{'en': 'Diabetes and diving', 'es': 'Diabetes y buceo'} Image

Diabetes and diving

fer's profile photo   07/25/2013 8:14 a.m.

Historically, Dan (diverse alert Network) advises not to dive of insulin-dependent divers, due to the high risk of hypoglycemia, which can lead to drowning, (due to loss of knowledge).The symptoms of hypoglycemia are perspiration, nervousness, fainting, palpitations, confusion, visual disturbances stupor, attack and loss of consciousness.Several of these symptoms can be confused with nitrogenic drug traffickers.

Until now one of the most interesting results is that diving significantly decreases blood glucose levels.(Plasma glucose concentrations are maintained in a fairly narrow interval of 70 to 110 milligrams per deciliter of blood (mg/dl)).This confirms the possible risk of hypoglycemia when diving, especially in strenuous or cold dives.However, it also shows that insulin-dependent divers with a moderate control of their condition can safely dive.For this, certain protocols must follow and monitor their glucose.

How can diabetes affect the diver?
It is a great obstacle to certify a diabetic, the possibility of an attack and the loss of consciousness due to hypoglycemia.The reaction to insulin and the speed with which low sugar levels can be harmed the power of decision and reason.

Out -control diabetes leads to eliminating large amounts of sugar in the urine, a process that quickly leads to dehydration, increasing the risk of decompression disease.

In general, diabetics - especially insulin -dependent - should not carry out activities during which a fainting can be dangerous.This is the case of diving with Scuba, since this situation would prevent respect for personal security measures and monitor the diving partner.

Studies
While there are differences between different countries.After evaluating several cases of dependent insulin diabetics who had performed immersions without problems, the medical commission of the UK Subacuatic Club (British Sub Aqua Club, BSAC) relaxed in 1991 the strict ban on practicing this activity to these people and, currently, theIt allows insulin -dependent diabetics that do not present cardiovascular problems or other complications (4).Instead, American clinical guides and other countries are stricter.Some authors recommend evaluating each person individually, while others recognize that it is very likely that in the near future there is greater tolerance in these cases.

In 1993, different alert Network sent a survey to its 115,300 members to determine how many of them were diabetics and diving despite the disease and, according to their results, 164 (129 insulin of the dependent) said they had made more than 27,000 dives with autonomous scanwithout having presented any important complication (2).Although symptoms of hypoglycemia were communicated, none of them caused a loss of knowledge.

It has not been investigated whether recreational diving in low stress conditions affects blood glucose concentrations.Dan began an essay in 1997 to evaluate the effects of this activity on recreational divers, and recently published his results in a scientific magazine (3).This article summarizes the main data of said study and proposes new research.To obtain more detailed information, the full article can be consulted.

Methods
The study evaluated the response of glucose in plasma to recreational diving in insulin -dependent diabetics adults and in a group of healthy divers, which was used as a control group.

The inclusion criteria in the first group were aRelatively controlled diabetes (at least), the absence of secondary complications of the disease, not having been hospitalized during the 12 months prior to the study as a consequence of severe alterations of blood glucose, and a good knowledge of the relationship between plasma glucose concentrationsand physical exercise.

Most dives were made in tropical or subtropical waters and from small or larger ships (liverands).Before each immersion, the glycemia of the participants should be greater than 80 mg/dl;To make sure of this, portable devices were used that determine blood glucose by reactive strips, with which glycemia was taken several times before and after the dives.

Results
83 divers participated in the study: 40 insulin -dependent diabetics and 43 controls.Of the 1,059 dives evaluated, 555 corresponded to the first group and 504, to the second.They were averaged from the data of the diabetics group, and it was obtained that their average age was 45 years, and the average time they had been diving and with diabetes, of 9 and 15 years, respectively.In addition, 77 % had already been diagnosed with the disease at the time they obtained the certificate of aptitude for diving with autonomous scan.The profiles of the dives were similar in both groups, with an average of 2.7 dives per day, and no case was recorded.

Who can and who cannot dive?
Any diabetic that cannot recognize hypoglycemia (low blood sugar), hyperglycemia (high blood sugar), or who is diagnosed with otoacidosis (acid condition by the rupture of ketones), bad function of an organ (kidneys, eyes., heart).It cannot dive, because the risk is very high.

Diabetics with high control of their condition, which understand the interrelation between diabetes and exercise, which are sufficient disciplined to follow these standards, can be qualified to dive sports, always under the approval and control of your doctor.

