Wife is a diabetic

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The ability of your wife to dive safely is not as dependent on whether or not she has Type 1 or Type 2 diabetes, but is more dependent on whether or not she uses insulin (and to a lesser degree, some of the older classes of oral agents) to control her disease and how frequently she is hypoglycemic. It would also depend what type of insulin she uses and it's pharmacokinetic profile. If she is never or rarely hypoglycemic, then running her blood sugars a bit high before a dive and having a small snack before the dive will increase her margin of safety during the dive. She should also check her blood sugar pre and post dive. But this is really a question to be taken to a dive medicine physician. There is no one size fits all answer to your question.
 
I dive with a diabetic often and he does all the testing and does very well:) I would not even known except the testing and the injections if required, he doesn't make a big deal of it, and there is a lot of good advise here:wink:
 
Thank everyone, she controls her diabeties with her diet. Its very controlled.
 
Thank everyone, she controls her diabeties with her diet. Its very controlled.
Make sure she gets a good heart check. Stress test might be indicated. Often, the blood vessels are effected by diabetes years before you can even make a diagnosis of diabetes.
 
Thank everyone, she controls her diabeties with her diet. Its very controlled.

Well in that case, she should not have any issues unless she has some underlying cardiac issues. I agree that she should have a thorough physical and possibly a stress test (which is technically recommended for divers over 40) before beginning her training.
 
They didn't make me do a stress test till I was 58, they did say it was waaayyyyy over due though and were surprised I hadn't popped something. Go figure
 
The ability of your wife to dive safely is not as dependent on whether or not she has Type 1 or Type 2 diabetes, but is more dependent on whether or not she uses insulin (and to a lesser degree, some of the older classes of oral agents) to control her disease and how frequently she is hypoglycemic. It would also depend what type of insulin she uses and it's pharmacokinetic profile. If she is never or rarely hypoglycemic, then running her blood sugars a bit high before a dive and having a small snack before the dive will increase her margin of safety during the dive. She should also check her blood sugar pre and post dive. But this is really a question to be taken to a dive medicine physician. There is no one size fits all answer to your question.

These statements are a little contradictory to each other. Everyone "uses" insulin however in Type 1 diabetics the pancreas is completely shut down and therefore Insulin must be administered continuously. For Type II, the efficiency to manufacture insulin is impaired but not completely shut down such as in Type 1 diabetics. So therefore, the ability to dive safely is MUCH more complicated and must be more closely managed in Type 1 diabetics than in Type II diabetics.
 
...in Type 1 diabetics the pancreas is completely shut down and therefore Insulin must be administered continuously. For Type II, the efficiency to manufacture insulin is impaired but not completely shut down such as in Type 1 diabetics.

That statement needs a little fine tuning, Padrogj.

The description of Type I diabetes is essentially accurate.

However, Type II diabetes is the result of one or both of the following abnormalities: (1) insufficient insulin being produced and (2) insulin resistance, a condition where the body's cells no longer respond appropriately to insulin. In IR, the effectiveness of that hormone in lowering plasma glucose levels is reduced, most often progressively.

Also, from an earlier post:
The key is how well (or not how well) you manage your diabetes. My son is Insulin Dependant (Type 1) (sic) but his Doctor signed the RSTC form without any hesitation. It is definitely a major factor when you factor in Diving but it is something that is very manageable. The key is consistent and controlled readings.

More accurately, the key to diving safely with diabetes are appropriately timed and properly done blood glucose readings coupled with appropriate treatment response to those readings.

Regards,

DocVikingo
 
That statement needs a little fine tuning, Padrogj.

The description of Type I diabetes is essentially accurate.

However, Type II diabetes is the result of one or both of the following abnormalities: (1) insufficient insulin being produced and (2) insulin resistance, a condition where the body's cells no longer respond appropriately to insulin. In IR, the effectiveness of that hormone in lowering plasma glucose levels is reduced, most often progressively.

Also, from an earlier post:

More accurately, the key to diving safely with diabetes are appropriately timed and properly done blood glucose readings coupled with appropriate treatment response to those readings.

Regards,

DocVikingo

You are missing the point DocVikingo. The intent of my post is stress the high level differences with Type 1 and 11 diabetes and put emphasis on the fact that there is much more involved with Type 1; not to write an elaborate discertation on the differences as I could have easily done that.
Your last statement essentially restates what I had stated earlier except with more verbiage: PROPER MANAGEMENT.
Why split hairs?
 
These statements are a little contradictory to each other. Everyone "uses" insulin however in Type 1 diabetics the pancreas is completely shut down and therefore Insulin must be administered continuously. For Type II, the efficiency to manufacture insulin is impaired but not completely shut down such as in Type 1 diabetics. So therefore, the ability to dive safely is MUCH more complicated and must be more closely managed in Type 1 diabetics than in Type II diabetics.

That's awesome that your son can dive! I used to hate it when a child wanted to be a long haul trucker or commercial pilot as those are still off limits to an insulin user. But the rest of the world is not.

One small point of correction. In general, most Type 2 overproduce insulin. The issue is generally not a problem with efficiency in manufacturing insulin, it is in lack of efficiency in using endogenously produced insulin (insulin resistance).

I'm going to have to disagree with the assumptions you made from my comments. I did not comment at all on the underlying pathophysiology of Type 1 versus Type 2, I'm well familiar with that. I only commented on the implications of the therapy which must be used in Type 1 and might be used in Type 2. Regardless of the body's ability to produce endogenous insulin, or the body's ability to properly use the endogenous insulin it makes, the use of insulin (and to a lesser degree, the use of sulfonylureas in some Type 2s) is something that puts a diver at higher risk while diving than the other therapies due to hypoglycemia which can occur in every patient who uses insulin, not just the Type 1 patient.

I do not agree with your blanket statement that is "much more complicated" to dive safely if you have Type 1. It may or may not be. Patients with longstanding diabetes or poorly controlled diabetes often develop some nerve damage which impairs their ability to recognize hypoglycemia when it occurs. Personally, if both patients take insulin, I'd put my money on a newer Type 1 who has a history of good control than a longstanding Type 2 with a history of poor control in terms of their ability to dive safely. Now if both patients had longstanding disease and a history of poor control, then yes, the Type 1 patient will most definitely have a harder time diving safely. Type 1 patients who use insulin pumps are generally able to easily titrate their blood sugars around activities, it is a little harder to do if they take intermittent injections.

Let's not get into Type 1a. :D
 
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