Diving with type 1 diabetes

[willayl]

Hi All

New to this site, just joined and am interested in your thoughts and advice on diving with diabetes

My 13 1/2 year old daughter (the 1/2 is important believe me) has just been diagnosed with type 1 diabetes and is insulin dependant

We are just getting all information together and getting to grips with it all

She has a very positive outlook on it and we are also keen for her to return to her normal activities (school, surfing, swimming, horse riding, gymnastics)

Her biggest peev is that she may not be able to dive for some time

She is a PADI Junior Open Water Diver and was hoping to complete her PADI Advanced Open Water course sometime this month (pre-diagnosis)

What is the consensus on diving with this condition, I have heard that some insurance companies wont insure divers with diabetes, we are insured with DAN (i need to contact them about this)

Her Endocrinologist has said that she can dive in October again

Any advice, thoughts etc are very very welcome

Will

 

[Duke Dive Medicine]

Hi Will,

There are recommended guidelines for diving with type I diabetes, linked here courtesy the Rubicon Foundation. Scroll down and click "view/open" for the full set of guidelines.

Best regards,
DDM

 

[bmorescuba]

Will,

We all know how much teenagers love to wait for things, but this is one case where I would be extremely hesitant to jump the gun on the official recommendations. And not just because 18 (or 16 w/ special) brings with it more maturity, but also because of the newness of the diagnosis. Type 1 diabetes does not mean the end of diving. It is very possible to dive as much as you want, still manage the disease successfully, and not have any diabetes-related incidents while underwater. However, this requires a great deal of familiarity with both the disease and with diving.

More than anything, living with Type 1 means coming to grips with the fact that the disease is omnipresent. When you eat, what you eat, when you exercise, how much you exercise, how you feel, etc. can affect your BG levels. A cup of white rice may have the same carb count as a cup of brown rice, but they may spike your level in totally different ways. Or maybe you had 1.5 cups of rice instead of one cup - that changes the equation as well. Only after living with type 1 for years can you predict all the variables with any reliability. It's been 25 years for me and sometimes I still miscalculate. With time, you become much more aware and develop an ability to sense Hypoglycemia earlier, which is the biggest danger while underwater. That's why the recommendations specifically mention Hypoglycemia Unawareness (or tolerance) as a danger. There are also many practical things to work out - will she use a pump? Can the pump be disconnected while the abdominal catheter stays in place? Does a booster shot need to be given to maintain basal? If you read section 3 of the guidelines, the overall idea is to skew one's level to be a little higher than ideal (but also not too high) and keep it that way throughout the dive. This is the method I practice. This is not easy to do when you're starting out, but over time it can become second nature.

One other thing worth mentioning. A lot of confident diabetics simply check NO on the medical forms. I can't condone this, and since you are verifying the medical form for a minor, you shouldn't either. If you assume that you won't falsify the medical form, then the endo will have to sign it. The endo will most likely use the Duke recommendations linked above and thus wouldn't sign it until age 16 at the earliest anyway.

She has her whole life ahead of her to enjoy the wonders of diving. I sure wish I had started earlier. I think by waiting until she's very comfortable and understands her condition, she can make sure diving continues to be a positive experience.

 

[sheeper]

2 things you must do.

1) Contact DAN.
2) Get reviewed by a physician with expertise in diabetes and dive medicine. DAN can refer.