Worker standing by a truck

Trucking is an enormous profession—10.7 billion tons of freight per year and the #1 form of employment in the majority of states.

But until recently, people with insulin-treated diabetes—type 1 and type 2—had to go through hoops to earn a commercial driver’s license (CDL).

That’s because they had to obtain an exemption from the Federal Motor Carrier Safety Administration (FMCSA)—the agency that regulates the trucking industry in the United States and is governed to reduce the number of crashes, injuries, and deaths involving large trucks and buses. The process was lengthy: Like, 180 days or longer. This system, the Diabetes Exemption Program, began in 2003.

But in 2018, the FMCSA formally ended the program. What does that mean for people with insulin-treated diabetes who want to earn a CDL? They can obtain a Medical Examiner’s Certificate—the standard certification other drivers must provide to confirm they are physically fit to operate a commercial vehicle.

The physical examination must be conducted by a licensed medical examiner listed on the FMCSA National Registry, and is valid for 12 months.

The new rule represents the first update to the Federal Motor Carrier Safety Regulations on diabetes since 1970, when Breakthrough T1D was founded. From 1970 to 2003, there was a ban on trucking with the condition. In 1970, the FMCSA established that “a person is physically qualified to drive a commercial motor vehicle if that person has no established medical history or clinical diagnosis of diabetes mellitus currently requiring insulin for control”—a blanket ban on all who needed to use insulin. This was due to studies at the time indicating that drivers with diabetes were involved in more crashes than the general population. This has since been rebuked.

So go forth, insulin-treated truck drivers, and let the open roads take you to your journey’s end!