Diabetes mellitus type 2 in aviators: A preventable disease

Introduction: The current epidemic of obesity and resultant diabetes mellitus type 2 (DMT2) is a tsunami that will impact healthcare worldwide and lap over into aerospace medicine. Metabolic syndrome (MBS) is the major link between obesity and DMT2. Methods: A review of U.S. Air Force Aeromedical Consult Service (ACS) records was accomplished looking at aviators with a diagnosis of DMT2. Case reports of three flyers with DMT2 are presented and discussed. Other aeromedical agencies were contacted regarding their experiences and this information was summarized. A literature review on DMT2, obesity, and metabolic syndrome was accomplished. Results: Of 70 charts for flyers identified with diabetes mellitus at the ACS between 1975 and 2000, over 95% were for DMT2. The mean body mass index for these aviators was 26.2. Currently, all services grant restricted waivers for some aviators with DMT2, none in high performance, single-seat aircraft. The FAA is currently allowing most flyers with stable DMT2 to operate aircraft in all categories with specific restrictions. Discussion: Obesity and metabolic syndrome are becoming increasingly prevalent in the aviation community. Aggressive actions to limit weight gain and identify those at risk for developing DMT2 must be considered for all populations.