DAN recommendation for Diving with Diabetes

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Actually that is a two way street. My wife is a veteren of 24 years in the NICU and the UR case manager Supervisor at two local hospitals were we live. I have a firend that is a ER doc and yes they see a lot of bad D episodes. BUT and this is a big one. A lot of them are first time daignoses some like a kid the other day with a 800 reading. Now he/she is fine, but on treatment of course. Frank is always telling me how hard it is to NOT generalize about diabetics based on his sckewed ER view. He knows he is seeing the worst or even the best at their worst. I have never been hospitalized because of my diabetes or any complication from it either. To say that 99.99 percent of diabetics DO NOT have the control or willigness to control our diabete like WSGTS's is just stupid. There are millions of us and millions of us the are compliant. Sure there are a ton in your ER but if you really keep check the records you will find that a % are first time diagnoses and a % will be repeat customers. If someone throws in the towel there is just nothing you can do for them, period. Some people decide to control the disease and some decide to let it control them. There are more insulin dependent diabetic divers than you think there are and most of them will never let it on they are. I have a Friend that is a NICU doc that never test himself and eats donuts all night. Nobodys perfect. I would rather dive with a diabetec than a smoker ! Diabetes control has come a long way real fast. Soon we will have internal insulin pumps with continous monitoring all sub-q. Medtronic has had a implantable pump for years available in europe. Islets may be rejection drug free one day. Just the monitor and the pumps have grown light years so fast. Here is another paradigm. Those diabetics , many of which were young when the stone age of treatment was all they had. Now they are dieng off and having many complications. It may be to late for them but the more Endos that go to the pump for treatment instead of all those archaic injections and insulin profiles the better we will all be.
It is much easier to maintian a level without droping or going to high. This is easier to do when you track you levels with a minmal then a high level of excersize. If you can keep levels up with a high amount of excertion then you know with a moderate level you will be a little higher and finally with minimal excertion you will be higher still. As long as the Minimal exertion does not run you too high and the High level of excetion does not run you too low then you have found your BG Profile for diving with diabetes. I have used this for Swiming, climbing, dog mushing, diving, se...., etc. etc.etc.
I lower my basal rate on my pump an hour before and remove it for diving .I intake 15 carbs before I dive, if there is current or cold I will take a little more depending on the starting BG level. I don't go longer than one hour surface to surfacemay be a little more life 5 or 10 minutes if all is swell. I Always have a good time and don't forget the cake frosting in the tubes with the hole in the bottom for attaching a wrist strap so they don't float away!

WW
 
We need more doctors like you, Blueraven. Unfortunately, in real life, most doctors are not as well versed in diabetic care as some of their patients.

In reality, most docs manage adult diabetics and only a few juvenile diabetics like yourself. I deferred most of my juvenile diabetics to their own endocrinologists.

Most adult onset diabetics don't care enough to maintain tight control. And it is not just because their doctors don't want them to. My own mother is not willing to do a finger stick even once a week, and 3 of her children are doctors.

She lives with my brother, who is a doctor, and we can't force her to monitor her glucose enough.

So reality of life is medicine is 90% psychology, and only 10% science.
 
My own father was admitted to the ER about 3 years ago for ketoacidosis. I felt bad about it, but can not do anything about it. It is his choice .... You might know the whole world about medicine, and take the best care of your own patients. But when a patient chose to take matter into their own hands... You can't do anything about it.

A doctor was sued for a diabetic patient's renal failure. Despite documenting in his chart numerous time when he counseled for the patient's non-complaint and failure to follow up... The woman still sued - saying he didn't do enough.

You can lead a horse to water, but can't make them drink.
 
fisherdvm:
I think it is a tough job for any doctor to manage diabetics.
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That's just the problem, it's impossible for a doctor to manage a diabetic, unless the doctor is going to follow the diabetic around 24/7 (even then). The diabetic has to manage themselves. It's unfortunate that you can't just take meds and eat/do whatever you want, it just doesn't work that way.

There has to be a certain amount of personal responsiblity for a T2. In only rare cases is the disease not caused by one's own actions, so I guess I'm still surprised that people don't see the way they live is killing them, and T2 is a warning to clean your act up.

Maybe I'm just wishing things were different!!!

Oh well,
wsgts
 
As a type 2 diabetic it is MY job to control my disease, not my doctors. I've been working on it for 15 years. That being said, I just saw my doctor a week ago with sugars consistantly back in the mid 300's to as high as 430. I "thought" I had been controlling it well enough without constant monitoring. Dumb? You bet!

I do know the symptoms "I" have when low (very jittery and nervous) and when high (sleepy and lathargic). The problem is the changes (when high) are so subtle that I will miss them until I am sleeping too much. Ironically when diving, I have the best control ever. With the increased exercise, better hydration, and better food I am more consistant in my health care.

My instructor I received my AOW from was type 1 and he struggled during our liveboard, frquently not diving due to not feeling well. In short, being a great diver and/or a model patient doesn't make the problem go away. After a 125 pound weight loss (used to be 145# but...) I can control mine much better but I will never be "normal".

Carl
 
In the same line of thought, carl, I'd rather dive with a type 2 and their HgA1c a little high, than diving with a type 1 who has meticulous HgA1c who might be pushing his physical limits.

I find it fascinating on hearing how professional athletes with type 1 manages their diabetes. But having a hypoglycemic episode on the football field surrounded by medics with iv glucose is much more acceptable than a diver in the middle of the ocean and 30 minutes from land.
 
Gene_Hobbs:
Added to the RRR today:

Scuba diving with diabetes mellitus--the UK experience 1991-2001.
Edge et. al. 2005
RRR ID: 4036, PMID: 15796312
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Gene, you are too objective... I thought that this forum is only for people with alot of hot air??
 
I've been a Type I diabetic for 46 years and scuba/skin diver for 37 years. The next product I would like to see is a waterproof continuous BG meter. Check air, depth and BG level how much better can it get.
 
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