A day in the life of a diabetic diver: the Undersea and Hyperbaric Medical Society/DAN.

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DocVikingo

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"Diving Hyperb Med. 2016 Sep;46(3):181-185.

A day in the life of a diabetic diver: the Undersea and Hyperbaric Medical Society/Divers Alert Network protocol for diving with diabetes in action.

Johnson R1

Abstract

Some people with well-managed insulin-dependent diabetes can dive safely. Those cleared to participate should control tightly the variables that impact blood glucose levels, including activity, timing, food and insulin. Honest self-assessment is critical. A diabetic diver should cancel a dive if seasick, unusually anxious, or following significant high or low blood glucose levels in the preceding 24 hours. The diver should enter the water with a blood glucose level above 8.3 mmol·L⁻¹ and below 14 mmol·L⁻¹ with a stable or rising trend in blood glucose established with glucose tests at 90, 60, and 30 minutes prior to a dive. The diver should carry emergency glucose at all times and brief dive buddies about hypoglycaemia procedures. This is a personal account of the author's experience diving with type 1 diabetes and details how the UHMS/DAN recommendations are put into practice on dive days. Key elements of the self-assessment process, long- and rapid-acting insulin adjustments, meal timing, responses to blood glucose trends, handling hypoglycaemia and approaching multi-dive days are described. Some considerations for people using insulin pumps are also briefly discussed."

Regards,

DocVikingo
 
Although I don't understand the measurements used in the article, I am a more newly diagnosed type 2 diabetic (diagnosed in April 2016), I do exactly what is described here. I take oral hypoglycemic medication & am in very good control with diet & the medications. I check my glucose levels before & between each dive,... if I go below a specific limit, agreed upon between myself & my Dr, I have been instructed to consume a rather high carb snack, pre- dive, to, prevent a possible crash. Since I am excersizing, the spikes are usually minimal & I tend to actually stay quite steady in my levels. I also carry a couple of glucose gel packets in my drysuit pockets & inform my buddy of potential issues that could arise. I have never had to use them,... but better to have it & not need it, than to need it & not have it. The packets are not at all bulky & no problem to carry along.
 
8.3 millimoles per liter converts to about 150 mg/dl, which is the unit of measure used in the US. 14 millimoles per liter coverts to about 250 mg/dl.

Best regards,
DDM
 
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