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Thread: Diving with diabetes

 


  1. #1
    Tod
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    Diving with diabetes

    While for some this may not be considered a disability, this seems like the best place on this forum to post this question.

    I have been an insulin-dependent diabetic for 25 years and a certified diver for over three years. I have recently completed a Solo Diving class through SDI, complete with two open water "check-out" dives with the instructor. After the completion of the course, I went on a weekend boat dive down in the Channel Islands with a group sponsored by my LDS. It was during this trip that I ran into a problem.

    After the second full day on the boat (12 dives so far for the trip) I went to bed around 10:00 PM. It turns out I had a very light dinner (few carbs) as I didn't care for the meal and because I was pretty tired, I didn't bother to try and fill-up on soda or snacks. Just before crawling in my bunk, I mistakenly took my regular dose of insulin before bed (out of habbit) and also neglected to test my blood sugar (too lazy). [This is the point in the story where I made my mistake. No denying it and no need to question it.]

    Sometime in the night, my blood sugar levels dropped (as would be expected) after the all the day's activities and partially due to the lack of calories during dinner. (I even did a night dive after dinner!) Anyway, as I slept I apparently started making some funny sounds (gurggling) and woke up some of the others near my bunk. When they tried to wake me I did not respond. This caused a bit of a panic as most assumed it was some sort of DCS or a stroke! My friend who was there with me (and who is also aware of my condition) informed them that I was a diabetic. The boat crew (by then) responded by providing me some glucose and I soon came out of it. Unfortunately, the Coast Guard was called and they sent a chopper out to the boat!

    Short version: Once they showed up, that was the end of my dive trip. Even though I was able to explain what had happened and was then able to walk around on my own, they insisted I take a ride in their chopper. I figured they were not bring me back and I was not happy.

    At the hospital, they took some blood tests and found that I was going to live and soon let me go. Unfortunately, I had no money, few clothes, and no idea how I was going to get back to where I started (the Santa Barbara Harbor). I was taken to some place in Oxnard. (Longer story about how the GREAT hospital staff there helped me out!)

    Now on to the issue:

    A few weeks later, I ran into my instructor from the Solo Diving class. He told me he heard about my adventure and began to question whether or not I should even be diving! Further, he was going to hold my Solo Diving certificate until he reconsidered this, citing the fact that had I had such a reaction while I was diving I would likely not survive. True. But the particular circumstances that led to my issue were self-induced (by my neglect to test myself and by the fact I took too large of a shot). I told him that normally I am aware of where my blood sugar levels are BEFORE I don my scuba tank and that I wouldn't even think to dive if I felt I may become hypoglycemic at any time during the dive. He didn't seem convinced. It was only at this point that I felt like I was treated like I had some sort of disability.

    Finally, he settled upon letting me have my certificate if I could produce a letter from my doctor - which I now have.

    Has anyone else ran into any sort of question over being a diabetic?

  2. #2
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    Quote Originally Posted by Tod
    While for some this may not be considered a disability, this seems like the best place on this forum to post this question.

    I have been an insulin-dependent diabetic for 25 years and a certified diver for over three years. I have recently completed a Solo Diving class through SDI, complete with two open water "check-out" dives with the instructor. After the completion of the course, I went on a weekend boat dive down in the Channel Islands with a group sponsored by my LDS. It was during this trip that I ran into a problem.

    After the second full day on the boat (12 dives so far for the trip) I went to bed around 10:00 PM. It turns out I had a very light dinner (few carbs) as I didn't care for the meal and because I was pretty tired, I didn't bother to try and fill-up on soda or snacks. Just before crawling in my bunk, I mistakenly took my regular dose of insulin before bed (out of habbit) and also neglected to test my blood sugar (too lazy). [This is the point in the story where I made my mistake. No denying it and no need to question it.]

    Sometime in the night, my blood sugar levels dropped (as would be expected) after the all the day's activities and partially due to the lack of calories during dinner. (I even did a night dive after dinner!) Anyway, as I slept I apparently started making some funny sounds (gurggling) and woke up some of the others near my bunk. When they tried to wake me I did not respond. This caused a bit of a panic as most assumed it was some sort of DCS or a stroke! My friend who was there with me (and who is also aware of my condition) informed them that I was a diabetic. The boat crew (by then) responded by providing me some glucose and I soon came out of it. Unfortunately, the Coast Guard was called and they sent a chopper out to the boat!

    Short version: Once they showed up, that was the end of my dive trip. Even though I was able to explain what had happened and was then able to walk around on my own, they insisted I take a ride in their chopper. I figured they were not bring me back and I was not happy.

