Previous restrictions on diving have loosened up for people with diabetes
We received these e-mails, and copy of a research report, recently:
To: monitor @ diabetesmonitor.com
From: jbshaw[at]worldnet.att.net
Perhaps you can let the diabetics know that the Scuba Diving Industry has loosened up as far as allowing diabetics to participate. I as PADI Open Water Diving Instructor can now teach classes to diabetics leading to certification. My daughter can now go to professional status if she wants to and become an instructor. Divers Alert Network is presently conducting studies in the Bahamas and starting in August will take the study to the Cozumel area. Divers participating must be Insulin dependant. I am trying to round up enough people interested in learning to dive and willing to take a Cozumel trip to participate in study. The certification dives will be free if trip is booked with me. Let's Go Diving!
The Cozumel, Mexico trip will take place September 17-28th [1997]. The host hotel will be the Casa del Mar and room rates are $40.00/night (single or double occupancy). The diving rates are $ 35.00 for a 2 tank dive.
We welcome and encourage you to bring along a friend, spouse etc. to act as your dive buddy or just for the trip. Hotel and dive packages will be arranged through DAN while airline reservations are to be made on your own.
Again, thank you for your interest in the DAN project. If you have any questions, please email me or call me at 919-684-2948 extension 627. I look forward to talking to you soon.
Donna Uguccioni, M.S.
Diving Physiologist
In essence, we allow well-controlled diabetics to dive provided that they have none of the long-term complications of diabetes. They must undergo an annual medical with a medical referee and must register with the diabetic database that we keep on all diving diabetics in this country [the United Kingdom] diving with SAA/SSAC/BSAC [diving clubs in the U.K.].
They must not have had any episodes of hypoglycaemia within the last year. They must carry a kit with them on the boat and educate their buddy and others in the club as to how to use it and when to use it. Blood glucose must be checked prior to diving and again straight after diving. The diabetic diver must carry glucose paste with him/her underwater and know how to use it. He/she should give a lecture once a year to the club on their condition.
We, together with another doctor, Michael Lerch in Germany, are undertaking a study in diabetics in the Red Sea in September this year [1997].
Research into the Reliability of Current Guidelines for Recreational Scuba Divers with Insulin-Dependent Diabetes
A Divers Alert Network Medical (DAN) Research Project under the supervision of Dr. Richard Moon, Medical Director of DAN
By Donna M. Uguccioni, M.S. DAN Research Department
One example is the set of guidelines developed by Dr. George Burghen, Chief of Endocrinology and Metabolism at the University of Tennessee, for use at a special camp for diabetics in the US Virgin Islands (Camp DAVI) In these guidelines, BG was measured four times: one hour pre-dive, thirty minutes pre-dive and immediately pre-dive. Post-dive BG was also measured. Dr. Burghen recently reported on BG in 32 IDDM divers during 146 dive exposures in which there were no incidence of symptomatic hypoglycemia. Thurm et al. used these same guidelines to study seven divers with IDDM in Palau and reported on these in 1995. There were no incidences of hypoglycemia reported during their study.
The DAN Medical Research Department will begin a project in 1997 to look in to the issue of insulin dependent diabetics scuba diving successfully. The "Research into the Reliability of Current Guidelines for recreational scuba diving with Insulin-Dependent Diabetes" Project's goals are to evaluate the prevalence of hypoglycemic episodes associated with scuba diving when following strict guidelines and to determine the compliance of diabetic divers following guidelines for monitoring their blood glucose levels while on a recreational dive trip. DAN researchers will also collect information about dive profiles and decompression illness for Project Dive Safety.
This is an observational research project, divers involved will be voluntary their time. DAN plans to collect data over a two year period by having approximately 15-20 subjects participate for a minimum of four days during one of four two week research trips. Participants plan the trip as a diving vacation, and may bring spouses or friends. Participants are responsible for their expenses including the doctor visit to sign their release form, airline fare, food and lodging, dive packages and dive equipment (as applicable). DAN will cover the cost of the two HbA1c tests and supply diabetic monitoring equipment.
Eligibility for this project requires the volunteer have a pre-trip HbA1c test and a post-trip HbA1c test done, and meet the following criteria:
- Insulin-Dependent Diabetes
- Certified scuba diver with a recognized agency
- Age 18 - 65
- Should not be pregnant. If you are planning to become pregnant do not participate in this study.
- DAN member with DAN master insurance or an equivalent insurance.
- Willing to follow protocol of DAN's Research into the Reliability of Current Guidelines for recreational scuba diving with Insulin-Dependent Diabetes
- Diabetologist or personal primary care physician release form
- HbA1c lab copy results and have their personal diabetologist or physician release them for this activity based on the following guidelines: HbA1c test in range of 4-9%
- NO history of any episode of severe insulin reactions (LOC [loss of consciousness], seizure) in past 12 months
- NO advanced secondary complications: coronary artery disease cardiovascular disease, peripheral vascular disease, proliferative retinopathy, neuropathy, renal disease.
- NO hospitalization within previous 12 months for insulin shock or diabetic ketoacidosis
- Hypoglycemic awareness and good understanding of the relationship between exercise and blood glucose levels
- Good control of their diabetes
- Able to accurately check blood glucose without supervision
- Able to detect and treat hypoglycemia without assistance
- NO hospitalization/surgery in 12 months for other conditions
For further information about this project or to receive the necessary paperwork, please contact Donna Uguccioni at DAN Research, 3100 Tower Blvd., Suite 1300, Durham, NC 27705; or call (919) 684-2948 ext. 627 Monday through Friday 9:00 a.m. - 5:00 p.m. (EST).
-- Donna Uguccioni ugucc001[at]mc.duke.edu
Also see
Diving and Diabetes By Christopher Edge, Chair, UK Sports Diving Medical Committee
