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Blood Glucose Response in Insulin-Requiring Diabetics

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BLOOD GLUCOSE RESPONSE TO RECREATIONAL DIVING IN INSULIN-DEPENDENT DIABETICS

D.M. Uguccioni, N.W. Pollock*, J.A. Dovenbarger, G.DeL. Dear, R.E. Moon. Divers Alert Network and Duke University Medical Center, Durham and *East Carolina University, Greenville, NC. (Sponsor: J.A. Houmard, FACSM)

Insulin-dependent diabetes mellitus (IDDM) has traditionally excluded people from participation in scuba diving. However, a growing record of safe diving in defiance of this ban is prompting reassessment. The purpose of this study was to measure blood glucose in divers with IDDM during the course of a multi-day diving vacation. Sixteen certified divers (nine male: 43±8 y [mean±SD], 85.1±14.1 kg, 1.77±0.12 m, 27.4±5.3 kg/m-2; and seven female: 44±5 y, 66.6±14.2 kg, 1.62±0.07 m, 25.3±5.3 kg/m-2) with a history of well-controlled IDDM (confirmed by HbA1c test no higher than 9% and physician documentation) participated in one of two, week-long subtropical diving trips.

Participants could dive up to four times per day, with blood glucose measured using a calibrated glucometer at 60, 30 and 5-10 min pre-dive, and immediately post-dive. Divers were restricted from diving if blood glucose level was below 80 mg/dL-1 immediately preceding a dive. A total of 131 dives were monitored. Divers conducted 8.2±3.3 dives per trip, 2.0±0.5 dives per day, with mean underwater time and depth of 38±7 min and 60±16 feet seawater, respectively.

Blood Glucose -60 min -30 min -10 to -5 min Post-Dive
Male (mg/dL-1) 188±71 203±75 210±68 159±59
Female (mg/dL-1) 196±56 237±58 248±49 193±60

Post-dive blood glucose was <100 mg/dL-1 following 13 dives, <80 following four and <65 following one (47 mg/dL-1). Divers refrained from making a dive in five instances because of inability to eat due to seasickness. There were no complications related to low blood glucose levels arising from any dives. These findings are consistent with recent observations that individuals with well-controlled IDDM may safely participate in recreational scuba diving under moderate conditions.

Supported by DAN Medical Research Program, Bayer Corp. and CAN-AM Care