Practical aspects
On the other hand, there are some practical aspects about the safety of the diabetics to which it is allowed to dive:

1) severe hypoglycemia can cause seizures and loss of knowledge, which can be mortal under water.

2) Unlike physical exercise on land, there is no reliable way to rest for a moment.In addition, underwater conditions can vary in a short time and a relaxed immersion in a quiet environment can suddenly become a situation that it requires great physical effort.

3) In the remote areas in which, sometimes, diving, control and treatment of serious diseases can be more difficult.

4) Diving in pairs is based on the principle that both divers are able to help their partner quickly and efficiently.However, if one of them suffers from a disease, it may not be able to fulfill this function.

5) Diabetes can be aggravated over time;When this occurs, the risks involved in diving are greater.

fer's profile photo
fer
07/25/2013 8:14 a.m.

@fer - Diabetes Tipo 1 desde 1.998 | FreeStyle Libre 3 | Ypsomed mylife YpsoPump + CamAPS FX | Sin complicaciones. Miembro del equipo de moderación del foro.
Co-Autor de Vivir con Diabetes: El poder de la comunidad online, parte de los ingresos se destinan a financiar el foro de diabetes y mantener la comunidad online activa.

  

Hello forum!I rescue this issue to see if there is someone who can advise me.

Two years ago I began to practice snorkeling from time to time, when I have been in some country of Clear Aguas and the Canary Islands.I like more and more, and it has led me to think that one day (not in the near future but not far), I would like to try the diving.
Arrival at this point, I looked for information on diabetes and diving, since it sounded to me that there was a problem.The truth is that I was surprised that the following is in force (I have extracted it from a forum of the year 2008):
Today, and until the Ministerial Order of April 26, 1973, published in BOE No. 173/1973 by the Undersecretariat of the Merchant Marine, diabetes is repealed, diabetes is an absolute and total contraindication for diving.Said regulations have not been repealed today, so it is understood that it remains in force, since the current security legislation in underwater activities does not speak at all of the contraindications;being therefore the criterion of the examiner and the aforementioned OM of 1973, restrictive and very demanding
It seems that the doctor has to give the person with diabetes an apt to dive.

From here I arise reflection and questions:
I think that if this law has not been repealed or modified, it should be done, since the simple fact of having diabetes will not make you drown.I think that knowing you, controlling the glycemia, etc etc (we already know by heart and for practice what we have to do), knowing how your blood glucose reacts under the sea and making short dives there should be no problem.

Anyone knows, if this law is still in force?Do you know someone with diabetes that dives?Everyone has to spend a medical examination to dive or is it only if you have diabetes?

And my last question : Would it be possible to dive with Dexcom?

Any response or idea would be of great help, thank you!

Maritxu22's profile photo
Maritxu22
05/04/2017 2:03 p.m.

DM1 desde abril 2006. 33años
Tresiba:12-14
Fiasp a demanda
Dexcom G6

Última HbA1c: 6% (junio)

  

Good @"maritxu22"

I am Padi Advanced, I've been diving for 7 years.

To get the basic diving title, the Open Water ask you for a medical certificate where you say you have no problem diving (all, diabetics or not).I had a very nice header who had to include that it was diabetic: d.If I had included it and the center where you are learning to dive is serious, they should not let you get it (according to the law you name above).Then they never ask for anything, neither to do dives, nor other courses.

The Dexcom to where I know, does not transmit data in the water, carry the receiver or not.It does not communicate by Bluetooth.I hope it is some of the improvements that include the next models, send data in aquatic environment.

I have never had any downturn in the depths, because more than anything I assure me to lower with the sugar sufficiently "high."Is it feasible to manage a downturn in the water at 28m deep?mmm ... I see it complicated.But diving in less depths where you do not have to make security stops to climb (you cannot rise suddenly when you go down more than x meters), you make sure you can climb to the surface and take a glucose gel.When always diving in pairs, you must agree on a sign in case you have a downturn with your partner, so that if you feel bad under the water, you understand and leave together the surface.

I have never done and I have pending, try to take a gel with the regulator on.

It is a bit like the driving license, is it worth saying that you are diabetic so that it has to renew it with more periodic than what is not?Do you want to stay all your life without trying something that catches your attention because it is diabetic?

piruha's profile photo
piruha
05/04/2017 4:12 p.m.

DM1 desde 1987 (con 3 años)
Lantus y Humalog
Dexcom g5

  

@"Maritxu22" This is the usual issue, laws of the year Chimpun, Bohemia glass somo .....

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Gala
05/04/2017 5:30 p.m.

