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Guidance/Advisory Criteria — Medications

Incretin Mimetic Therapy

An incretin mimetic, such as exenatide (Byetta), is used to improve glycemic control in people with Type 2 diabetes by reducing fasting and postprandial glucose concentrations. An incretin mimetic is indicated as adjunctive therapy to individuals who are taking metformin or a combination of other oral agents. Use of an incretin mimetic in conjunction with a sulfonylurea has an increased risk of hypoglycemia.

Incretin mimetics are not insulin and can be used without an exemption.

Certification/Recertification — Incretin Mimetic

Waiting period

No recommended time frame

You should not certify the driver until the treatment has been shown to be adequate/effective, safe, and stable.

Decision

Maximum certification — 1 year

NOTE: The Federal Motor Carrier Safety Administration (FMCSA) recommends frequent monitoring determined on a case-by-case basis.

Recommend to certify if:

The driver with diabetes mellitus who uses an incretin mimetic:

  • Meets all the physical qualification standards.
  • Has a treatment plan that manages the disease and does not:
    • Include the use of insulin.
    • Have side effects that interfere with safe driving.

Recommend not to certify if:

As a medical examiner, you believe that the nature and severity of the medical condition and/or the treatment of the driver endangers the safety and health of the driver and the public.

Monitoring/Testing

FMCSA recommends that a driver taking an incretin mimetic provide a written statement from the treating health care professional. The written statement should:

  • Describe driver tolerance to the medication.
  • Indicate how frequently the driver is monitored for adequate blood glucose control.
  • Include efficacy of treatment.

Follow-up

FMCSA recommends frequent monitoring of the driver who is taking an incretin mimetic.

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