Adults with insulin-requiring diabetes have the support they need to enjoy recreational diving with the release of a new position statement by the Australian Diabetes Society.
The statement describes suitability criteria, restrictions on scope of dives, blood glucose management and other general recommendations for diving with diabetes.
A review by a multidisciplinary working group, including endocrinologists and representatives from the South Pacific Underwater Medical Society (SPUMS), found ‘motivated individuals with well-controlled diabetes’ adhering to the guidelines could safely participate in recreational diving.
Working group member Dr Mervyn Kyi, an endocrinologist at Royal Melbourne Hospital, said the update was a major step forward from the outdated view that diving with diabetes was too dangerous.
“As technology has improved for managing diabetes, more people – especially young adults with type 1 diabetes – are well controlled and living without major complications which may put them at risk of losing consciousness underwater,” he told the limbic.
“This is the most up-to-date and comprehensive review in this area which gives the green light to people with insulin-requiring diabetes who wish to dive,” he said.
The position statement recommends people with diabetes wanting to dive seek a medical review from both their usual treating physician and a doctor qualified in diving medicine.
The strongest contraindications to diving with diabetes included hypoglycaemia unawareness and a history of severe hypoglycaemic events in the previous year, Dr Kyi said.
A protocol for blood glucose management includes checks at 60 min, 30 min and immediately before each dive. Oral carbohydrate is recommended when glucose levels are below the target range of 8.3-16.7 mmol/L.
The guidance also suggests skipping sulphonylurea medications on dive day to further reduce the risk of experiencing a hypoglycemic event underwater.
The position statement also highlights the important role of good communication with a dive buddy and limiting dives with restricted access to the surface such as deep dives below 30 metres, those with mandated decompression stops or in environments such as caves.
Dr Kyi said the position statement was consistent with those from other countries and provided useful guidance to endocrinologists, GPs and other doctors managing patients with diabetes.