Diving

[CarlG]

Hi guys I’m T1 and in need of some advice.

I’m trying to get my doctor/nurse to sign off my diving med form to allow me to dive.
The only problem I have is they keep saying no as I’m not a normal person with normal readings.
I think this is down to them not understand completely regarding diving and Diabetes.
As soon as they read the guide lines set out they run a mile.

I have attached the part they run when they read
But I have dived before and know people do dive.

I’m in good control hb1c is 46 but due to have one in the next week or so.
My readings are around 5.5-7 twice a day.
I never had any ups or downs in the 6 years I had T1.
I have spoken to a private PADI doctor that is regerstard with HSE he has said I need my Doc/nurse to say I’m in control or my diabetes.
But again they won’t sign.

What can I do I love my diving it keeps me fit and helps keep my levels.
Has anyone had the same problem or know what to do next.

 

[Northerner]

Hi Carl, welcome to the forum 🙂 I've no personal experience of diving, but I know we have had members here in the past who do, and are T1. I'd suggest contacting the Diabetes Uk Helpline to see if they can direct you to some good resources:

https://www.diabetes.org.uk/how_we_help/helpline

If you have good control I don't see why it should stop you - people can fly commercial airlines with T1 these days! 🙂 Good luck!

 

[Pumper_Sue]

As you only test twice a day I can understand why your medical team wont sign you off. Do you drive, if so how do you comply with the driving laws and testing Also how do you control your diabetes MDI or twice a day injections (Mixed insulin)

 

[CarlG]

I’m use humlin M3 twice a day I test before breakfast and dinner.
But I also check before I drive to make shore I’m 5 or above.
Just want to check pumper Sue that I mean diving not driving.
But
My blood is well controlled it’s never been a problem.

Can you explain why you think because I test only twice a day they won’t sign me off so I can have a better understanding.

I have spoken to a a private doctor all they need is for my doctor to say I’m in control with out any problems as I’m in control and have not had any problems I can’t understand why.

The problem I think is the rule and regs regarding diving has changed as up to a couple of years ago it was a big no no for a diabetic to dive but now there is a better understanding etc if it’s controled it may be fine but doctors are a bit weary for one reason or another.

 

[Sally71]

What would you do if you had a hypo underwater? Even the best controlled diabetics can't avoid hypos completely. You can't eat underwater and you can't come up quickly!

 

[CarlG]

I understand that but we can say that about driving and other day to day thinks and sport.
Diving has moved on so much in the last years and is safer than ever.
But I do understand your concerns tho

 

[Pumper_Sue]

I’m use humlin M3 twice a day I test before breakfast and dinner.
But I also check before I drive to make shore I’m 5 or above.
Just want to check pumper Sue that I mean diving not driving.
Yes I realised you had said diving and not driving I was concerned with your statement you only tested twice a day which meant you couldn't be testing before you drove either.
But
My blood is well controlled it’s never been a problem.
I can not see how you can say it's well controlled with the lack of testing you do,

Can you explain why you think because I test only twice a day they won’t sign me off so I can have a better understanding.

I suspect the Doctors are of the same opinion it's their job and reputation on the line and your life if they get it wrong.​

I have spoken to a a private doctor all they need is for my doctor to say I’m in control with out any problems as I’m in control and have not had any problems I can’t understand why.
Perhaps they are going on your past history? I read your previous posts from when you first joined the forum so can understand the Drs point of view. It's a hard pill to swallow but better to be safe than sorry.
The problem I think is the rule and regs regarding diving has changed as up to a couple of years ago it was a big no no for a diabetic to dive but now there is a better understanding etc if it’s controled it may be fine but doctors are a bit weary for one reason or another.

 

[Alister]

I am a diver myself (t2 but on insulin) trained to Dive leader standard with BS-AC & SAA but have not yet dived since diagnosis. I am not a member of any club or organisation, I just have a few friends who are always looking for a Buddie. I will be diving the valentine tanks out of pool this weekend.

I have not bothered with a diving medical for many years, even before I was diagnosed To my mind if something does go wrong then I probably wont be around to worry about it anyway. As for my buddie it would be my word against his and as I wont be saying much...

