Diving with Type II Diabetes

[Hintermann]

First of all, there is no such thing as "non-insulin dependent" diabetes. While Type 1 diabetics need insulin right from the beginning, many long-standing Type 2 diabetics are also on insulin, usually along with oral medication. In type 2 diabetes, the intrinsic insulin production actually increases in the first few years because the beta-cells in the pancreas work harder to make-up for the decreasing insulin sensitivity of the peripheral tissues. But this also "exhausts" the insulin producing beta-cells so that the intrinsic insulin production begins to fall away and by the end of 15 years after diagnosis, will be down to practically nothing. By that stage, even the combination of diet-exercise-different tablets fails to control the diabetes and so adding external insulin injections will be necessary.

In your case, even though you are not on insulin, your dive insurance, actual risk etc will depend upon the tablets that you are taking. Metformin alone almost never causes hypoglycaemia and so the risk is very low. However, if you are taking sulfonylureas like gliclazide, glimepiride etc, there is a risk of hypos and so monitoring is usually necessary. The risk is low with other oral diabetes medications except meglitinides like Repaglinide. Most dive insurers will be aware of all this and so it will reflect on their decision.

 

[pjhansman]

There are also many, many long-standing Type 2 diabetics are not on insulin. But it does depend on what oral meds you are taking.

The really important part here is that, as Hinterman said, Metformin alone almost never causes hypoglycaemia and so the risk is very low.

 

[Starfarer42]

Always take some drinkable glucose whit you on the dive. Drinking is far easier than chewing down below. Abort when hypoglycaemic after taking the glucose!

Yes. I always have glucose tablets on me even though I haven't needed them since I stopped taking Amaryl. I've got myself some liquid glucose in foil packets that I think should survive the pressure just fine, and I plan to carry them with me in the water. Plus, I'm thinking I'll keep a bottle of juice nearby in case I'm feeling low after the dive.

Is there any particular technique for taking glucose (in liquid form) while under water? The DAN guidelines say to surface first, establish buoyancy and *then* take glucose but you're not the first person I've seen online to mention taking it under water. I'm wondering if that's something I should practice as part of my OW course. Hypoglycemia can come on *fast* and being able to take glucose immediately might be important.

---------- Post added July 27th, 2014 at 11:36 AM ----------

I've decided to follow the DAN guidelines (glucose at 150 mg/dL and rising) as closely as possible, at least for now. I'll be testing my sugars before and after every dive so maybe I'll modify that once I have some better data and understand how diving affects me personally.

Thank you, everybody, for the great information. This has been really useful.