Diabetes and diving

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missmeld

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My name is Melissa and I am 31 years old. I have insulin dependent diabetes since I was 13. I have been using an insulin pump for about 8 years now. I don't have excellent control. My last A1c was 8. I have no complications associated with diabetes. When I was pregnant 2 years ago, I had excellent control with A1c's of 6. Since then, I had an insurance change which caused me to find a new doctor who apparently didn't know much about pumps. I have since found a new doctor and we are working our way to get me better control. I now use an Animas IR2000 pump. My husband and I are planning on going to St. Marteen for Labor Day weekend and since he is a SCUBA diver, we thought it would be great if I could finally learn too. Plus we live in Florida and the opportunities to dive are abundant. Originally my doctor's office gave me a letter saying it was okay to dive. However I have found out it was my doctor's PA that wrote the letter and the doctor and her other PA do not agree that I should dive till they know more about diving and diabetes. Meanwhile I have already started taking lessons, with my ocean dive scheduled for Aug 28th and 29th. They said they have been trying to speak to a doctor with the pump company who specializes in sports medicine. This has been going on for 3 weeks now, and they have not gotten any information. They said they do not feel comfortable giving me the okay to dive. Time is of the essence and I was wondering if anyone had any info/links to share with me. Also, although I filled out on my medical questionaire that I am diabetic, my instructor must not have noticed it because he has yet to ask me for a medical release, so I have not brought it up. I know this is wrong not to notify him or my buddy, and I do intend to go to class early onThursday and talk to him. Thanks.
 
I don't know much about diabetes and how diving interacts with it. My wife is also a diabetic and is afraid to learn to dive because of it. I too would like more information on this.
 
missmeld:
My name is Melissa and I am 31 years old. I have insulin dependent diabetes since I was 13. I have been using an insulin pump for about 8 years now. I don't have excellent control. My last A1c was 8. I have no complications associated with diabetes. When I was pregnant 2 years ago, I had excellent control with A1c's of 6. Since then, I had an insurance change which caused me to find a new doctor who apparently didn't know much about pumps. I have since found a new doctor and we are working our way to get me better control. I now use an Animas IR2000 pump. My husband and I are planning on going to St. Marteen for Labor Day weekend and since he is a SCUBA diver, we thought it would be great if I could finally learn too. Plus we live in Florida and the opportunities to dive are abundant. Originally my doctor's office gave me a letter saying it was okay to dive. However I have found out it was my doctor's PA that wrote the letter and the doctor and her other PA do not agree that I should dive till they know more about diving and diabetes. Meanwhile I have already started taking lessons, with my ocean dive scheduled for Aug 28th and 29th. They said they have been trying to speak to a doctor with the pump company who specializes in sports medicine. This has been going on for 3 weeks now, and they have not gotten any information. They said they do not feel comfortable giving me the okay to dive. Time is of the essence and I was wondering if anyone had any info/links to share with me. Also, although I filled out on my medical questionaire that I am diabetic, my instructor must not have noticed it because he has yet to ask me for a medical release, so I have not brought it up. I know this is wrong not to notify him or my buddy, and I do intend to go to class early onThursday and talk to him. Thanks.
I suggest you contact DAN. http://www.diversalertnetwork.com/

They can refer you to the proper people. There are many diabetics (I know several Technical and commercial divers as well)who dive and there are protocols in place.

do a google searh on YMCA and Diabetes they have an published protocol.
 
There's a wealth of information on scubaboard, and you'll find many strong opinions. The bottom line, in my opinion, is that your case needs to be individualized. This is a very controversial area. The primary worry for a type 1 diabetic diving is a hypoglycemic event at depth. You'll find that some diabetics carry a glucose gel with them that they can take at depth in emergency, and many let their sugars run a little high for the several hour period that they're out on the water & diving. Checking your sugar immediately before a dive & adjusting appropriately would be of utmost importance.

However, many will tell you that you should not dive at all & it's completely contraindicated.

My advice is to call DAN (1-800-446-2671 or 1-919-684-2948, Mon-Fri, 9am-8pm (EST)) for advice & referral to either a dive physician or an endocrinologist in your area that is familiar with dive medicine.

(This post should not be considered medical advice; for that, you should see your personal physician. Whether or not you should ultimately dive is something that you will have to explore with healthcare professionals familiar with your entire medical history.)

Jim
 
Hi missmeld,
I've been an insulin-dependant diabetic for 24 years. I started using a pump last year. I don't know about your pump model but if it has the ability to program temporary basal rates or basals that are different throughout the day, use that feature! That way you can fine-tune the machine to how your BG runs through the day. And you'll only know that from testing alot. Prior to a dive I make sure my BG is at least 160. If I have to, I carb up. I also disconnect my pump when I'm diving. I carry glucose in a tube underwater, but I've never needed it.

Here's a site that may be useful: http://www.diabetesnet.com/diabetes_tools/index.php

Also check out the DAN site mentioned before. There's good info there.

Learn everything about programming and fine-tuning yourself and don't rely on a doctor to know about it.

You really want to make sure you're in good control before proceeding. That's critical.

Good luck.
 
My Fiance is a diabetic diver, she is alos on the insulin pump. She has had no complications thus far. She normally runs between 6.5 and 8 but lets her sugars go up to 12 or so before any dive. She disconnects for the dive and at the end of the diving (If there is more than one she hooks up between dives and test) she gives herself a correction bolus to bring her sugars back down to range if they haven't dropped on there own. She also carries a gel pack with her on her dives. So I would contact dan and your doctor and ease into diving. But diabetes shouldn't stop you if you can keep it under control above the water.

Rob
 
I'm also an insulin dependant diabetic. I'm also an instructor. As long as you have good control of your condition and follow the correct procedures for diving with diabetes, you should have no problem enjoying the sport. You should have your doctor contact DAN for more clerifications. Previous posts have given you the web site and phone #. You should have filled out a RSTC medical form prior to starting your class. That form also has a list of contacts your doctor can call. PM me if you would like me to email you a PDF copy.

My statement of following the correct procedures is a subjective statement. There are no "rules" of diving with diabetes. Instead you will need to find what works best for you. For example, my routine of pre and post diving is that I check my BS an hour before the dive. I check it again 30 minutes before the dive. I give it one last check just before the dive. I do this so I can gauge what my BS's are doing (going up or down) and I can adjust the changes as neccessary. I like to have them around 175-200 before a dive. They usually fall to 130-120 after a dive. I also carry glucose gel in my BCD. After the days diving, I check it again and boluse or set a temp basil rate to get my BS back in check. This routine has been working for me for the last 2 years. You need to find what works best for you. Since I've been on the pump, I've had no issues with low BS.

Good Luck.

Duane

DISCLAIMER: I am not a medical doctor, nor do I play one on TV, and I didn't stay at a Holiday Inn last night (actually I had to sleep on the couch). My opinions above are just that, opinions.
 

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