If a diabetic truck driver is suddenly impaired by an an episode of hypoglycemia he can potentially loose control of his vehicle and crash. Hypoglycemia is a condition in which blood glucose drops to a dangerously low concentration and creates symptoms such as blurred vision, shaking, trembling, unclear thinking, fainting, seizure or coma. Too much insulin relative to the amount of glucose in the bloodstream can cause blood sugar levels to drop too low, resulting in hypoglycemia. Drivers with stable, well-controlled insulin-treated diabetes mellitus (ITDM) usually don’t suffer from these types of episodes and are not considered more dangerous than other drivers as long as their condition is well controlled. However current regulations prohibit truck drivers from operating interstate commercial vehicles unless they obtain an exemption from The FMCSA. The process of obtaining this exemption is costly and time consuming for the drivers and for the FMCSA administration. A notice of proposed rule making would enable truck drivers with ITDM to obtain a Medical Examiner’s Certificate from a Medical Examiner at least annually in order to operate in Interstate Commerce if the Treating Clinician who is prescribing the insulin for the driver can provide documentation that the truck driver’s diabetic condition is stable and well controlled.