Diabetes mellitus, advances and their implications for aerospace medicine

The authors describe a case of Type 1 diabetes mellitus (insulin dependent) in a 34-year-old fighter pilot, which included a 15-month remission ('honeymoon period'). The pathogenesis, characteristics, diagnosis, evaluation, and the aeromedical implications of Type 1 diabetes are discussed. The use of C-peptide values in accessing beta cell function is also discussed. The risk of poorly controlled diabetes, diabetic ketoacidosis, and visual acuity fluctuations were major reasons to disqualify this individual when in remission. The importance of determining the type of diabetes for prognosis and aeromedical disposition is stressed.