### The Journey of Pietro Marsala: America's First Commercial Airline Pilot with Type 1 Diabetes Pietro Marsala has made history as the first person with type 1 diabetes (T1D) to be granted a First Class Medical certification by the Federal Aviation Administration (FAA), allowing him to work as a commercial airline pilot. This achievement is monumental not only for Marsala but also for all people with diabetes (PWDs), breaking one of the last barriers in career options for those with the condition. Marsala's journey began with a childhood dream of becoming a pilot. He earned his private pilot's license and was on his way to a commercial piloting career when he was diagnosed with diabetes at age 21. Initially misdiagnosed as having type 2 diabetes (T2D), he managed to get off insulin and regain his medical certification. However, a correct diagnosis of T1D led to another revocation of his certification. Determined to fly, Marsala obtained a special issuance medical certificate, allowing him to work as a flight instructor. He logged over 4,500 flight hours on insulin, far exceeding the minimum required for airline pilots. His persistent efforts and data sharing with the FAA played a crucial role in changing policies to allow insulin-using pilots to fly commercially. Marsala's certification was initially valid for only six months, requiring regular updates of his glucose management data. Despite the challenges, he views this as part of being a pioneer and hopes it will be easier for future pilots with diabetes. Marsala's story is a testament to overcoming obstacles and achieving dreams despite medical conditions. His efforts have paved the way for others with T1D to pursue careers in aviation, proving that the sky is no longer the limit for people with diabetes.