"Miembro del equipo de moderación del foro"

  

Hello forum!
Simply comment that I finally encouraged my diving and took out the Open Water, and it was very worth it!
I have made 7 dives without any hypoglycemia, rather in two I left too high, until the trick took.In the boat I have always taken bar and caramelos and ready.
I have not said that I had diabetes or valued any doctor, since by filling the certificate they told me "put not everything", and I did.My partner knew it and ready.It has been very worth it!

Greetings!

Maritxu22's profile photo
Maritxu22
08/09/2018 1:41 p.m.

DM1 desde abril 2006. 33años
Tresiba:12-14
Fiasp a demanda
Dexcom G6

Última HbA1c: 6% (junio)

  

I admire you all those who practice this sport but not only for doing so having diabetes but because it is the most beautiful thing that the seabed exists.Thank you for commenting to all your diving experiences.

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jconegar
08/09/2018 5:39 p.m.

Miembro del equipo moderador del foro.

Ultima prueba realizada:
Maratón San Petesrburgo (Rusia)
https://luchojuntoamidiabetes.blogspot.com/2019/07/maraton-san-petersburgo-rusa-42195-mts.html

Prueba deportiva Ruta de las Fortalezas.
http://luchojuntoamidiabetes.blogspot.com/2019/05/ruta-de-las-fortalezas-2019-54700.html

Facebook: Jorge Moto
Usuario Dexcom G6 y microinfusora Tandem T: Slim X2 Basal IQ

  

Hello!For me the diving issue had been something I wanted to do but always stayed in the inkwell.At first for money (it is a expensive activity) and then because my partner gave something and of course, I was not going to dive and leave it on the beach ...
The fact is that when I decided three years ago it was already diabetic T1 (I have been for four) and I was not funny because if something happened, the insurance would not take care of precisely for having hidden information.
Total that I was a thorn that wanted to remove me because the snorkeling fell short.Last year we traveled to the Philippines and I was reading and reading and I found a school in the Canary Islands that in its regulations put as guidelines that the diabetic had to comply to be able to access the title (I took out the Open Waters).So my doctor made me a report that had not had severe hypo or hospitalization that had good controls etc and I had no problem.
The best thing is that they advise to go with someone who knows your sick and there it came out that my partner also took the open with me.
Since then I take food to the ship, I control it before and after and always the monitor or guide is aware of what could happen.
One of the best things I have done in life!

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Karme
08/13/2018 7:19 a.m.
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I add the guidelines to give you a medical certificate:

1. There should be no evolutionary complications of diabetes.
2. Medical conditions:
* Treatment without major modifications in the last year.

* No episodes of symptomatic hypoglycemia would be in the last year.

* No hospitalization in the last year by diabetes related condition.

* Satisfactory control of diabetes in the last year (HBA1C & LT; 9 %).

* There is no microalbuminuria.

* There is no retinopathy (incipient retinopathy can be considered an exception).

* There is no sensitive, motor or regional neuropathy.

* No Micro or Macroangiopathy evidence.

3. Additionally, a report of the endocrinologist is required about whether there is in his opinion a physical or mental problem that incapacitates for the realization of the exhaustion exercise (apart from diabetes).
4. An annual physical examination must be performed by a doctor related to diving.
5. It is essential in diabetics over 50, the realization of an ECG of effort.

Encourage that we can also!

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Karme
08/13/2018 7:25 a.m.
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When putting the photic, the guidelines have been stepped on ...
1. There should be no evolutionary complications of diabetes.
2. Medical conditions:
* Treatment without major modifications in the last year.

* No episodes of symptomatic hypoglycemia would be in the last year.

* No hospitalization in the last year by diabetes related condition.

* Satisfactory control of diabetes in the last year (HBA1C <9 %).

* There is no microalbuminuria.

* There is no retinopathy (incipient retinopathy can be considered an exception).

* There is no sensitive, motor or regional neuropathy.

* No Micro or Macroangiopathy evidence.

3. Additionally, a report of the endocrinologist is required about whether there is in his opinion a physical or mental problem that incapacitates for the realization of the exhaustion exercise (apart from diabetes).
4. An annual physical examination must be performed by a doctor related to diving.
5. It is essential in diabetics over 50, the realization of an ECG of effort.

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Karme
08/13/2018 7:29 a.m.
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karme said:
add the guidelines to give you a medical certificate:

1. There should be no evolutionary complications of diabetes.
2. Medical conditions:
* Treatment without major modifications in the last year.

