Insulin Treated Diabetes Mellitus 2019 Update

On September 19, 2018, Federal Motor Carrier Safety Administration (FMCSA) published the Qualification of Drivers; Diabetes Standard final rule adopting a revised physical qualification standard for operators of commercial motor vehicles (CMVs) with insulin-treated diabetes mellitus (ITDM) (83 FR 47486). The revised standard lifts the blanket prohibition on insulin use and provides that Certified Medical Examiners may evaluate and determine, with input from the treating clinician, whether to issue a Medical Examiner's Certificate, MCSA-5876, to qualify the driver to operate a commercial motor vehicle in interstate commerce. The effective date of this final rule is November 19, 2018.

In light of the final rule, FMCSA has determined that an exemption program for ITDM individuals is no longer necessary. The Agency intends to publish a Federal Register notice to withdraw the 2003 final disposition (68 FR 52441) and the 2005 revised final disposition (70 FR 67777) notices concerning the decision to issue exemptions to certain ITDM individuals. Once published, FMCSA will send notification to all Certified Medical Examiners.

FMCSA encourages all certified medical examiners to familiarize themselves with the revised rule and begin medical certification of ITDM individuals under the new rule. Please note that the final rule stated that the Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870 is posted on the FMCSA and National Registry websites. In addition, FMCSA will conduct webinars for Certified Medical Examiners to provide an overview of the final rule. The pre-recorded webinar is currently available at the following link:

The NRCME Training Online program and spiral bound study guide book have been updated to reflect changes in the 2019 Diabetes Standards.

The new Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870 can be downloaded here:


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