UPDATE 3/18/2019:If you have occasion to drive into Canada, please be aware of this update. Commercial drivers with insulin-treated diabetes mellitus are still statutorily prohibited from driving a commercial vehicle in Canada. https://www.fmcsa.dot.gov/international-programs/medical-qualification-requirements
Until recently, if you were prescribed insulin to manage diabetes, you could not get a physical certification to drive a commercial vehicle without a special waiver by the FMCSA.
The FMCSA has issued new rules that allow for a insulin-dependent diabetic to have his or her prescribing doctor complete a standard form confirming that the prescribed treatment is being properly followed by the driver, resulting in stable blood sugar such that there is no concern about the likelihood of an unanticipated loss of consciousness resulting from low blood glucose episodes.
The concern, regarding insulin therapy is that if it is over-dosed for the amount of glucose consumed, it could cause enough of a drop in blood glucose that the patient loses consciousness. In the past, this was not an uncommon occurrence in that managing optimal blood sugar could be challenging in many cases, however with newer realtime blood sugar monitoring and insulin pumps, etc., in a lot of cases that concern has been effectively addressed.
If you have previously participated in the diabetes waiver program opr if you are applying for a commercial license for the first time as an insulin dependent diabetic, be sure to download the form and have your doctor complete it before your next exam. You will find a link to the form at http://alliancedx.com