Scuba Diving Guidelines

Someone had mentioned (and I know it’s been long-believed) that Type 1s cannot scuba dive. I decided to take a look at the guidelines and found that we CAN dive, but under very strict constraints:

Guidelines From DAN for Diabetics Who Want to Dive
DAN suggests that some diabetics may dive safely in controlled settings.

• Age ≥18 years (16 years if in special training program)

• Delay diving after start/change in medication

  • 3 months with oral hypoglycemic agents (OHA)
  • 1 year after initiation of insulin therapy

• No episodes of hypoglycemia or hyperglycemia requiring intervention from a third party for at
least one year

• No history of hypoglycemia unawareness

• HbA1c ≤9% no more than one month prior to initial assessment and at each annual review

  • values >9% indicate the need for further evaluation and possible modification of therapy

• No significant secondary complications from diabetes

• Physician/Diabetologist should carry out annual review and determine that diver has good
understanding of disease and effect of exercise

  • in consultation with an expert in diving medicine, as required

• Evaluation for silent ischemia for candidates >40 years of age

  • after initial evaluation, periodic surveillance for silent ischemia can be in accordance with
    accepted local/national guidelines for the evaluation of diabetics

• Candidate documents intent to follow protocol for divers with diabetes and to cease diving and
seek medical review for any adverse events during diving possibly related to diabetes

Scope of Diving
• Diving should be planned to avoid

  • depths >100 fsw (30 msw)
  • durations >60 minutes
  • compulsory decompression stops
  • overhead environments (e.g., cave, wreck penetration)
  • situations that may exacerbate hypoglycemia (e.g., prolonged cold and arduous dives)

• Dive buddy/leader informed of diver’s condition and steps to follow in case of problem

• Dive buddy should not have diabetes

Glucose Management on the Day of Diving
• General self-assessment of fitness to dive

• Blood glucose (BG) ≥150 mg·dL -1 (8.3 mmol·L -1 ), stable or rising, before entering the water

  • complete a minimum of three pre-dive BG tests to evaluate trends
    60 minutes, 30 minutes and immediately prior to diving
  • alterations in dosage of OHA or insulin on evening prior or day of diving may help

• Delay dive if BG

  • <150 mg·dL -1 (8.3 mmol·L -1 )
  • >300 mg·dL -1 (16.7 mmol·L -1 )

• Rescue medications

  • carry readily accessible oral glucose during all dives
  • have parenteral glucagon available at the surface

• If hypoglycemia noticed underwater, the diver should surface (with buddy), establish positive
buoyancy, ingest glucose and leave the water

• Check blood sugar frequently for 12-15 hours after diving

• Ensure adequate hydration on days of diving

• Log all dives (include BG test results and all information pertinent to diabetes management)


Another thing I was warned against when I was interested in taking scuba…was not to scuba if one had a blood pressure problem. I really wanted to, talked w/ my MD at the time, and he advised against it specifically because I was on BP meds. I decided to kayak instead:) and of course, snorkel.

When I looked into it I found that only PADI would certify diabetics. I plan on dragging my hubby with me to get certified as a “present” to myself when we have both lost the weight we want to lose - 1/4 of the way there!

I took my CMAS (level 1) in france when I was 16/17 years old, and I must admit we didn’t tell them I was diabetic
(because they wouldn’t allow it!). My brother joined me on the course so at least he would be able to help me if needed. I have not been scuba diving alot since, but have done a couple more times in france and a whole week in Egypt = Great!! As long as you are careful and extra attentive on the day I don’t think it should be a problem for diabetics - we do drive cars, climb mountains etc too! Go for it! =)