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Pilots with Diabetes: the inside story behind this exciting cause

Have you heard about Pilots with Diabetes? They’re a group of dedicated pilots who want to change Civil Aviation laws in South Africa.

We spoke to Jonathan Collins to find out more…

What is Pilots with Diabetes?

We are advocates for all pilots with all types of insulin treated diabetes – Type 1 and Type 2. Pilots with Diabetes SA is a movement that has been formed to raise awareness of legislative challenges we are faced with, when applying to be certified as medically fit by the South African Civil Aviation Authority (SACAA). We want to further the South African aviation landscape for all existing and aspiring diabetic pilots. Existing pilots who have been diagnosed and lay the foundations for aspiring young people who want to pursue a career in aviation. 

pilots with diabetes sa

Why did you start it?

In early 2020, I was diagnosed with Type 1 Diabetes. This put an abrupt and premature end to my airline career at a very young age – I was only 28 years old at the time. After applying to the SACAA Aeromedical Committee, they initially declared me “permanently medically unfit” to fly as an airline pilot. This was extremely disappointing for me, as I’m passionate about flying and all types of aircraft – big or small.  

I quickly realised that there must be other pilots that have also succumbed to a similar diagnosis. Perhaps they were diagnosed before access to CGM (thanks @bete_it and!) and new therapeutic interventions that have revolutionised diabetes management. This motivated me to form the movement to find others and build a presence in the diabetic community.

Why is having Type 1 diabetes an issue for pilots?

pilot with diabetes jonathan collins

Type 1 diabetes is actually not an issue for pilots. Worldwide there are accepted protocols (rules) and practices that allow pilots to fly commercially under certain conditions. The South African national legislation was last updated in 2015 and is the only obstacle in flight path before we can be re-certified to fly commercially.

We are optimistic that this legislation can be reviewed and updated as there is supporting research and tangible evidence from international aviation authorities that represent some of the biggest aviation regulators in the world. They are: Australia, Austria, Canada, Ireland, the UK and the USA. Their modern approach to medical certification is considered “international best practice”. It demonstrates that our national legislation has not moved with the times, and has not considered new therapeutic treatments in diabetes management such as access to CGM technology.

What do other countries do?

Each country listed above has a national aviation authority that has developed a medical “protocol”. A protocol is a set of rules and guidelines that allows a pilot to be certified as medically fit to fly commercially – usually with certain restrictions.

An example of a restriction would be limiting an insulin dependant diabetic pilot to fly with a co-pilot when operating in a scheduled airline service type of operation. Some of the rules would dictate how regularly a pilot must test their blood glucose. Typically this would need to be done before signing on for duty, before and during the flight, repeating this check every 60 minutes and just before landing. The blood glucose value would need to be shared with the other pilot, the cockpit voice recorder and also recorded in the pilots logbook. This certainly creates a heightened awareness of the pilot’s blood glucose to safely conduct the flight. Each international aviation authority has slightly different rules, but on average the international best practise for blood glucose tolerance is between 5.0 mmol/l and 15.0 mmol/l. An HbA1C of 8.5% or less is recognised by all the regulators as being the upper limit for medical certification. This is extremely achievable with good diabetes management. 

What are you suggesting for South African Pilots with Diabetes?

We have explored overseas legislation and international best practice and amalgamated it into a set of rules and guidelines that we can apply in a South African context. Fortunately for us, the South African Civil Aviation Authority is one of the most progressive and forward thinking aviation authorities in Africa and recognised as being one of the top 10 in the world. We look forward to engaging with them meaningfully and adding value to the development of a protocol that furthers South African aviation and furthers the lives of all diabetic pilots and aspiring young aviators with diabetes!

cockpit with insulin

How can we help?

We really want to raise awareness within the diabetic community and people interested in aviation. We are challenging beliefs of what diabetic people can do.

There is an old aviation cliché that says, “The Sky is the Limit”. In our circumstances, the only limit we should have to observe is how well we control our blood glucose levels while flying.

The public at large needs to realise that diabetic people should not be limited by the condition they have, and that they can fulfil their lives to the maximum. We would sincerely appreciate it if your followers could participate in our movement by signing our petition and following our cause on all our social media platforms.

Sign the Pilots with Diabetes petition here!

Pilots with Diabetes South Africa

How can we follow your cause?

We would love to be in touch with any of your community members, whether diabetic or not, who LOVE flying and are absolutely “plane” crazy.
We can be contacted on Facebook: PilotswithDiabetesSA
Or Instagram:

pilots with diabetes petition


The SACAA has invited Pilots with Diabetes to a meeting on the 26th March 2021!

What to read next?

What are Type 1 and Type 2 diabetes? Finally! An easy explanation.

What is a CGM? Flash glucose monitoring and CGM: Not sure what the difference is, or what these words mean? Read this article.

We did it! How to claim the Discovery CGM Benefit: A step-by-step guide to claiming the new CGM Benefit.

What to read next
Join South Africans with Diabetes on Facebook

Join our diabetes community

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Sweet Life is a registered NPO/PBO (220-984) with a single goal: to improve diabetes in South Africa. We are funded by sponsorships and donations from aligned companies and organisations who believe in our work. We only share information that we believe benefits our community. While some of this information is linked to specific brands, it is not an official endorsement of that brand. We believe in empowering people with diabetes to make the best decisions they can, to live a healthy, happy life with diabetes.