However I do appreciate this is not everyone's attitude & if you are diving on holiday then a medical certificate may become necessary.

Perhaps you should refer them to the BSAC page on diving with Diabetes
http://www.ukdiving.co.uk/information/medicine/diabetes.htm

Medical conditions.
The diver should not have any of the long-term complications of diabetes. The medical conditions apply equally to insulin-dependent and non-insulin-dependent diabetics. Although hypoglycaemia is a relatively uncommon complication in non-insulin-dependent diabetics the risks are not negligible and any potential diver should be using a short-acting anti-diabetic drug, if such medication is necessary. However, it does appear that non-insulin-dependent diabetics can generally exercise without fear of a deleterious metabolic response. The diving clubs in the U.K. (BSAC, SAA and SSAC) issue a common set of forms for the diabetic and his/her diabetologist to complete which ask if any of the following statements are true:

• Has the diabetic's medication regime altered within the last year?
• Have any episodes of hypoglycaemia occurred within the last year and if so, under what circumstances did these occur?
• Has the diabetic been hospitalised within the last year for any condition related to diabetes?
• Has the diabetic's level of control been in any way unsatisfactory throughout the last year?
• Is microalbuminuria present?
• Is there any degree of retinopathy present?
• Is there any degree of neuropathy (sensory, motor or autonomic) present?
• Is there any evidence of vascular or micro-vascular disease present and, if so, where?

The diabetologist is also asked to comment whether in his/her opinion, the diabetic is in any way mentally or physically unfit to undertake the degree of strenuous exercise that scuba-diving demands. If the answer to any of these questions is "yes" then the diabetic would not normally be allowed to dive. An exception is normally made if the diabetic has only mild background retinopathy. The diabetic must undergo a complete physical examination on an annual basis and be passed as fit to dive by a physician with a special interest in scuba diving after reviewing the answers to the questions posed above. In addition, for diabetic divers over the age of 50, an exercise ECG is mandatory. Finally, a copy of the forms is sent to Dr. Chris. Edge in order that a database can be built up on the diabetic divers for future reference.

 

[Northerner]

I am a diver myself (t2 but on insulin) trained to Dive leader standard with BS-AC & SAA but have not yet dived since diagnosis. I am not a member of any club or organisation, I just have a few friends who are always looking for a Buddie. I will be diving the valentine tanks out of pool this weekend.

I have not bothered with a diving medical for many years, even before I was diagnosed To my mind if something does go wrong then I probably wont be around to worry about it anyway. As for my buddie it would be my word against his and as I wont be saying much...

However I do appreciate this is not everyone's attitude & if you are diving on holiday then a medical certificate may become necessary.

Perhaps you should refer them to the BSAC page on diving with Diabetes
http://www.ukdiving.co.uk/information/medicine/diabetes.htm

The question about retinopathy seems harsh, if they are taking background retinopathy into consideration - this isn't sight-altering or threatening and often temporary.

 

[Pumper_Sue]

Although hypoglycaemia is a relatively uncommon complication in non-insulin-dependent diabetics the risks are not negligible and any potential diver should be using a short-acting anti-diabetic drug, if such medication is necessary.

This unfortunately rules out Carl for diving then as he is on a mixed insulin and this is very difficult to adjust.

 

[Alister]

The question about retinopathy seems harsh, if they are taking background retinopathy into consideration - this isn't sight-altering or threatening and often temporary.

The full document does say that minor signs of retionpathy should not be a problem

It does look like taking insulin might make getting a medical difficult, looks like Carl may have to decide whether he is willing to take the risk & dive without one, if that is even possible diving with a charted company - especially abroad & may insist upon it. I would also expect holiday insurance could be an issue.

 

[Deleted member 21371]

Hi guys I’m T1 and in need of some advice.

I’m trying to get my doctor/nurse to sign off my diving med form to allow me to dive.
The only problem I have is they keep saying no as I’m not a normal person with normal readings.
I think this is down to them not understand completely regarding diving and Diabetes.
As soon as they read the guide lines set out they run a mile.

