Type one diabetes and Scuba diving

Mel dCP said:

We could say that type ones shouldn’t dive, climb, run, get tattoos, do ziplines, persue careers in medicine... because “what if”? (I’m doing/have done the last three). But surely those also apply to anyone?

When we’re serious about doing a thing like this, we make **** sure our sugars are solidly under control.

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.................and gather as much information as possible to be safe, also the instructor would of had all the training and certificates, insurance etc to prove, he or she has the ability and knowledge of the sport/past time and is fully competent.

kitedoc said:

It is about real risks and inadequate solutions. The diver I mentioned in the first post being saved by 2 orca - now that is an interesting situation. Or is that not relevant??

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But that's life, I know full well that life is a one time offer and to use it well and I am in awe of people who climb, dive, has blue lights flashing, go in to burning fires, out at sea, these people are taking risks themselves to help, treat and save other's.

DCUKMod said:

Bearing in mind the duration of your diagnosis, I think it would be fair to comment things have likely changed a bit.

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My wife has been scuba diving in recent years and has kept me up-to-date !!

I became PADI certified about 15 years ago, before I was diagnosed type 1.

Understanding what I do about diving, then it is possible to dive but taking care to observe a few things, firstly dives generally last around 30-40 minutes, new divers tend to use the oxygen up quicker as they are not used to breathing deeply under water and can be anxious so tanks last for shorter times. So you really only have less than an hour between blood glucose checks which isn't too long and as long as you've got a plan on how to manage your levels then it shouldn't stop you. You always dive in a group or with a buddy and there are lots of checks under water to make sure your buddy is ok so communication is closely observed. I would also recommend avoiding alcohol in the 24 hours before the dive.

It's a good idea to dive on the high side, what you are unable to account for until you are in the water is what the temperature will be, if it's pretty cold then your body will use more glucose in the process of keeping your body warm, so best to dive without any quick acting insulin on board, I would also have a biscuit, small snack or easier still some chocolate before going down to help keep levels up, it's best to work on the theory of keeping high and correcting a high after the dive rather than worrying about going low whilst below. Also you may not feel yourself going hypo in the water if it's cold, there's alot going on down there and your in a foreign environment, so staying high will provide a good buffer to avoid a potential hypo.

Also speak to the dive club before you go to check your t1 status, some may not allow t1's as they're not covered in their insurance, others may simply want assurance you are tightly controlled and have a plan on how to accomplish the dive before you go down.

I haven't dived with type 1, but this is the plan I would follow if I had the chance to dive again.

My oh was a dive instructor for many years (in fact that’s how we met when he trained me!). I think people may be somewhat overconfident in what such instructors know about diabetes or it’s potential effects on a diver. The doctor doing their medical is the one who will have that detailed knowledge but the instructor most likely won’t. As far as they know if you’ve been passed as fit to dive as a diabetic then you are. Individuals may have far greater or lesser knowledge but many will just want to know you feel fit and have taken the steps you should have before diving.

Bon83 said:

I'm not a diver but I know a few people who regularly dive. Diving is a risk - which requires calculation and careful judgement to avoid bad decision making. T 1 d folk I'm afraid are often very aware of making correct, considered decisions in daily life. I know I put a lot more thought into running than my none diabetic counterparts - I will always have emergency food/mandatory kit list at an event - I know plenty don't. Bad decisions and recklessness put people at risk- not being insulin dependant.

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I haven’t dived in some time but I was a VERY safety conscious diver. I always tried to dive with people whose level of risk aversion was similar to my own. I’ve dived with a number of people once and only once due to their poor decision making and recklessness. As far as I know none of these were type 1. (Same reasoning has applied to car drivers I won’t travel with again too)

As a buddy to a type 1 I would still want the same level of reassurance they weren’t an idiot and had done all the necessary prep to make it a safe dive as I would a non diabetic. Yes this would also mean being confident they had their levels under control and had learned their tolerances and reactions to diving progressively and safely And that I wasn’t their guinea pig for a drastic jump in circumstances.

I’ll be honest and say I think I’d want them to be well controlled on land though and rigorous in their own safety first and diving with anyone with a medical condition does add another layer of complexity to fully consider. But I’d also want to know an alcohol drinker wasn’t hung over or still drunk too though! Or someone with any another medical condition had taken all their precautions too.

It comes down to trust. Diving with someone involves trust regardless of who they are.

DCUKMod said:

that the T1 would be made known to him and a discussion ensue

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Agree, I just don’t hold out much hope that any particular dive leader or instructor would have any diabetes knowledge beyond what the potential diver told them and as such is totally reliant on the sensible decisions and accurate information shared by said diver.

Completely agree each and every diver has the responsibility for themselves and those they dive with to be honest and knowledgeable about their health status.

I’m T1 and had been for 20 years before I first dived. It’s a few years now since I’ve scuba dived, mainly because the money and opportunity weren’t there any more. However, in my time I clocked up 112 dives. I loved it, there’s few things better than discovering communities of life forms below the sea. I trained in the Southern Hemisphere and am a Certified Diver with NAUI, not PADI, but the demands are similar. I only dived in warmer waters; the coldest was the Mediterranean.
I always went into the water at 9 or above, preferably 11, as I knew that I would have sufficient to counter the loss of energy that occurred during an hour’s dive and heat loss . The water was always colder than me and since I wore a wet suit, not a dry suit, the heat from me was transferred to the surrounding water. I also knew that I needed to have energy to deal with unexpected events, currents, and to survive on the surface if I came up some way from the dive boat and/or in rough weather. The bcd (buoyancy control device - a jerkin that’s inflated and deflated to help make a diver buoyancy neutral) has pockets that can contain waterproof packets of glucotabs or jelly babies that can be accessed once you surface. I had lucozade, glucotabs etc waiting on the dive boat. If you need to do a shore entry or exit then that will take more energy and the kit’s heavy when you’re on land.
It’s important, I found, to fully educate a dive buddy about T1 hypo symptoms, although I was lucky and they never needed to rescue me. Divers, good divers, keep a close eye on their buddy while underwater as there can be other things apart from T1, from kit fails to accidental injuries, that mean they need help. Again, I was lucky, and a buddy was always someone to share the joy and excitement of what we saw rather than someone who helped or needed help, though our older daughter was once rescued by her buddy when some hoses split and her air escaped.
I found that the deeper I dived, the more energy I used as the water was colder down there. The PADI and NAUI qualifications certify you to descend to 30 metres but the best things are often found much closer to the surface, and if you get the opportunity, and if Climate Change doesn’t bleach them all, then there are few things lovelier, in my opinion, than an hour spent at 5 - 10 meters watching the amazing fish, nudibrachs, clams and anemones to be seen on a coral garden.
Oh dear, I miss it. After I qualified the rest of the family followed suit. Our older daughter did a degree in Marine Biology, later became a Dive Instructor and worked in Fiji and NZ before getting a ‘real’ job teaching science.
If you can do it safely then I think scuba diving’s a so-called risk worth taking.