How does a “controlled diabetic situation” affect my ability to SCUBA dive? I have had many dives before, but haven’t been underwater for two years. Since then, I have begun insulin shots with oral medications. I use a sliding scale for my NovoLog, baselining at 10 units. I rarely go over 16 as my levels in the morning are 100 to 130 mg/dl [5.6 to 7.2 mmol/L] and in the evening usually 160 to 200 mg/dl [8.9 to 11.1 mmol/L]. I also take 60 units of Lantus each night. I weigh 223 and my most recent A1c was 7.6 (down from previous 11). I am going to Caymans at the end of month and have done a lot of research as to the risks. I was asked by my “Advanced Class” instructor to find more information. Any help as to effects of diving and diabetes would be appreciated, also risk factors. I love to dive, but don’t want to die while doing so.

There are two camps when it comes to SCUBA diving with diabetes (insulin requiring). One says, as long as you are controlled and take the precautions to avoid lows ( i.e.,starting with a blood sugar of about 180 to 200 mg/dl [10.0 to 11.1 mmol/L]) and highs you are okay. The other camp says, if you go low and need to take fast acting glucose and you are confused and cannot get to the surface quickly enough, you are putting yourself at risk. People who dive with high blood sugars or have certain complications associated with their diabetes are more prone to decompression sickness (the bends). Knowing how exercise affects the blood sugar is also crucial in helping to formulate a plan prior to scuba diving.

The same argument can be made with someone who is a rock climber. The minute someone is told they “can’t” do something due to their diabetes this often inspires people do prove the critics wrong.

There is a certain risk involved with SCUBA diving whether you have diabetes or not. The idea is to reduce the risk as much as possible and to consult with experts who have diabetes and dive on a regular basis. One such person is Stephen Prosterman who is the director of Camp DAVI and Diving and Field supervisor for the University of the Virgin Islands in St. Thomas, Virgin Islands. His e-mail address is [email protected].

As always, when starting something new or with higher risk involved like SCUBA diving, it is important to keep your health care team involved.

RP