Flying and Health — Page 112, Lesson 176

Let’s talk about hepatitis C and diabetes — two conditions that have significant implications for flying. First, hepatitis C. This is a viral infection that attacks the liver. It is transmitted primarily through intravenous drug use and shared needles. There is also a risk of maternal transmission — that is, from mother to child during birth — and possibly some forms of sexual contact. Tattooing and immunisation with improperly sterilised syringes are also common causes. The good news is that vaccines exist for hepatitis C. Now, diabetes. There are two main types: type 1 and type 2. Type 1 diabetes is often referred to as juvenile diabetes because it is normally found in young people. In this type, either there is a deficiency of insulin, or the pancreas simply does not produce insulin at all. Insulin is the hormone that controls your blood sugar — your glucose level. People with type 1 diabetes therefore require regular insulin injections to manage their glucose levels. Type 2 diabetes usually affects adults, and pilots are not immune to this condition. It is caused by either the pancreas not producing enough insulin to maintain a normal blood glucose level, or — more commonly — when the body is unable to effectively use the insulin it does produce. That state is called insulin resistance. Research is continuing into how insulin resistance develops, but it is thought that the principal causes are obesity, poor diet, and sedentary lifestyles. Both types of diabetes can also be a result of family history. Let’s look at the symptoms. These include thirst, frequent urination, blurry vision, irritability, tingling or numbness in the hands or feet, frequent skin, bladder or gum infections, wounds that do not heal, and extreme unexplained fatigue. However — and this is important — in most cases of type 2 diabetes, there are no symptoms at all. People can live for months, even years, without knowing they have the disease. This form of diabetes comes on so gradually that symptoms may not even be recognised. Type 2 diabetes can potentially be avoided through diet and exercise. Treatment includes diet modification and control, regular exercise, home blood glucose testing, and in some cases, oral medication and/or insulin injections. Now, the complications of diabetes can be numerous and serious. They include hypertension — that is, high blood pressure; tearing of the retina of the eyes, which can lead to blindness; neuropathy — which is loss of feeling or numbness, especially of the lower limbs and feet; blocked arteries, with associated chances of heart attacks and strokes; kidney failure; and hypoglycaemia — low blood sugar — caused by taking too much insulin, which can lead to a coma. So, for a pilot, any of these conditions — hepatitis C or either type of diabetes — would have to be carefully assessed and managed, because they directly affect your fitness to fly.