Diabetes is yet another common reason why someone can fail a DOT physical exam. In both types of diabetes, the body doesn’t make enough insulin to keep blood sugar levels balanced. This means that glucose, or sugar, leaks into the urine instead of being absorbed into the cells to be used as energy. People with diabetes can also have high blood pressure and abnormal cholesterol levels, both of which increase their risk for heart disease. In addition to medication, there are some lifestyle changes you can make to lower your risk for developing diabetes. For example, eat more fruits and vegetables, lean meats and low-fat dairy products. Try to get more physical activity, too. Aim for at least 30 minutes of exercise five days a week. Limit screen time.