Fit for Dive medical - Diving with new Type 1 diagnosis

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AMcG

AMcG

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Relationship to Diabetes
Type 1
Hello!

I'm going travelling soon to South East Asia and really really want to dive.

  • I got my open water to 18m in Malta 2 years ago and haven't done a dive since
  • I was diagnosed in March 2018 haven't had and hypo's where I've blacked out.
  • Not been a total super-woman at bloody sugars but not too bad all the same - fair amount of greens.

My diabetes team advised I ask my GP to see if she would do my fit for dive medical certificate. When I went to see her, she said, as a diver herself she was a bit unsure if it was a good idea considering i'd been diagnosed so recently (March 2018) and the risks involved, but she was going to look in to it and book me on for a private medical, although it sounded like she wanted to word her statement in a way that would sound like she wasn't sure I should dive really...

1. Any diabetic divers think it's a bad idea for me to dive with such a recent diagnosis?
2. Can you recommend a good 'fit to dive' medical certification place in the South West England?

Thanks so much
Amy
 
Hi AMcG,

I’m a Master Scuba Diver which is the highest certification you can get when you are a type 1 diabetic. Diabetes in itself won’t stop you from enjoying the amazing underwater world. You just need to be extra careful and sensible.

Here’s where you stand; as a qualified diver, you are fully responsible for yourself. At the dive centre, you will have to fill out a form, listing any medical conditions. If you disclose your condition, you will need a doctors certificate to say you’re fit to dive, as you know.

In my opinion, if I’m honest, there is a warning bell that you’re a new diver AND a new diabetic. At this moment in time, you haven’t yet notched up that much experience in either field, so it does actually feel a little risky. If you had hundreds of dives in your log and were completely comfortable with all your equipment and were confident about the underwater environment, then the diabetes would be the only variable. Or vice versa.

You also have to take into consideration that you’re going to be on holiday, so you may find your overall control a little more difficult as you won’t be eating the foods you normally do, at the times you normally do, and you might be more active than normal. All these things can throw off your normal level of control as the best of times. Or they do for me anyway.

Diabetics used to be banned from diving completely, so disclosing your condition back then meant staying on dry land. T1 folks just ticked the ‘no health problems’ box and off they went. Which you can do (I think there may even be a tick box to say you dont want to disclose this info) but I wouldn’t recommend that. You definitely want your guide to know that there is a chance that you might need to end your dive early, should your levels drop. The ‘loser’ sign against your forehead would signal low blood sugars, but if you’ve checked the box to say you’re healthy, then your guide would just think you’re being rude!! lol.

You might well have a long speed boat ride to the dive sites, as is often the case. You also need to consider things like sea-sickness – if you can’t keep anything down then that becomes a problem. I’ve been in that position and it’s not nice. So it’s not just the 50-60 mins of being underwater to think about. And remember, it’s not unusual for new divers to be a bit nervous before a dive, which might make your levels react slightly differently. Should anything happen when out on the boat, the entire group would be recalled and brought back to shore.

You are doing the right thing in terms of finding an industry approved doctor. Maybe one of these links might help you find someone in your area:

UK Health & Safety list of Medical Examiners for Divers

UK Diving Medical Committee

Divers Alert Network

If you do dive, then make sure your buddy and the guide both know the low blood glucose signal. And invest in a pelican waterproof box to keep your meter + insulin in. Take plenty of jelly beans to keep on the boat so they’re there when you surface. Be sensible and limit any alcohol the night before. Watch out for the heat on the boat, it can interfere with your insulin, so a frio pocket is a good idea. But of course, and most importantly, have fun! 🙂

Hope this all helps. Let me know how you get on. If you need anything, please feel free to contact me.
 
