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Diabetes and Scuba Diving Guidelines

Until quite recently (2005), the guidelines for divers with diabetes mellitus (DM) were somewhat confusing. In fact, there used to be a blanket ban imposed for all diabetics in diving.

This help guide explains how the latest changes affect diabetes and scuba diving, especially for divers who are able to manage their condition.

So, is Diabetes a Contraindication for Diving

Sometimes, scuba diving safety facts can be ambiguous and difficult to comprehend.

For example, some of the medical community still consider diabetes as being a 'relative' contraindication for scuba diving.

Why is that?

To begin with, any diver who suffers impaired consciousness will pose a risk to their own life and to the health of others around them.

The danger will increase if the diver also loses cardiovascular fitness.

So, until the guidelines changed, these potentially hazardous situations prompted clinicians to describe diabetes as being one of the absolute contraindications for scuba diving. Hence, the outcome was an outright blanket ban.

However, Divers Alert Network (DAN) and the Undersea and Hyperbaric Medical Society changed scuba diving and diabetes guidelines following extensive research into the disease back in 2005.

Here's the best part:

According to the latest regulation, diabetics may take part in scuba diving activities as long as they use medication (or their diet) to treat and manage their condition.

Diabetes Mellitus and Diving

Some people cannot produce insulin (or respond effectively to it). But, the human body needs the insulin hormone to facilitate glucose (the main sugar found in blood).

A healthy individual can maintain plasma glucose in a narrow range - typically between 70 and 110 milligrams per deciliter (mg/dL) of blood.

But, people who are living with the diabetes disease can experience some dramatic fluctuations in plasma glucose (e.g. hypoglycemia and hyperglycemia).

The bottom line is this:

Hypoglycemia (low levels of blood glucose) can lead to loss of consciousness. Whereas, hyperglycemia (long-term elevations of blood glucose) can result in compromised eyesight and circulatory problems.

Difference between Type 1 and Type 2 Diabetes

Simply put, Type 1 diabetes is an inability to produce insulin. Some people might refer to it as the insulin-requiring diabetes mellitus (IRDM).

In contrast, Type 2 diabetes (also called mature onset diabetes) refers to the inadequate production of insulin. The insensitivity of the cells in the body to insulin is also known as Type 2 diabetes.

Pro Tip: In activities where a sudden loss of consciousness poses a significant risk to any individual with diabetes (especially IRDM) a total exclusion was the official guideline, including scuba diving.

Can You Scuba Dive if You are Diabetic?

So now you may be asking yourself 'how safe is it for people with diabetes to scuba dive'? In fact, complying with the current guidelines for diving with diabetes means many more diabetic divers can participate.

Nonetheless, you must be taking proper steps to manage your condition, either with medication or through your diet.

Hence, if you are healthy enough to dive you may participate in recreational scuba activities - with approval from your physician. Consider these three important factors before you dive:

  1. Type 1 diabetics have a higher risk for hypoglycemia. Even so, it can still affect people with Type 2 diabetes and anyone taking insulin or oral hypoglycemic agents (OHAs).
  2. Newly diagnosed diabetics, or anyone with an unstable condition, will face a bigger risk of having a medical problem.
  3. If you are diving with diabetes, it is important to get examined on a regular basis. Some complications of the disorder may create some additional risk and disqualify you from diving.

Important: Always follow any advice that your physician recommends, and read the additional guidelines listed below.

What Are the Risks for Divers with Diabetes?

There are several reasons why doctors discourage diabetics from taking part in scuba diving. In fact, hypoglycemia and hyperglycemia are 'potentially' life-threatening conditions. So, typical symptoms and effects that hypoglycemic divers (Type 1 diabetes) may encounter include:

Pro Tip: It can be difficult for divers to distinguish hypoglycemia from the common nitrogen narcosis symptoms when scuba diving at depth (e.g. below 18 metres).

Some of the common symptoms that Type 2 diabetes hyperglycemic divers may encounter include:

Some of the symptoms are difficult to identify and manage while diving. In fact, responding to an unconsciousness diver underwater can create significant risk for everyone involved.

Current Guidelines for Diving with Diabetes

Diving Safely with Diabetes

Even though there are steps you can take to make diving with diabetes safer, symptoms of severe hypoglycemia can be fatal if experienced underwater.

Often, it is difficult to rest while diving. In addition, your conditions may change with little - if any - warning signs.

It can turn a relaxed dive into a physical struggle or fight for survival. Plus, managing scuba injuries and illnesses underwater will be more difficult in remote areas.

Key takeaway:

It's important to find a dive buddy who is familiar with industry standards. Regulations suggest that all individuals in a group are able to provide adequate and rapid support for each other.

A pre-existing medical condition can impair one of the pair. In this case, the assumption may lose accuracy. When diabetes becomes progressive, the risks for diabetics in scuba diving also increase.

Getting Screened for Diabetes

The latest estimates issued by the CDC suggest around 9.4% of Americans have diabetes. And yet, almost 24% of those people remain 'undiagnosed'.

So, what are the current recommendations from the American Diabetes Association? They say individuals without symptoms or risk factors should get screened for diabetes every three (3) years from the age of 45.

You should start diabetic screening earlier if you are overweight, obese, or you have other risk factors (e.g. heart disease, high blood pressure). But, thirty (30) minutes of exercise five times a week can help to prevent, or delay, the onset of Type 2 diabetes.

Pro Tip: Undiagnosed diabetes can lead to an increased likelihood of having heart disease, ischemic stroke, and other life-threatening conditions.

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