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Truck Drivers with Diabetes – How High is too High?

Blood Sugar 210

Blood Sugar 210

Sites all across the internet are showing that qualification for a CDL truck driver requires a blood sugar reading of less than 200.  I would like for someone, anyone,  to provide me with the link to the regulation that actually shows this to be the case.

According to the FMCSA under Part § 391.41, an applicant is qualified to operate a Commercial Motor Vehicle if he or she :  “Has no established medical history or clinical diagnosis of diabetes mellitus currently requiring insulin for control.”

Again, we must note that truck drivers requiring insulin may still be able to drive under the Federal Diabetes Exemption Program.

Nowhere in the regulations, that I can find, does it specifically state that a commercial truck driver’s blood sugar must be under 200.  Many sites report that the 200 minimum is listed on the CDL Medical Examination Report, which I found to be false as well.

According to Barnes Care, an occupational medicine facility, new DOT Medical Guidelines went into effect on September 30th, 2004.  They note that a CMV driver’s blood sugar reading must:

  • Maintain a fasting blood sugar of 140 or below or . . .
  • Maintain a 2 hour postprandial blood sugar of 200 or less or . . .
  • Maintain glycosylated hemoglobin of 8 percent or less

Word has it that the FMCSA will be moving away from the urinalysis test for sugar and will be going to the A1C blood testing.  Currently, the American Diabetes Association recommends an A1C reading of under 7% for those with diabetes, but actual guidelines for the CDL truck driver has not been established.

  • The “normal” range for blood sugar is typically 70-100 fasting and not over 135-140 after a meal.

Still, actual blood sugar levels required for CMV qualifications are not listed anywhere within the Federal Motor Carrier Regulations that I can find;  only the mention of diabetes mellitus. So where is the “under 200” figure coming from?

Speaking with a local Diabetes Center, I was told that blood sugar readings had the following meaning:

  • 70-140 = normal
  • 140-160 = elevated
  • 160-200 = high
  • 200 and above = dangerous

Anyone with an actual link to the FMCSA regulation showing that qualifying CDL truck drivers must show a blood sugar level of under 200, please provide the link through our “comment” page.

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By: Allen Smith

Allen Smith is a 37 year veteran who started at an early age in a household goods family moving business. He began driving straight trucks in 1977 and moved to the big rigs in 1982. His experience within the industry includes; owner operator, company driver, operations manager, and owner of a long distance HHG moving business, taking many of the long haul moves himself when needed. Allen Smith, a truck driver advocate who is driven by the desire to help others succeed within an industry where injustice, unrewarded sacrifice, and lack of respect and recognition exists. Allen and his wife Donna are hosts of Truth About Trucking ”Live” on Blog Talk Radio. Other websites include AskTheTrucker, TruckingSocialMedia, NorthAmericanTruckingALerts, TruthAboutTrucking, and many Social Media websites. In 2011 Allen and Donna hosted the first Truck Driver Social Media Convention, designed to create unity and solutions for the trucking industry. This is now being extended through the North American Trucking Alerts network as those within the industry join forces for the betterment of the industry. Allen strongly supports other industry advocates who are also stepping up to the plate to help those who share honesty, guidance and direction. He believes that all those involved in trucking need to be accountable for their part within the industry, including drivers, carriers, brokers, shippers, receivers, etc… The list of supporters and likeminded people grow daily, networking together and sharing thoughts and ideas for the betterment of trucking. He has coined the popular phrase "Raising the standards of the trucking industry"

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13 Responses to Truck Drivers with Diabetes – How High is too High?. - Post a Comment

  1. John

    well from what my doctor has instructed never over 160 anything below that is fine but they also told me that if i get as low as 60 70 range that it is getting to low… on the pill and the fed regs do not list anything in numbers

  2. Allen Smith

    Exactly, John. No numbers in the Regs, so why is everyone saying “under 200” ?


  3. George or RolloverRiderPGR sugar reading

    This is the link to the PAGE of § 391.43Medical examination; certificate of physical examination. Diabeti3es is way dow the page and there are NO numbers!

    But FMCSA 391. has all the information on all qualifications of commercial drivers physical and medical and reading thorough it they have NO reference to the 200 number in your question and the website can’t get any more up to date until they change rules again!

