I am now typing this as a certified Open Water Scuba Diver!! What what?!?!?!
When we first started talking about going scuba diving, I was a little nervous. I had the typical fears of anyone who was first trying it out. I won't be able to breath. I'm going to freak out and die. A SHARK IS GOING TO EAT ME!!! You know. Your run-of-the-mill, totally normal anxieties. However, there was one fear that was somewhat reality-based. I'm diabetic and could potentially have a low blood sugar 70 feet down in the great big sea. It was a scary thought.
When I went to good ol' Google for some help and advice, I couldn't really find anything. I came across one woman's blog post, which really was quite helpful and realized that I definitely wanted to do a post on scuba diving and diabetes in case anyone, like me, was out there looking.
I'll probably do this in a two-part post. One to actually give the details of what I did to prepare for diving as a diabetic and another on my actual experience on getting my certification. Here's a nice little step by step plan, that probably only diabetics would be interested in. But, hey, it is a diabetic's blog afterall!
STEP ONE - Get Endocronologist Approval (get approved medical form here)
PADI (Professional Association of Diving Instructors) recommends that you be on insulin treatment for one full year before diving, but really it's just to ensure that you have good blood sugar control, which I do, for the most part. I had my endo fill out this form and brought it with me to the dive shop. I've heard/read that other places, like Australia have a lot more stringent protocols with diabetics and their medicals.
STEP TWO - Decide Method of Injection
Having recently gone on the pump, I was inclined to stay on it during my dives; however, it generally wasn't recommended. I decided I was going to just use pens on our trip, but once I got down there, I did a combination of the two. This probably wouldn't work for all diabetics. My insulin needs are still relatively low at this point that a couple of hours without insulin didn't send my blood sugar out of control. Also, because our first few dives were from the beach, I didn't think my clutzy self could fuck it up and drop the pump in the water.
Another thing to consider in using the pump instead of the pens when scuba-ing is that you do risk ruining the infusion set you are currently wearing as it will be saturated for an extended period of time. With pens, you won't have to worry about that.
STEP THREE - Checking Your Blood Sugar
This is two fold. You need to check your blood sugar getting into and out of the water. The woman in the blog I referenced before checked her blood sugar three times before entering the water, once at 30 minutes, again at 15 minutes, and once more before entering the water. This was to ensure that her blood sugar wasn't dropping going in. I wasn't so diligent but I did ensure that my blood sugar was high, like 190's - 200's high. This was actually a perfect range since my blood sugar dropped with each dive.
I was diligent in checking getting out of the water as well. I should have done a better job in tracking blood sugar drop in reference to depth and amount of time in the water, but I was on vacation! Overall, my blood sugar dropped anywhere from 50 - 100 points.
STEP FOUR - Snacks
This was actually the first step on the list, but thought it might come off as a little irresponsbile. :) It is important to have some kind of gel/snack with you that can be used to raise your blood sugar, even under the water. I opted for honey packets. They would be something I could easily suck out of the package if I need to do so under the water.
Usually, on the boat, they served fruit and cake after each dive. Not exactly diabetic snacks. I won't lie though. I had me some cake! Remember that whole vacation thing! But, if I had had better self-control, I also brought familiar snacks with me. Familiar in that I know usually by how much they might raise my blood sugar, like my favorite Kashi granola bar.
STEP FIVE - Letting Others Know
When first talking about getting scuba certified, I was concerned about what role diabetes would play in shops allowing me to dive. It, technically, hasn't been a year since starting insulin. I had a few people suggest to me that I just not share my disease. While it is compelling to skip the disclosure altogether, I thought better of it for many reasons. My personal safety, the safety of the other divers, and the unfair responsibility I would place on my buddy (Jerry) in the event anything went wrong were the top three.
It was important for the dive shop (Scuba Gamma), the instructors, and dive masters to know. They didn't necessarily know what to do with that information, but at least they were aware.
Overall, besides the blood sugar testing and pounding granola bars before entering the water, diabetes didn't really impact on my scuba experience. However, I am really glad I took these precautions so that I could focus on my real concern about scuba, that grumpy Great White known as JAWS!!!! Haven't you seen Jaws 2, 3, and 4?! He comes back, people!