    At the hospital, they took some blood tests and found that I was going to live and soon let me go. Unfortunately, I had no money, few clothes, and no idea how I was going to get back to where I started (the Santa Barbara Harbor). I was taken to some place in Oxnard. (Longer story about how the GREAT hospital staff there helped me out!)

    Now on to the issue:

    A few weeks later, I ran into my instructor from the Solo Diving class. He told me he heard about my adventure and began to question whether or not I should even be diving! Further, he was going to hold my Solo Diving certificate until he reconsidered this, citing the fact that had I had such a reaction while I was diving I would likely not survive. True. But the particular circumstances that led to my issue were self-induced (by my neglect to test myself and by the fact I took too large of a shot). I told him that normally I am aware of where my blood sugar levels are BEFORE I don my scuba tank and that I wouldn't even think to dive if I felt I may become hypoglycemic at any time during the dive. He didn't seem convinced. It was only at this point that I felt like I was treated like I had some sort of disability.

    Finally, he settled upon letting me have my certificate if I could produce a letter from my doctor - which I now have.

    Has anyone else ran into any sort of question over being a diabetic?
    Sorry to hear of this probome I to am type 2 diabetic but control my sugar with Advandamet (pill) . No one has ever asked me or advised me not to dive but hearing this story I think it's time to call the Dr. whom knows I dive and get a letter of clearence incase a question from a charter comes in to play.
    Tim Creighton
    Grifith, Indiana

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    I too am a Type 2 diabetic and have never had a problem. I control by diabetes by running and diet. I started out w/ glucovance (pills) controlling the spikes w/ insulin until I brought my weight down and that is where I am today. I have woken up dizzy w/ a very low blood sugar once before so understand to some degree what you were feeling.

    Diving w/ diabetes is always risky. Thats why the questionaire asks the question when you sign up to get certified. When your diving there's a huge risk that you could get low blood sugar and become disoriented. I'm not sure of a method to drink orange juice or get a quick sugar fix to handle the situation, its more a proactive situation then a reactive.

    It sounds like you understand the error made and always, always check those levels.

    Good luck,
    Doug
    Before you criticize someone, you should walk a mile in their shoes. That way, when you criticize them you're a mile away and you have their shoes.

  4. #4
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    We have had 3 major incidents

    with folks (not all divers, one a non-diving cameraman) who went into (insulin shock) too much insulin on one of our boats, one while at depth. Very freaky for the crew. Your boat crew did absolutely right to evacuate you, I'd have done the same. Our company policy is to allow diabetics to dive only with a letter from their doc stating clearly that the doc understands the dangers, your diabetes is under control, and you are cleared to dive. Not checking your blood sugar placed your boat crew under a tremendous amount of stress. You wouldn't have sued if you died, but what about your next of kin? A diver sick on the boat who can't be evacuated (the Coast Guard will not always fly) requires the entire boat to be brought to shore. I am not flaming, just giving you other things to think about.

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    I'm an insulin dependant diabetic as well. Only I control my condition with an insulin pump and not injections. This allows me to know worry too much about having low blood sugars on a dive since the pump is disconnected from my body, hence no insulin. I've been questioned about my condition and the steps I take to ensure my safety and the safety of my students. My tech instructor was OK with it as is my future trimix instructor. All this being said, instructors are not doctors and can't be expected to know how one's condition will affect them during diving. Hence it is always prudent to err on the side of caution.

    I don't know how SDI handles instructors withodling certification, but in the PADI world if you pay for the course and complete all of the diving objectives, the instructor cannot withold your certification. Did you fill out a medical form prior to taking the solo diver course? If not, then your instructor was covering his behind by not sending in your certification until he got a medical form. It should be filled out and signed by a doctor before any in water activities begin.

    Duane

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    Simple solution here is to 1. check BGL 1 hour before dive 2. whether you need to or not (BGL reading fine or slightly high)...eat a candy bar or drink a high sugar drink. 3. before dive check BGL and make sure its around 200 min.

    I'm a T2 diabetic, have clearance letter from my Dr. and I ALWAYS make sure that I do the above. Heck, when I'm on a diving trip I will not even take insulin at all and eat whatever I wish. I like my BGL to stay between 200 - 225 when I'm diving trip.

    Also I will not dive on a trip unless my brother (dive buddy) is with me diving. End of story!

    Diving while diabetic is really no different than thoes that dive with heart conditions or any other condition.