* No episodes of symptomatic hypoglycemia would be in the last year.

* No hospitalization in the last year by diabetes related condition.

* Satisfactory control of diabetes in the last year (HBA1C & LT; 9 %).

* There is no microalbuminuria.

* There is no retinopathy (incipient retinopathy can be considered an exception).

* There is no sensitive, motor or regional neuropathy.

* No Micro or Macroangiopathy evidence.

3. Additionally, a report of the endocrinologist is required about whether there is in his opinion a physical or mental problem that incapacitates for the realization of the exhaustion exercise (apart from diabetes).
4. An annual physical examination must be performed by a doctor related to diving.
5. It is essential in diabetics over 50, the realization of an ECG of effort.

Encourage that we can also!

Simply congratulations !!!!What a photaca !!!!

jconegar's profile photo
jconegar
08/13/2018 3:57 p.m.

Miembro del equipo moderador del foro.

Ultima prueba realizada:
Maratón San Petesrburgo (Rusia)
https://luchojuntoamidiabetes.blogspot.com/2019/07/maraton-san-petersburgo-rusa-42195-mts.html

Prueba deportiva Ruta de las Fortalezas.
http://luchojuntoamidiabetes.blogspot.com/2019/05/ruta-de-las-fortalezas-2019-54700.html

Facebook: Jorge Moto
Usuario Dexcom G6 y microinfusora Tandem T: Slim X2 Basal IQ

  

Excellent theme, and this is my field.I work as a diver.I am Divemaster and diving from the age of 15.I practice free diving that is in Apnea, and the article is truly interesting.I share my experience.I am no longer using insulin, I managed to eliminate it with diet and exercises, now use metformin, but I was still with insulin and diving.I was precisely suspected that my glucose was lowered in the diving, so I assured me to hydrate well with electrolyte drinks as well as snacks before diving.In this case if I know that the activity will lower the sugar, you compensate it not taking the quick and eating healthy before the activity.I apply the same philosophy for every exercise routine.I let insulin pass, and I do my quiet activity.I do the metformin the same, if I am going to perform a physical activity, I omit it and I follow my normal routine.When I finish, I hydrate me, I take the glucose metric, and usually at safe levels.I have not felt any symptom of hypoglycemia in my divers.

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DiegoA
08/15/2018 3:04 a.m.
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Hello,
I am an Advanced diver of Acuc, and they only asked me for a medical certificate similar to that of the driving license.I have really enjoyed underwater, I have made hundreds of dives and I have never had a hip.

Of course, when you do consecutive dives or diving cruises it is difficult to adjust the glucose, so I used to start the dives over 200, since I did not trust.Now with the freestyle on I don't dive, I am sure that when I put on the neoprene I started hahaha!

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DiabetesForo
08/17/2018 5:07 p.m.
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Ahhh against, but then it's not so free ...

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DiegoA
08/17/2018 10:31 p.m.
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Hello good!I am Advance Open Water and I have always diving being diabetic.When I obtained the certifications I obvious that it was diabetic to avoid problems.Then when diving I have gone to numerous centers and have never put me.

For me the key is to control sugar levels before making the immersion, enter the water to a minimum of 200 to have room and carry some gel in the jacket.In my case I always notice the hypoglycemia so this gives me peace of mind, in case of not noticing them, I no longer know if I would dare ... I also recommend diving with a partner or instructor who knows the situation and has some action guidelines in case of hypoglycemia.

Regarding free freestyle, I have used it to dive and surprisingly has resisted immersions of 18 - 20 meters.In normal situations I do not use free when you dive because of the fear of spoiling, but as it cannot be removed once, if there is an occasion to dive, I prefer to risk;)

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xavisur
08/19/2018 6:58 p.m.
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Thanks for putting the guidelines for the medical certificate!The endocrine will be asked next time.When I told him that I was going to get the Open Water, he simply told me that it seemed very good, I didn't have much idea how it is going.
The truth is that I think it is better to say that you have diabetes so that they get used to seeing that we can dive without any problem.

Regarding the sensors, I made my 7 dives with the Dexcom sensor and come on, no problem in depths of between 16 to 21 meters.
What happens to me whenever I get into salt water is that when leaving the first measurements are somewhat lower, but then it works well.

Thank you for sharing your opinions and experiences with diving!

Maritxu22's profile photo
Maritxu22
08/20/2018 4:35 p.m.

DM1 desde abril 2006. 33años
Tresiba:12-14
Fiasp a demanda
Dexcom G6

Última HbA1c: 6% (junio)

  

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