I have attached the part they run when they read
But I have dived before and know people do dive.

I’m in good control hb1c is 46 but due to have one in the next week or so.
My readings are around 5.5-7 twice a day.
I never had any ups or downs in the 6 years I had T1.
I have spoken to a private PADI doctor that is regerstard with HSE he has said I need my Doc/nurse to say I’m in control or my diabetes.
But again they won’t sign.

What can I do I love my diving it keeps me fit and helps keep my levels.
Has anyone had the same problem or know what to do next.

Have a look at
http://www.ukdmc.org/medical-conditions/diabetes-mellitus/

I'm type 2, and originally went through the process, so I could sign off the forms correctly.

It's unfair to expect your gp to sign off on you, as they know nothing bout the sport.
However, mine was happy to sign off on my diabetes control, and I stressed that was all they were signing off on, some just put down the results, and the surgery stamp still.
No interpretation, just the bare facts of what I was actually achieving.
I submitted a copy of my annual eye test as well.
After I had to get a dive doctor to independently sign me off as fit to dive.

I never had any issue then, although to be fair, since I have "reversed" my type 2, I do tend simply to self certify now.

 

[Deleted member 21371]

The question about retinopathy seems harsh, if they are taking background retinopathy into consideration - this isn't sight-altering or threatening and often temporary.

You are diving to 30m, 4 x atmospheric pressure, (or deeper)
Then returning your body back to 1 atmosphere pressure.
Any event means you are possibly going to have to surface quickly, then be taken to a barometric chamber to be decompressed to avoid decompression sickness.
Even just a bad ascent can cause an issue.
The probability is it will be sight altering if you are susceptible.

 

[Alister]

Very good points Traveller
These are all risks that need to be considered by the individual as well as the Doctors.

 

[CarlG]

Have a look at
http://www.ukdmc.org/medical-conditions/diabetes-mellitus/

I'm type 2, and originally went through the process, so I could sign off the forms correctly.

It's unfair to expect your gp to sign off on you, as they know nothing bout the sport.
However, mine was happy to sign off on my diabetes control, and I stressed that was all they were signing off on, some just put down the results, and the surgery stamp still.
No interpretation, just the bare facts of what I was actually achieving.
I submitted a copy of my annual eye test as well.
After I had to get a dive doctor to independently sign me off as fit to dive.

I never had any issue then, although to be fair, since I have "reversed" my type 2, I do tend simply to self certify now.

This is what I have found due to the doctor no knowing what the diving is about they seem to be reluctant to sign anything.
I have said all I need is that they look at my history and make a yes or no from there and that that’s all they need to put down that way I can go to a PADI doctor.
I have said I have spoken to a PADI doctor and that’s the advice I have been given by them and then they will do the rest ( at a cost to me ) that I’m more than happy to do.

I have been diving before with out any problems but now I need a signature I’m finding it hard to get.

 

[CarlG]

I am a diver myself (t2 but on insulin) trained to Dive leader standard with BS-AC & SAA but have not yet dived since diagnosis. I am not a member of any club or organisation, I just have a few friends who are always looking for a Buddie. I will be diving the valentine tanks out of pool this weekend.

I have not bothered with a diving medical for many years, even before I was diagnosed To my mind if something does go wrong then I probably wont be around to worry about it anyway. As for my buddie it would be my word against his and as I wont be saying much...

However I do appreciate this is not everyone's attitude & if you are diving on holiday then a medical certificate may become necessary.

Perhaps you should refer them to the BSAC page on diving with Diabetes
http://www.ukdiving.co.uk/information/medicine/diabetes.htm

Hi Ailster
I like you way of thinking I was considering what you were saying.
Like you say if all goes wrong I prob never going to know but hay that’s life.
When it came down to diving on the day if I did not fill right or my levels were all over then of cause I would not dive.
I was told never let diabetes run my life well I like diving and if I can’t get signed of then its won and I’m not letting it run my life and dictate what I can or can’t do lol.

You can drive a HGV fly a plane captain a ship biggest in the world be in charge of many things that can cause harm but when it comes to breathing under water it’s like it’s something new.

