Case Studies: Optimal Glucose Profiles in Air Traffic Control Officers

Aviation personnel, including air traffic control officers (ATCOs) on insulin, are assessed as unfit in many countries, including most European, due to pending hypoglycemia-related incapacitation risk.However, over the last decades, insulin treatment has become progressively safer through steadily evolving technological advances.Consequently, the Federal Aviation Administration (FAA) in the USA and the European Union Aviation Safety Agency (EASA) in Europe have considered whether aeromedical examiners might assess pilots on insulin as fit for flight under specific protocols.Such a position might pave the way for fit assessment in all insulin-treated aviation officers and ATCOs, who, despite experiencing different environmental stress factors, show the same high commitment to their jobs as pilots.After showing the excellent continuous-glucose-monitoring-proved metabolic profile attained by two insulin-treated ATCOs (one working as apron, the other immediately after being diagnosed), we discuss the literature concerning potential stress-related glucose changes and suggest allowing them to go on working to let the system exploit at best the significant time and financial resources spent in challenging, highly specialized job training given growing reduction in staff for planned retirements in the next few years.