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And the medical practitioners come slowly out of the gallery. Just wished I knew what all the words meant.
That's awesome that your son can dive! I used to hate it when a child wanted to be a long haul trucker or commercial pilot as those are still off limits to an insulin user. But the rest of the world is not.
One small point of correction. In general, most Type 2 overproduce insulin. The issue is generally not a problem with efficiency in manufacturing insulin, it is in lack of efficiency in using endogenously produced insulin (insulin resistance).
I'm going to have to disagree with the assumptions you made from my comments. I did not comment at all on the underlying pathophysiology of Type 1 versus Type 2, I'm well familiar with that. I only commented on the implications of the therapy which must be used in Type 1 and might be used in Type 2. Regardless of the body's ability to produce endogenous insulin, or the body's ability to properly use the endogenous insulin it makes, the use of insulin (and to a lesser degree, the use of sulfonylureas in some Type 2s) is something that puts a diver at higher risk while diving than the other therapies due to hypoglycemia which can occur in every patient who uses insulin, not just the Type 1 patient.
I do not agree with your blanket statement that is "much more complicated" to dive safely if you have Type 1. It may or may not be. Patients with longstanding diabetes or poorly controlled diabetes often develop some nerve damage which impairs their ability to recognize hypoglycemia when it occurs. Personally, if both patients take insulin, I'd put my money on a newer Type 1 who has a history of good control than a longstanding Type 2 with a history of poor control in terms of their ability to dive safely. Now if both patients had longstanding disease and a history of poor control, then yes, the Type 1 patient will most definitely have a harder time diving safely. Type 1 patients who use insulin pumps are generally able to easily titrate their blood sugars around activities, it is a little harder to do if they take intermittent injections.
Let's not get into Type 1a.
And the medical practitioners come slowly out of the gallery. Just wished I knew what all the words meant.
In general, most Type 2 overproduce insulin.
Leslie,
I agree with your disagreement on the assumptions of my initial disagreement. And I am in total agreement with your agreement. Does that make sense?
Gary
This is true at the start of the disease, before the BG hits levels that gets us diagnosed. Typically by the time we get diagnosed, it's because all that overproducing of insulin to overcome the insulin resistance has caused the pancreas to start burning out and not producing so much insulin. It's at that point the BG starts to rise and we get diagnosed from those high BG numbers and the high A1c.
I control mine with diet, exercise and metformin. The biggest trick I've found is to use my meter to test before and after meals, and before and after exercise and of course diving. This has taught me how different foods effect my numbers, as well as different activities. With this info, it's a fairly simple matter to keep good control, and figure how much and what I want to eat before a dive to maintain good numbers and prevent a low from the exercise. I time the eating before the dive such that my post meal spike would occur during dive, thus avoiding any highs as well as lows from the excercise. In case of the unexpected, I do carry a couple of tubes of glucose gel in my BC pocket. Just got to plan for the BG, no different than planning bottom times and air consumption
Do you ever get hypoglycemic on Metformin? It is not frequently seen, but you are smart to carry the gel anyway.
Ask away. Bottom line is that insulin users with both types of diabetes (and to a lesser extent, the Type 2 patient who take and older class of oral agent which can cause hypoglycemia) have to be very careful when diving. Doc Vikingo was spot on that the blood sugars have to be tested pre and post dive, with an appropriate response to the information obtained, to dive safely. A lot of insulin using diabetics run their blood sugars a bit higher before a dive, and have a complex snack before the dive as well (i.e., NOT just simple carbs, but some protein/fat too).
The OPs wife being diet controlled makes the above unimportant in her case. She just needs a good physical with special attention to her cardio fitness.