Diabetes

[Bluetickle]

Greetings,

I have a friend, actually a really good friend, who wants to learn to scuba dive and is interested in eventually maybe learning to cave dive. I want to be his buddy.

I'm being intentionally vague, and I won't mention his name for privacy reasons.

My friend has insulin dependent diabetes... (pause)

Stop and think to yourself - what conclusions have you already drawn?


..............................................> ???



This poor guy is rock solid smart, has perfect tight control of his diabetes, and is completely and totally aware of the physiology of this disorder and how to manage it and does so to perfection. He works in the medical field and is a professional care giver. He knows his stuff and lives it.

Actually, he is most likely in better health than perhaps 90% of the cave diving community. You know who I'm talking about you fat beer-belly cave divers! :)

If anyone could adequately manage this condition while diving, this is the person... I don't have any doubt.


Please provide your input on this subject, and if you can offer any advise on this situation, it would be greatly appreciated.

Come to think of it... if he was breathing nitrox, a high partial pressure of oxygen would be beneficial to a diabetic.

Are there any diabetic cave divers?

Cheers!

[Webmaster]

I don't know about cave divers, but I have two friends I cave with that are both insulin dependent and have pumps. They both do some long, fairly hard trips with no problems. They just wipe the mud off, whip the monitor out and check their sugar.

As long as he keeps good track of everything between dives I don't see a problem with it.

[FW]

Talk to Harry Averill. He is in the NSS-CDS instructors list. http://www.nsscds.org/training_new/instructorlist.htm

[Kelly Jessop]

They just wipe the mud off, whip the monitor out and check their sugar.



Kind of hard when underwater

For the longest time we classified lack of training as the root cause of cave diving accidents,now medical issues has become an issue and statisitically significant. I'm not saying that diabetes is a factor in these accidents,but with any disease process it should be looked at seriously before entering the overhead environment,and taking the chance to endanger others.

[smaclean]

I think his best course of action, assuming he is truthful when filling out his medical form, is to find an instructor who is truly educated about his condition. The federal ADA prohibits discrimination based on a medical condition. This being said, the agencies will place the burden on the instructor then hanging them out to dry if anything happens. AAUS frequently have to go to some great lengths to get a grad student or scientist in the water with disabilities.

[Arnold Mesiser]

I do believe DAN has some good-recent articles online about diabetes and diving



On this subject-I wonder how many divers are undiagnosed diabetics ?

[contender]

Greetings,

I have a friend, actually a really good friend, who wants to learn to scuba dive and is interested in eventually maybe learning to cave dive. I want to be his buddy.

I'm being intentionally vague, and I won't mention his name for privacy reasons.

My friend has insulin dependent diabetes... (pause)

Stop and think to yourself - what conclusions have you already drawn?


..............................................> ???



This poor guy is rock solid smart, has perfect tight control of his diabetes, and is completely and totally aware of the physiology of this disorder and how to manage it and does so to perfection. He works in the medical field and is a professional care giver. He knows his stuff and lives it.

Actually, he is most likely in better health than perhaps 90% of the cave diving community. You know who I'm talking about you fat beer-belly cave divers! :)

If anyone could adequately manage this condition while diving, this is the person... I don't have any doubt.


Please provide your input on this subject, and if you can offer any advise on this situation, it would be greatly appreciated.

Come to think of it... if he was breathing nitrox, a high partial pressure of oxygen would be beneficial to a diabetic.

Are there any diabetic cave divers?

Cheers!


I am, but mine is well controlled. Whenever the doctor changes my meds or I feel bad I will not dive because of the risk that something could happen. I was diagnosed with this last year, but was certified many years before. YMCA used to have a good protocol for this, if you can find it, give it to your friend and have a doctor evaluate him using it, if he checks out ok, dive dive. He just needs to be extremely careful in an overhead environment, because of the fact that there is a risk no matter how well contolled his condition is.

[Squirrel Girl]

This poor guy is rock solid smart, has perfect tight control of his diabetes, and is completely and totally aware of the physiology of this disorder and how to manage it and does so to perfection. He works in the medical field and is a professional care giver. He knows his stuff and lives it.

Actually, he is most likely in better health than perhaps 90% of the cave diving community.
I have known 2 insulin-dependent cave divers. One was Bill Wilson. He took things very easy, I believe, and he managed it. I didn't know him well.

The, other, Ian Rolland. He was probably in the top 1%, in terms of fitness. He died in a sump. Let me tell you, having a friend die on an expedition is one serious bummer and makes you re-think your cavalier, "It's his choice, it'll be OK" attitude.

The only thing was that he hadn't been insulin dependent so long that he really understood the situation as much as he might have.

So, I don't think I'm someone to tell someone else not to, but I now am more wary than I was before Ian died.

[Slüdge]

Barbara, when this thread started the first thing I thought about was the expedition and Ian. The old "it's my decision, it'll be all right" doesn't sound all that true right now.

