What the examiner looks at
The examiner checks for severe diabetic retinopathy under 49 CFR 391.41(b)(3) and 391.46. For a driver on insulin, the examiner needs the MCSA-5870 and the glucometer records. Three months of records are needed for a full 12-month certificate.
Can an examiner still ask for an A1C?
An examiner may ask for any test needed to decide whether the condition is controlled; the number they act on is their medical judgement, not a federal cutoff.
How long the card lasts
A driver may be certified for up to 24 months. For insulin-treated diabetes the maximum is 12 months (49 CFR 391.45).
What the carrier keeps
The carrier keeps the medical certification in the driver qualification file (49 CFR 391.51(b)).
For the insulin standard in full, read DOT Physical and Diabetes: Insulin, the ITDM Standard, and the MCSA-5870. For tracking the expiration date once the card is issued, read CDL Medical Card Expiration Tracking.