Can I Pass a DOT Physical with High Blood Pressure or Diabetes?

Can I Pass a DOT Physical with High Blood Pressure or Diabetes?

High blood pressure and high blood sugar levels are common conditions that many truckers deal with since cardiovascular disease is the leading cause of medical illness and sudden death in drivers who operate commercial motor vehicles.

To drive a commercial motor vehicle (CMV) over 10,000 pounds, you need to pass a DOT physical, which ensure that drivers are in good health to do their job safely.

DOT physical are simple medical exams, but if you have diabetes or are worried about high blood pressure or high blood sugar levels, you may be worried about passing the exam.

Here is everything you need to know about passing a DOT physical if you have high blood pressure or high blood sugar (diabetes).

What is a DOT Physical Exam?

First, let’s cover the basics.

A DOT physical, also called a CDL physical, is a test of your general health, mental and emotional well-being and is a requirement that is mandated by federal law for anyone planning to drive a commercial motor vehicle (CMV).

The federal regulations in §391.11 Subpart B require all drivers of commercial motor vehicles (CMVs) to pass a physical to obtain a DOT medical card.

A DOT medical card is considered relevant and valid for up to 24 months. However, if you have diabetes or high blood pressure, you will be required to have your DOT physical more frequently to ensure you are safe to drive. Your medical card may only be issued for 3 months, 6 months, or a year.


Can I pass a DOT physical with diabetes or high blood sugar levels?

Yes, you can pass a DOT physical if you have diabetes.

However, diabetes is one of four conditions that have “objective disqualifiers” where, if your symptoms of diabetes meet one of their disqualifying conditions, you will automatically fail the exam.


Hyperglycemia (high blood glucose) means there is too much sugar in the blood because the body lacks enough insulin. Associated with diabetes, hyperglycemia can cause vomiting, excessive hunger and thirst, rapid heartbeat, vision problems and other symptoms.

Automatic disqualification for diabetes applies to drivers who have been diagnosed with severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy.  

This often leads to a similar question, “can I pass a DOT physical if I have Type 2 diabetes?”

Again, yes, but it depends on your medical examiner’s opinion of the severity of your condition. But, if you control your diabetes and regularly monitor your condition, you should be able to pass a DOT medical exam.  

In a DOT physical, medical examiners will look for signs of diabetes and may recommend further investigation if they believe you have diabetes.

The medical examiner will:

  • ask if you have a history of diabetes
  • ask if you are controlling elevated blood sugar levels with diet, pills, or insulin
  • examine you for other diabetic conditions like testing urine for the presence of sugars
  • ask if you regularly monitor your blood sugar level
  • ask if you have a history of feeling faint, dizzy, or any other loss of consciousness
  • ask if you had a hypoglycemic reaction in the past and details surrounding the situation if you had  

DOT physical requirements for drivers with diabetes

In the past, drivers could apply for the Diabetes Exemption Program if they used insulin to control their diabetes. In 2018, the program was deemed unnecessary and gave the medical examiner the ability to determine whether an individual is safe to operate a CMV.

The regulations now require drivers with diabetes to:

  • bring their latest lab work (within the last 4 months) with fasting blood sugar and HGA1C to the medical exam
  • have used insulin for at least 3 months before passing a DOT physical (if controlling diabetes with insulin)

To pass a DOT Physical with diabetes, you just need to have your diabetes under control and prove that you are managing it regularly.

For undiagnosed diabetes, the DOT physical requires you to have a blood sugar level of less than 8% in this test (a normal range is less than 5.7%).  

Pre-diabetic levels arebetween 5.7% and 6.4%, and your medical examiner may refer you for further investigation or monitoring, so it does not get worse.

Lastly, if the medical examiner uses a urine test to search for diabetic conditions, they are searching for hemoglobin A1c, which has a limit of 10% for the DOT physical. However, if the A1c levels are higher than 8%, the medical examiner may recommend further testing and monitoring.  

Can I pass a DOT physical with high blood pressure?

Yes, you can pass a DOT physical if you have high blood pressure, but your medical examiner may require regular monitoring of your condition and shorter expiration of your medical card.

High blood pressure can weaken arteries from the constant pressure of blood flowing through them, leading to kidney failure, damage to the blood vessels in the eyes and fluid backup in the lungs.

To pass a DOT physical, your blood pressure must be under 140/90.

Drivers with blood pressure over 140/90 can still get certified to drive, but the certification will only be for 1 year or less depending on the level of hypertension.

If this becomes a long-term issue, your medical examiner may help you find ways to lower your blood pressure, such as recommending:

  • drinking more water instead of coffee and soda
  • stopping any negative drinking or smoking habits
  • eating a healthier balanced diet with more fruits and vegetables, especially with higher amounts of potassium (bananas, oranges, carrots, etc.)
  • exercising and meditation routines

Simplify the entire DOT physical, drug testing, consortium, and DQF process

Our complete Proactive Safety Management (PSM) program has been organized to get you through an FMCSA audit by managing your driver qualification files, drug consortium, Electronic Logging Devices (ELD), vehicle maintenance and more.

Whether you are a large trucking company that is onboarding drivers quickly or a construction outfit with multiple trucks in your fleet, you need to stay aware of FMCSA regulations.

Questions about DOT Compliance, Licensing, Audits, Programs, etc.?

Our DOT Specialists are here to help!

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