This proposed rule was published today 5/04/2015 and may very well be:

The most important this year regarding driver qualification standards.

The immediate link is available by going to Docket ID: FMCSA-2005-23151 at the regulations.gov website or simply clicking this provided link to read the document in full.

Why is this so important?  Insulin treated diabetes mellitus (ITDM) is one of few medical conditions that if not carefully and meticulously treated and monitored in truck drivers can present a significant public safety risk due to hypoglycemia and sudden incapacitation.  The Diabetes Exemption Program currently in place reviews each case on an individual basis and provides the opportunity for public comment when commercial drivers using insulin want to engage in interstate commerce.  Leaving the final decision solely to the medical examiner in lieu of this process is risky for many reasons that is better discussed at a later time.

Speaking from the point of view of a medical examiner, the most important task now I think is for all examiners to read and familiarize themselves with this proposed regulation ASAP.  If passed, the regulation can be a “game changer”, and I am afraid probably not for all the best reasons.  My reservations to this new proposed rule are not only because of the known risk that hypoglycemia can pose to the public, but also whether all medical examiners will have adequate time and resources, and for that matter the ability to properly evaluate such drivers.  On the other hand, the driver will likely incur additional expenses, as it is unlikely that he or she can be certified in one visit, because even more important than before, close consultation and coordination with the driver’s treating physician will be essential to ensure that driver remains compliant with treatment and is medically stable.

Fo now Please read this proposed rule immediately!  Discuss with fellow examiners, drivers, motor carriers, and patient advocate groups, and ultimately all of us should comment on the FMCSA website before the deadline July 6, 2015, regardless of our point of view.  As always, comments to this post are always welcome.

Randolph Rosarion M.D.