---
title: "ATCO.MED.B.025 Metabolic and endocrine systems — ANNEX IV – PART ATCO.MED – MEDICAL REQUIREMENTS FOR AIR TRAFFIC CONTROLLERS, ATCO · Avioverse"
description: "Applicants with metabolic, nutritional or endocrine dysfunction may be assessed as fit subject to demonstrated stability of the condition and…"
url: "https://avioverse.aero/regulations/easa/atco/part-atco-med-medical-requirements-for-air-traffic/subpart-b/atco-med-b-025"
---

# ATCO.MED.B.025 Metabolic and endocrine systems

ANNEX IV – PART ATCO.MED – MEDICAL REQUIREMENTS FOR AIR TRAFFIC CONTROLLERS · Regulation (EU) 2015/340 · EAR revision 14 Jun 2024

IR Implementing rule

## ATCO.MED.B.025 Metabolic and endocrine systems

(a) Applicants with metabolic, nutritional or endocrine dysfunction may be assessed as fit subject to demonstrated stability of the condition and satisfactory aero-medical evaluation.

(b) Diabetes mellitus:

(1) Applicants with diabetes mellitus requiring insulin shall be assessed as unfit.

(2) Applicants with diabetes mellitus requiring medication other than insulin for blood sugar control shall be referred to the [licensing authority](https://avioverse.aero/glossary/easa/licensing-authority). A fit [assessment](https://avioverse.aero/glossary/easa/assessment) may be considered if it can be demonstrated that blood sugar control has been achieved and is stable.

IR · ATCO.MED.B.025 — Regulation (EU) 2015/340 · ATCO Easy Access Rules · EAR revision 14 Jun 2024

AMC Acceptable means of compliance

## AMC1 ATCO.MED.B.025 Metabolic and endocrine system

(a) Metabolic, nutritional or endocrine dysfunction

Applicants with metabolic, nutritional or endocrine dysfunction may be assessed as fit if the condition is asymptomatic, clinically compensated and stable with or without replacement therapy, and regularly reviewed by an appropriate specialist.

(b) Obesity

(1) Applicants with a Body Mass Index 35 may be assessed as fit only if the excess weight is not likely to interfere with the safe exercise of the privileges of the [licence](https://avioverse.aero/glossary/easa/licence) and a satisfactory cardiovascular risk review and evaluation of the possibility of sleep apnoea syndrome has been undertaken.

(2) Functional testing in the working environment may be necessary before a fit [assessment](https://avioverse.aero/glossary/easa/assessment) may be considered.

(c) Thyroid dysfunction

Applicants with hyperthyroidism or hypothyroidism should attain a stable euthyroid state before a fit assessment may be considered.

(d) Abnormal glucose metabolism

Glycosuria and abnormal blood glucose levels require [investigation](https://avioverse.aero/glossary/easa/investigation). A fit assessment may be considered if normal glucose tolerance is demonstrated (low renal threshold) or impaired glucose tolerance without diabetic pathology is fully controlled by diet and regularly reviewed.

(e) Diabetes mellitus

(1) The following medication, alone and in combination, may be acceptable for control of type 2 diabetes:

(i) alpha-glucosidase inhibitors;

(ii) medication that acts on the incretin pathway;

(iii) biguanides.

(2) A fit assessment may be considered after evaluation of the operational environment, including means of glucose monitoring/management whilst performing rated duties, and with demonstrated exemplary glycaemic control.

(3) Annual follow-up by a specialist should be required including demonstration of absence of complications, good glycaemic control demonstrated by six-monthly HbA1c measurements, and a normal exercise tolerance test.

AMC · AMC1 ATCO.MED.B.025 — Regulation (EU) 2015/340 · ED Decision 2015/010/R · ATCO Easy Access Rules · EAR revision 14 Jun 2024

[All rules in SUBPART B – SPECIFIC REQUIREMENTS FOR CLASS 3 MEDICAL CERTIFICATES](https://avioverse.aero/regulations/easa/atco/part-atco-med-medical-requirements-for-air-traffic/subpart-b)

Consolidated from the EASA Easy Access Rules (revision 14 Jun 2024, extracted 13 Oct 2026) for convenience. Not the official publication — verify against the Official Journal of the European Union and the EASA publications before operational use.