non-progressive. Decision not to certify should include: – Evaluation by neurologist or physiatrist – Specialist may recommend simulated driving skills test or equivalent functional test – Annual recertification that repeats specialist evaluation and driving test if indicated.

Do not Certify CDL Driver Only If ::
Diagnosis of Peripheral Neuropathy.
Diabetes neuropathy is acceptable if limited to temperature sensation loss only.

IMPORTANT
In the past if you were unhappy with the results of your DOT physical exam you could simply go down the road and get another. NOW the DOT Medical Examiner is required to enter your Exam results into the DOT National Database as either qualified, not qualified, or temporarily disqualified. So any problems must be resolved with the original Medical Examiner before an acceptable medical card can be issued to the driver.

Dr. Paul McLemore D.C.
National Certified Medical Examiner

Dr. Paul McLemore R.M.T., E.M.T., B.S., B.S., M.S., D.C.
Certified in acupuncture
Fax (940) 644-2067
Texas State Chiropractic License 8843
National DOT Medical Examiners Certificate 8404451981


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