Sorry for the rant lol

 

[Deleted member 21371]

This is what I have found due to the doctor no knowing what the diving is about they seem to be reluctant to sign anything.
I have said all I need is that they look at my history and make a yes or no from there and that that’s all they need to put down that way I can go to a PADI doctor.
I have said I have spoken to a PADI doctor and that’s the advice I have been given by them and then they will do the rest ( at a cost to me ) that I’m more than happy to do.

I have been diving before with out any problems but now I need a signature I’m finding it hard to get.

Your GP won't sign the PADI forms. You need a HSE dive doctor to do that.
Your GP doesn't need to make a yes no on the form, apart from 10 and 11, and even if they decide not to answer, it shouldn't be a problem.
The referee will understand what they are doing, and will fill in the PADI form.

http://www.ukdmc.org/medical-referees/

Ring one, and have a word.

 

[CarlG]

You are diving to 30m, 4 x atmospheric pressure, (or deeper)
Then returning your body back to 1 atmosphere pressure.
Any event means you are possibly going to have to surface quickly, then be taken to a barometric chamber to be decompressed to avoid decompression sickness.
Even just a bad ascent can cause an issue.
The probability is it will be sight altering if you are susceptible.

I’m only diving for recreational so up to 8-10m at a guess I’m not looking at deeper. My buddies do that while I drive the rib or boat

 

[Deleted member 21371]

Hi Ailster
I like you way of thinking I was considering what you were saying.
Like you say if all goes wrong I prob never going to know but hay that’s life.
When it came down to diving on the day if I did not fill right or my levels were all over then of cause I would not dive.
I was told never let diabetes run my life well I like diving and if I can’t get signed of then its won and I’m not letting it run my life and dictate what I can or can’t do lol.

You can drive a HGV fly a plane captain a ship biggest in the world be in charge of many things that can cause harm but when it comes to breathing under water it’s like it’s something new.

Sorry for the rant lol

To be fair, it can seriously affect anyone with you.
If anything happens, they will still feel obliged to help, you can take their mask off, take their air out, all sorts of things if you become belligerent if you go low.
Even if you just pass out, they will have to do a rapid ascent with you, probably blow off some or all decompression stops, miss the safety stop, and even worse, if they have a problem and you over exert, and hypo while helping, you're probably both not going to make it.
And even if you decide not to dive, your dive buddy can't go on his own.

So it isn't just the diabetic that is at risk here.

Not aimed specifically at you here, just a general statement about the sport.

 

[Alister]

Not aimed specifically at you here, just a general statement about the sport.

Not taken personally at all in fact I agree with everything above (& any of the above scenarios could happen to anyone not just a diabetic).

That is why anyone considering diving with me with will be made fully aware of my condition so then can make an informed decision on whether or not they are prepared to take the risk. They will also be advised that in the case of an emergency I consider their safety to be paramount.
If that means they simply crack the bottle on my buoyancy compensator and send me to the surface alone or even leave me then so be it.
If a potential buddy is in anyway unsure because of my condition then for their sake I don't want them diving with me.

Actually that was my attitude even before becoming Diabetic, I would not want a buddy to suffer because of something that happened to me.

Likewise if a buddy gets into trouble I will do my best to assist but not at my own risk.
In my training we regularly taught that their were 3 types of casualty, conscious & cooperative, concious & uncooperative or unconscious (which becomes cooperative by default).
is the casualty was uncooperative Wait, they will eventually become cooperative one way or the other.

In fact for this weekends dive I am already thinking about the best way to minimise the risk - any comments welcome.

1 The dives will be close to sure & of limited depth - 20M Max probably < 15 this is to minimise the risk of mistaking a hypo for nitrogen narcosis - or vice versa.
2 check BG level before diving & take 2 or 3 gluco-tabs to give a boost
3 Make sure I have a good breakfast & take a quality packed lunch with me.

I am also considering reducing or omitting my morning Basal, I have quite a small dose anyway only 10 units. & do not use a bolus.


(sorry if this is hijacking the thread)

Diving is a dangerous sport, We all have to accept that.