Hi Caroline

Thanks so much for your comprehensive message. It's really helpful, if a bit hard to read as I'm still feeling a bit angry about the whole type 1 thing. I just feel a bit resentful about it stopping me do things :-/

My partner, who I'm travelling with, would be my diving buddy, and he knows a lot about my diabetes. You've mentioned loads of really helpful things I hadn't thought of, thank you, they're going in my diabetes checklist book! If I do get approved I will make sure I prepare thoroughly for it and be super over-cautious. I can see now that it is risky :( We will probably begin with doing a refresher course before we do anything, if i get approved that is.

That list is really good - thank you, I've emailed the 5 closest to me and will start working further afield if they can't do it within the time frame. Hopefully I can get an appt so I can get an answer either way.

Cheers
Amy
 
@travellor and @missclb

Guess what? My GP has signed me off! Stamped 🙂

Thank you so much for your warnings though, I have realised it's no trivial matter. I've decided I'm not going to even think about diving until my blood sugars have adjusted to the change in temperature and increased activity, and I will wait until their stable - be it weeks or months. Then will begin with a refresher course at a PADI approved centre, and just do shallow dives to begin with, 20-30 min (my partner usually tears through his air by then anyway) preparing by testing lots prior to the dive and a mars bar just before and treats on the boat for after.

I've never had trouble with sea-sickness and I've been on some bumpy boat rides so hopefully I shouldn't have a problem there - but will maybe try and find some dives that don't need a boat ride out to begin with, just to ease in to it.
 
It's really refreshing to read a helpful message like that posted by Caroline. I've been a T1 for approaching 40 years and haven't let it stop me doing pretty much what I've wanted, including scuba diving, paragliding, long distance cycling and walking. It doesn't seem to become easier controlling blood sugar levels after 4 decades practice and exercise seems to have an increasing effect on my bg levels. Still. the way technology is advancing, we'll have some kind of closed-loop system soon that will help reduce hypos. I've always been fastidious in ensuring that, particularly before diving or paragliding, I didn't have any active bolus that might take me low, even if that has meant not eating for a few hours before. Also if I'd carried my heavy paraglider gear up a hill, I took glucose tablets to stabilise my blood glucose level and that I was confident it would not plummet while engaged in the sport. That way I managed cross-country flights of over 3 hours. Mars bars are something like 17% fat, which a nutrition expert might say has a slowing effect on absorption of carbohydrate. If it works for you, that's fine, but glucose tablets give you more options in terms of measurable quantity that might be more suitable. I'd recommend talking to a diabetes specialist nurse about your planned activity and examine your bg control record. Do you see a pattern emerge where you are prone to hypos at particular periods? When you understand why that happens and what you are going to do to counter it when diving. If you go to Bali, there is a quite shallow wreck dive, where I saw several nudibranches (multicoloured, almost fluorescent, underwater caterpillar-like creatures) that I hadn't seen anywhere before. They looked other-worldly. Anyway, stay safe and enjoy your trip.
 
@Ukeydukey – you are an inspiration, well done for doing EVERYTHING you do!

@AMcG – i totally get your frustration, but it's not forever. Use it to help you nail this thing and you'll be able to do everything that Ukeydukey does, in no time at all. Lol. Learning to scuba dive was my goal when i was diagnosed, it gave me a goal to work towards. I can tell that you'll be a great diver because you've weighed up all the information and make a good call on waiting. PADI would be very proud of you! It's always hard to call a dive off, but PADI always bang on about doing that if things don't feel right. Your ideas for getting in the water again are spot on.

And not to put too much pressure on your shoulders, but if anything happened to you because of your diabetes while diving, then it would come to light and likely make PADI change their rules. The fact that diabetics were banned from diving a while ago was apparently because a diabetic sadly had a heart attack while scuba diving, so they decided to err on the side of caution and do a blanket ban for all of us.

You can always snorkel until your heart's content, and likely see just as much without any time constraints. Have a wonderful holiday, sounds like perfect timing given your recent diagnosis. xx
 
I saw a publication issued by PADI about diving with diabetes, have a look on their website as I think its there
 
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