  4. Allen Smith

    Thanks George . . . yes, this is the point of the post. No blood sugar levels are listed in any Federal Regulation for the qualifications for truck drivers. Numbers for vision and blood pressure are clearly defined, but not blood sugar.

    All these sites and articles, etc., stating the “under 200” message are false.

    Thanks for your reply,

  5. mYke

    SO what are your requirements for type 2 diabetics in order to get there medical card. I am in michigan, I take oral meds and insulin. where do my numbers have to be to get my card?

  6. PJ

    As of August 4, 2011, I am one of the close to 2,000 insulin dependent diabetics who has been issued a Federal Diabetes Exemption Program waiver. One of the rules is that before driving, your blood sugar must be between 100 and 400. If it is lower than 100 or higher than 400, corrective action must be taken. If under 100, you must take insulin or fast acting glucose and wait 30 minutes. Test again and repeat if necessary until your b/s is 100 or higher. If your b/s is over 400 and it has been more than 2 hours after your last injection and eating, you are to take additional insulin and wait 30 minutes. Re-test and do not resume driving until your b/s is less than 400. You are also required to pull over and test your b/s every 2-4 hours and follow the same procedure. You are required to provide to your endocrinologist, on a quarterly basis, a daily record of your actual driving time to correlate with your daily glucose measurements. You also must have a quarterly report from your endocrinologist, which is provided by the FMCSA, along with your daily driving record and glucose measurements. You are also required to see your optometrist/opthmalogist annually as well as your examine doctor for your D.O.T. physical, which is only good for one year. If anyone is going through this process, good luck and have patience as it is a process that can take up to 180 days. If you have any questions about the program, call 703-448-3094. This is the number for the Federal Diabetes Exemption Program, in D.C. Diana is the contact, and she is very helpful. You have to leave a message and they will get back to you within 2 days.

  7. Dan

    I am a healthcare provider, and came across your website, and thought I would add my “two-cents” for what it’s worth. The regulations mention that a person who has diabetes needs to be shown to be under control. If a person has a random blood sugar 200 or above, then they are NOT under good control. See the website for further information. I also find it interesting and not particularly helpful when the FMCSA leaves we providers out by ourselves when they say that we are ultimately responsible to determine whether we, the examiners, deem the individual being assessed as having an increased risk of being incapacitated. So, there are precious little details to go on, a lot of it is up to our judgement. I think that is why some providers may be found to be more “strict”, and others may be a bit more lenient. I hope that you find this information useful.

    • Demetric Randell

      If a person has a random blood sugar 200 or above, then they are NOT under good control.

  8. gl carney

    does a driver with diabetes not using insulin, but on meds have to have an AIC test to renew a CDL license ?

    • Scott Hyden

      in May my blood glucose was 310 and I was denied a medical card now I’m trying to figure out how low I have to get my number to get a medical card

    • Allen Smith

      Didn’t the Doctor tell you? Call him and ask him.

  9. John

    I have been told A1C must but 8 or under to even be considered for a medical card. 200 average BGL is the maximum average to even come close to a A1C of 8. Doctors doing medical certifications generally want to see more then one good A1C below 8 to consider the person in control. Since truck driving is unhealthy anyway for diabetics overall. It’s important for the doctor to see a ability to control the blood glucose levels.

  10. Steve

    there is NO a1c cut off level per the FMCSA regulations. Indeed the prior comment form above doctor is correct in saying “good control” but that is a subjective statement and it varies from one provider to another. The FMCSA suggests that Insulin requiring diabetes be less than 10% but that statement was not applied in like fashion to the paragraph discussing non-insulin requiring diabetes. It all seems confusing to the drivers/ their companies and even to the examiners themselves. I suppose at some point the ADA is going to lobby to get the A1c around 7.2. FMCSA will probably negotiate a level between 7-8 % (using blood pressure as an example of letting things be a little higher than medical guidelines would suggest). Problem with all of this is that there is not research data saying a particular driver with a particular a1c level is at a higher risk of crash than say another comparable driver with a lower A1c level. Obese driver were at higher risk and DM is associated with obesity but were factors other than sugar contributing (perhaps sleep apnea)?
    Anyways, I think if you want to be on the safe side of dm care, you should try to lose weight , and keep sugars around 7.2% on our A1c. That way you are not so tight you run risks for hypoglycemia which IS dangerous on the road. Keep on truckin 🙂

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