[Bluetickle]

Thanks for the excellent responses!

Can anyone think of any obscure physiology that may not be apparent or obvious...?

Perhaps, something like increased metabolize "hunger" after/during diving and so on...

[Squirrel Girl]

Barbara, when this thread started the first thing I thought about was the expedition and Ian. The old "it's my decision, it'll be all right" doesn't sound all that true right now.

Well, I don't know that I'd change my mind that that's true. But I think of it as a WAY more serious situation.

We all insist that we can cave dive, even though it's serious and we could die. We think we plan and practice enough that it's worth the risk. That same argument is true of diving with diabetes. Only that the risk is truly significant. And probably somewhat harder to manage--more nebulous.

Interestly, also, after Ian had died, an journalist was there and told of how he was diabetic. He was skiing and wasn't feeling right. He considered that it was his diabetes, calculated that that couldn't be the problem, and then ate a candy bar anyway. Suddenly it improved his blood sugar and he realized, "OF COURSE" it was his diabetes. But it's the mind that gets affected first. Then the body.

So, I wouldn't forbid (as if I could) someone from taking up (cave) diving, but I would like them to know how really iffy it is.

[Squirrel Girl]

Oh, yeah. And two of our team members typed up the accident analysis and interviewed some medical specialists. I believe it was published in Underwater Speleology. The expedition was in spring of '94. I'd guess the accident report would have been published sometime in spring of 95. Maybe late 94. I'd highly recommend it.

[Gene_Hobbs]

The DAN workshop is available:

Pollock NW, Uguccioni DM, Dear GdeL, eds. Diabetes and recreational diving: guidelines for the future. Proceedings of the UHMS/DAN 2005 June 19 Workshop. Durham, NC: Divers Alert Network; 2005. RRR ID: 5538 (http://archive.rubicon-foundation.org/5538)

As the AAUS standards were mentioned, here is a 2006 publication from Pollock:

Pollock, NW. Evolving Standards for Diabetes and Diving: Implications for Scientific Diving. In: Godfrey JM, Pollock NW, eds. Diving for Science 2006. Proceeding of the American Academy of Underwater Sciences 25th Symposium. Dauphin Island, AL: AAUS; 2007. RRR ID: 8001 (http://archive.rubicon-foundation.org/8001)

There is a ton of other work and opinions that have been published throughout the years, some of those can be found here (http://archive.rubicon-foundation.org/dspace/simple-search?query=diabetes+diving&submit=Go).

[Webmaster]

Kind of hard when underwater


Of course, but how long does a dive last for most folks, 1-3 hours maybe? Knowing how you react and checking it between dives would be important. And would probably preclude any real long dives.

Checking it on a 12+ hour trip is pretty much necessary.

[whodunit68]

Yup, though I'm NIDDM type 2.
See DAN (diversalertnetwork.org). Plenty of data. Start him diving!!!



Greetings,

I have a friend, actually a really good friend, who wants to learn to scuba dive and is interested in eventually maybe learning to cave dive. I want to be his buddy.

I'm being intentionally vague, and I won't mention his name for privacy reasons.

My friend has insulin dependent diabetes... (pause)

Stop and think to yourself - what conclusions have you already drawn?


..............................................> ???



This poor guy is rock solid smart, has perfect tight control of his diabetes, and is completely and totally aware of the physiology of this disorder and how to manage it and does so to perfection. He works in the medical field and is a professional care giver. He knows his stuff and lives it.

Actually, he is most likely in better health than perhaps 90% of the cave diving community. You know who I'm talking about you fat beer-belly cave divers! :)

If anyone could adequately manage this condition while diving, this is the person... I don't have any doubt.


Please provide your input on this subject, and if you can offer any advise on this situation, it would be greatly appreciated.

Come to think of it... if he was breathing nitrox, a high partial pressure of oxygen would be beneficial to a diabetic.

Are there any diabetic cave divers?

Cheers!

[Oister]

Would it be a good idea to carry some sort of sugar gel on dives? Maybe it could add some redundancy or increase the safety factor.

[Squirrel Girl]

Would it be a good idea to carry some sort of sugar gel on dives? Maybe it could add some redundancy or increase the safety factor.
Ian had a power bar (or something like it) in his dive pouch. He didn't eat it.

[Kelly Jessop]

Of course, but how long does a dive last for most folks, 1-3 hours maybe? Knowing how you react and checking it between dives would be important. And would probably preclude any real long dives.

Checking it on a 12+ hour trip is pretty much necessary.

Hmmm... guided dives in the future at Diepolder3

Cave card,trimix card,100 cave dives-check
waivers and fees-check
gas check by guide-check
blood glucose check by guide-check
Okay lets go diving

I realize professionally I see some of the worst cases,but a concern I would have is someone doing a dive with high level of METs,and blood sugar bottoming out quickly due to high activity level.