    Remember when diving it not a problem of having a high BGL it when hypoclicemia sets in that the problem starts. I've had my BGL up around 400 for over a week before (not a smart move...esp. long term) but the only problem I had was that I got ill a little quicker, mood changed to being grumpy and vision change. When I got med. the BGL dropped back to normal and I'm here today. When my BGL has dropped very low thats when I couldn't think straight, lost ability to focus on any problem...in other words I was basically "drunk" and "incopasitated"(sp?).

    So like I stated above. On dive day or dive trip I make sure my BgL is very high as to avoid hypoglycemia.

    This just works for me.

    Jeremy
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  7. #7
    Tod
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    Quote Originally Posted by divewookie
    ...Your boat crew did absolutely right to evacuate you, I'd have done the same. Our company policy is to allow diabetics to dive only with a letter from their doc stating clearly that the doc understands the dangers, your diabetes is under control, and you are cleared to dive. Not checking your blood sugar placed your boat crew under a tremendous amount of stress. You wouldn't have sued if you died, but what about your next of kin? A diver sick on the boat who can't be evacuated (the Coast Guard will not always fly) requires the entire boat to be brought to shore. I am not flaming, just giving you other things to think about.
    Thanks for the comments, I appreciate them. I hope I didn't sound like I was bashing the boat crew for calling for help or doing their job. I believe they did the right thing under those circumstances and I would have done the same. My frustrations were two-fold: 1) that I had already came out of it and I felt like I was okay before the Coast Guard wanted to take me away; and 2) that I was upset with myself for allowing this to happen.

    I believe that had the USCG left (without me) the dive boat would have been free to continue the dive trip with me on board. I suspect that had that happened, the boat crew would also be at liberty to make a decision as to whether or not to allow be to continue to dive.

  8. #8
    Tod
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    Quote Originally Posted by ppo2_diver
    Did you fill out a medical form prior to taking the solo diver course? If not, then your instructor was covering his behind by not sending in your certification until he got a medical form.
    I did fill out a four page form before taking the class (that was full of legal waivers to release the instructor and SDI from any liability for teaching that class). One of those four pages was devoted to health questions, where I responded that I was a diabetic and even provided the dates of my last doctor's visit (as well as a phone number).

    My instructor was a retired dentist in his other life. I think this is partially why he got so concerned with the topic (after he found out about the boat trip incident). I also wonder if he ever read through my four page questionaire form after I filled it out! I suspect he may not have. Nevertheless, now that he knows I am a diabetic I worry that I will be treated differently when I attempt to take more classes and further my dive education.

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    Maybe you guys could tell me. My friend who is very eager to join me diving has diabetes 1 with good control, according to himself. His regular physician has doubts about him diving, and sent him of for a greater examination at a diabetes clinic.

    Problem is, I don't think anybody there has a clue about diving! How is the best way to come about this in a safe manner, and still not exclude him from diving if he can dive?

    I have told him he will always have to plan his dives according to his own premises, and with a buddy (me?) who is more than usual aware of his condition, and can take steps for him if he suddenly can't.

    -What to do buddies? Any tips how to go about it if the "insulin-physician" just prefers to have his own *ss safe?...

    (PADI OW starts monday. Diabetes examination wednesday... )

  10. #10
    Tod
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    Quote Originally Posted by KOMPRESSOR
    How is the best way to come about this in a safe manner, and still not exclude him from diving if he can dive?
    I don't see anything wrong with having him keep searching for a doctor who undersands diving and diabetes. If he is active and tries various physical things on his own, he should explain this to his doctor.

    Quote Originally Posted by KOMPRESSOR
    I have told him he will always have to plan his dives according to his own premises, and with a buddy (me?) who is more than usual aware of his condition, and can take steps for him if he suddenly can't.
    Good plan. Speaking for myself, I take great comfort in knowing that my friend understands my condition and can assist if I am having any problems. But above that, I also need to understand that I have my limitations.

    Quote Originally Posted by KOMPRESSOR
    What to do buddies? Any tips how to go about it if the "insulin-physician" just prefers to have his own *ss safe?...
    This is really up to your friend. Personally, I don't like (okay, I hate) it when someone just tells me I cannot do something because I have Type 1 diabetes. Most professionals (doctors) I've talked with, however, are usually more than pleased to see someone like me wanting to remain active. That is one of the best things for my health. Sure my doctor sometimes cringes when I tell him what I've been up to, but since he has known me for 16 years he has grown to accept that I am who I am and that I will continue to be that way whether or not anyone else likes it!

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