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Cholelithiasis
Participants in an international workshop sponsored by DAN and the Undersea and Hyperbaric Medical Society in 2005 reached agreement that prospective divers who are able to control their diabetes with either dietary measures or medication and who are otherwise qualified to dive may undertake recreational scuba diving provided they meet certain criteria. The Recreational Scuba Training Council in the United States ratified this conclusion.
The criteria are detailed in the full consensus guidelines, which consist of 19 points that are divided into three sections: • Selection and surveillance • Scope of diving • Glucose management on the day of diving
For a summary of the guidelines, see DAN.org/ diabetes. For the full text of the guidelines, see DAN. org/ DiabetesSummary. DAN also offers a free online seminar on diving safely with diabetes at DAN.org/ education-events/elearning.
The guidelines contain practical recommendations for medications and procedures in case a diver develops hypoglycemia (low blood sugar) underwater. Individuals with diabetes, as well as their buddies and dive leaders, should be aware of the status of any divers with diabetes and knowledgeable about the signs and symptoms of hypoglycemia and the procedures that may be required in case a problem arises.
Divers with diabetes can be very sensitive to manifestations of hypoglycemia. Many people will feel early warning signs such as weakness, nausea, blurred vision, sweating, anxiety or trembling. As the diver’s blood sugar continues to drop, fatigue will set in and changes in mental status can occur. An affected diver may eventually become combative or unaware of their surroundings. In severe cases, they may lose consciousness or have seizures. Episodes of hypoglycemia that lead to changes in mental status or seizures can result in drowning.
