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DOT A1C Guidelines

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Published on May 30, 2023, 10:18 a.m.


Here are essential DOT A1C guidelines to keep in mind:

  • According to DOT A1C guidelines, drivers with diabetes must have an A1C level of less than 8.4% before operating a commercial motor vehicle (CMV).
  • Drivers must submit proof of their lab results in the form of a current laboratory slip or report.
  • If the driver's A1C exceeds 8.4%, they may be disqualified from operating CMVs and must schedule a follow-up test within 30 days.
  • To qualify for certification after 30 days, the driver must have an A1C at or below 8.0%.

  • The medical examiner can also request additional tests or issue restrictions if they believe someone has an impaired ability to operate a CMV.


If you drive a commercial vehicle weighing over 10,000 pounds (CMV), you must pass the Department of Transportation (DOT) physical. While there's no need to be fearful of the exam, if you have diabetes or suspect you do, it may raise some concerns about your eligibility. Regardless if this is your first DOT physical or fifth, it's best to become familiar with the rules concerning diabetes and blood sugar levels. The exams must be done every 24 months, so preparation is vital!

Does a DOT Physical Do Diabetes Testing?

Say you drive a commercial motor vehicle. Your physician needs to check for any signs of diabetes. An unchecked diagnosis can cause fatigue, stress, and sluggishness, which can make driving a CMV dangerous. In the worst cases, untreated diabetes can lead to hypoglycemia - possibly resulting in loss of consciousness or seizure. To keep yourself safe and stay in control while behind the wheel, it's essential to identify if you have diabetes and get it under control. If your physician believes you may have diabetes, they will likely recommend further investigation.

Your DOT medical examiner will need to know if you have a history of diabetes or if you are currently managing high blood sugar levels with dietary changes, medication, or insulin. They'll also look for any other indications of diabetes and test your urine for sugar. This is all part of the exam to ensure you're fit to operate safely while on the job.

Can I Pass My DOT Physical While Having Diabetes?

Having diabetes doesn't mean you can't pass a DOT physical exam. However, it is essential to note that if your symptoms of diabetes meet any of the four objective disqualifiers, you will not be able to pass the test. These disqualifying conditions include severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy. If you have any of these, it's best to talk to your doctor about other options for passing the exam.

For those with diabetes or a medical condition such as hypertension, annual DOT physicals are required to ensure that you remain qualified to operate large commercial vehicles. Additionally, yearly eye exams must also be taken due to the possibility of vision impairment caused by diabetes. Keep your health up-to-date and stay safe on the roads!

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Can I Pass the DOT Physical Even Though I Have Type 2 Diabetes?

If you are managing your diabetes and keeping it under control, you can likely get the green light from your medical examiner to operate a commercial motor vehicle. You must bring them all of your relevant information so they can make an informed decision. With proper maintenance and monitoring of your health, there's no reason why you shouldn't be able to drive safely!

Does the DOT Have Blood Sugar Requirements?

Are you worried about having high levels of sugar in your urine? If you haven't been officially diagnosed with diabetes, but know or suspect you have higher-than-normal blood sugar levels, it's essential to be aware that a physical exam can detect this. Typically, the result should be lower than 8%, while a healthy person usually has less than 5.7%. Knowing this information in advance can help ensure your results are within the expected range.

Per the DOT, What Are Acceptable Blood Sugar Levels?

Suppose your blood sugar level is between 5.7% and 6.4%. In that case, you may be considered pre-diabetic, which could lead your medical examiner to refer you for further investigation or monitoring or suggest lifestyle changes. Although this won't necessarily prevent you from passing the DOT physical, monitoring your blood sugar levels is essential so they don't rise too high before your next checkup. If your levels are below 5.7%, then you're within a normal range.

Conclusion: A1C DOT Physical Guidelines

Hemoglobin A1c is a type of blood sugar that can be detected in urine tests. It is an indicator of poor glucose control, which may occur if you have uncontrolled diabetes. The A1c limit for physical exams is 10%. Therefore, it's important to keep your A1c levels within this range. Doing so can maintain good health and reduce the risk of diabetes-related complications.

If your A1c level exceeds 8%, your medical examiner may express concern about your health and refer you for additional tests or monitoring. However, your A1c must be below 10% to pass the DOT physical. This guideline should be taken seriously since it helps ensure that drivers are in good health and can safely operate a vehicle. Handling this requirement appropriately will help to keep everyone on the road safe.

Say that you're still yet to be diagnosed with diabetes. There are steps you can take to lower your A1c levels. Eating smarter and limiting portion sizes will help reduce the amount of sugar produced in your cells, leading to healthier A1c numbers. Avoid sugary snacks and choose nutrient-rich options; that way, your cells will have all the energy they need without relying on excess sugar. With a few simple changes, you can start gaining control over your blood sugar levels.

​​​​​It's important to remember that your medical examiner is on your side. They want to ensure you're healthy and safe to operate a commercial motor vehicle, both for your safety and the safety of others. If it turns out that you have high A1c levels, it's essential to talk to your doctor about what steps you can take to bring them under control.

If you fail due to uncontrolled diabetes or high A1c levels, don't worry - as long as they are brought back down, you'll be able to reapply for the DOT physical again. So don't give up - follow the advice from your physician and work towards getting back into compliance with the DOT requirements!

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Summary: What Are the DOT's A1C Guidelines?

  • The A1C test measures average blood glucose levels over the past two to three months and is used to diagnose diabetes.
  • The U.S. Department of Transportation (DOT) recommends that all commercial drivers have an A1C test done once per year, with 6.5 percent or less results indicating reasonable glycemic control.
  • Drivers with an A1C result between 6.5 and 8 percent must provide additional information regarding their medical history, lifestyle habits, and other relevant conditions before being allowed to operate a commercial motor vehicle.
  • Drivers with an A1C result in higher than 8 percent will be disqualified for the duration of their physical exam but can reapply at any time under certain circumstances.

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