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:


National Registry of Certified Medical Examiners Remains Offline



The Federal Motor Carrier Safety Administration’s (FMCSA) website used by medical providers to obtain their certification as a NRCME medical examiner is down indefinitely according to a press release from the FMCSA.

“The National Registry of Certified Medical Examiners website is currently down,” the website said. “FMCSA IT Support is aware of the issue and is working on a solution to remedy the situation. Once the site returns to service, a notification will be sent to all certified medical examiners. We suggest drivers and carriers continue to visit the site periodically to determine availability.”

The FMCSA’s National Registry of Certified Medical Examiners online system was hacked that prompted its outage. Concerns about the vulnerability of drivers’ and examiners’ data were raised. The FMCSA on January 9 ensured that the data was protected, and apparently, nothing sensitive was stolen. We will post an update when the NRCME website returns to functionality. In the mean time continue to check for updates on the national registry website located at:

Update Regarding Posting and Use of Driver Examination Forms

 NRCME DocumentationAs a result of the unexpected delays in posting the final versions of the newly revised driver examination forms and recognizing that MEs need to have access to the forms prior to the effective date for a number of reasons, FMCSA will allow MEs to use both the current and newly revised versions of the Medical Examination Report Form and Medical Examiner's Certificate from December 22, 2015 until April 20, 2016.

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