Hey guys,

I'm a new diabetic and a commercial diving supervisor (diagnosed 1.5 yrs ago). I'm just in the final stages of getting my medical back which has been a year long drawn out process. While it's not a requirement, I was wondering if anyone had used a real time glucose monitor underwater. I know there was a study back in 2005 where someone did. It would be nice to have the meter itself in a clear dry box and have it alarm when it trends down. I know that my personal blood sugars and or insulin absorption are the same under pressure as it is at the surface through a series of chamber dives and wet dives but it would still be nice to have a back up.

Cheers

Cooter

Views: 149

Replies to This Discussion

I'm glad that you're nearing the end of the red tape! I dive only very occasionally, so I don't bring anything down with me, pump or CGM. But I can see how it would be ideal for you to do that because it's a great tool. Do you have the CGM yet? I think some of the things will probably be manufacturer dependent. I know that the MM is submersible, but I would have doubts about whether it would do well or maintain water-tightness under pressure. And since it transmits so poorly through air I think positioning the receiver as close as possible to the transmitter would be clutch. I think Dex would probably fair much better, though I'd check what they'll replace because it would really suck if something goes wrong and you end up out-of-pocket on it.

I wish I had better info. You might get better advice over in the Athletic Diabetics board. There are a lot of triathletes that may at least have some sort of clue on how to make it work in water.

http://www.tudiabetes.org/group/athleticdiabetics
I don't have a CGM yet. Trying to do my due diligence before dropping x thousands of dollars to see what to buy and if it will even give the results that would make it worth while to me.

I've talked to 1 manufacturer about a year ago and left it with them if they could give me 1 for free, I'd develop the water tight housing for free and give to them no charge. No dice. LOL It was a long shot, but what the hell.
I left the commercial end of diving years ago and went to college to be an injunear. I stick to the fun stuff in scuba gear nowadays. There is no reason a diabetic cannot dive, either commercial or recreational, as long as he is in control of his glucose levels. Since most of the commercial world uses oxygen decompression and a quick trip to a chamber, being diabetic on a long dive should not present any hazards.

I stick a tube of glucose goop in my BC pocket for emergencies. My dive buddy is one bad ass diver, and if he sees me stick the tube in my mouth, the dive is aborted and he is in control. This includes trimix dives to 300 feet with rebreather gear.

When I was a young hard hat, I don't remember my supervisor diving all that much. He did get in the water occasionally, especially when the rest of the team reached deco limits or we had a tough one nobody could figure out. My suggestion would be to modify your helmet so that you can stick a tube of glucose in your mouth. It doesn't take much. You might also have to train your tender to recognize low glucose levels. My girlfriend can tell I am low from the change in the sound of my voice. If I am getting very low, I mumble a lot. Time for the tender to get you out.

Messing around with electronic gizmos underwater is always a crap shoot. For instance, if you did get an underwater glucose monitor to work, what would happen if you picked up an arc cutting torch and started to cut steel? The magnetic effects would most likely fry the internals of the monitor.

I would strongly suggest learning to listen to your body. While standing around on a barge and yelling at riggers is one form of exercise, getting in the water and doing hard hat work requires a much higher energy level. Being in good control in the former could quickly deplete your glucose reserves in the latter, and could lead to trouble. Time to abort the dive, even if the work is not complete. The boss is not going to like that. If you do have an unanticipated need to dive, try eating a Power Bar as you are getting dressed.

The cool part of being a recreational scuba diver is I can abort a dive and get out of the water and nobody says too much about it. For the record, I have never had to use the glucose in my BC. There have been two or three occasions out of thousands of dives when I looked over at my buddy, flashed him my "Glucose Getting Low" sign, and we got out of the water. In your case, my suggestion would be to train your mind to listen to your body. It is something all of us go through, diver or not. If your mind can listen to your body, you won't need the monitor. The other thing is to make sure the rest of your dive team understands the implications. If you have to abort a dive, there should be no questions. As Dirty Harry said, "A man has to know his limitations".

Just my thoughts.

Rock the Ancient Diver
Rock,

Ya I took 2 years of engineering before I figured out it had nothing to do with trains... All kidding aside, I work for a pretty good company and me getting in the water is more for my sanity and to actually see first hand on those tough ones nobody can figure out. We have a lot of green guys here and as you know, its the supervisors ass when something isn't done right. Especially in the ship repair biz. Myself and one of the guys I worked with created a glucose delivery system for the kirby morgans. Took out the part of the liner in the back of the head (center) and inserted a baby bottle liner filled with whatever (apple juice or gatorade). Ran a camel pack hose from there that comes into the oral nasal. If I ever do get low, just suck on that to get me to surface. We don't do much deco stuff as in Canada, you have to lug around a chamber to do that. Plus, our primary focus is ship repair so it's usually less than 30ft.

The good part is that I can get back to the habitat stuff. We do repairs where we install habitats (around stern seals or thruster tunnels or whatever) and the only diving is to get into and out of the habitat. Gear is stripped inside. You can eat, check your levels, guys smoke in there. I did a bunch of testing by doing 2 hrs of cardio in the chamber and testing my levels every 15 mins to see a pattern then comparing it to the same cardio routine on the surface. More or less identical. I can say that there is no immediate effects from pressure on a diabetic as far as glucose levels are concerned. Meters are a bit off at 30 ft of pressure but I'll be using a back up meter and it gives a general range of where you are.

So when you dive, do you adjust your basal the night before? I see it as a recommendation in some of the literature I've read. I did a couple of dives not taking any basal the night before and my levels were unchanged pre and post dive during a 2 hr dive. I doubt I can get away with that forever. The consensus is that I am still honeymooning from most of the opinions on the boards. I have very good hypo awareness. I'll still pick and choose my dives, but getting in at all is a plus. No one at my work would say a word if I had to abort because of a low. At least not my local guys. When we're on the worldwide jobs, I'd have to take the time to explain. I probably would attempt to not even myself in a time sensitive situation where it would become an issue to abort.

I never really thought about welding and cutting while wearing the device. I don't really know enough about CGM's besides they are a subdermal probe and a wireless hand held. Figured I could put the hand held in a clear pelican box and maybe hear it beep if it trends down. Maybe the plastic and rubber will isolate the current? I mean electricity would take the path of least resistance being dissipating through the water and avoiding the pelican box? (Your thoughts?) But at least with welding, you're usually not slugging your guts out. You usually get cold from not moving so that being the case, I guess I just wouldn't wear it then. The thing is, now that I will be able to get in to do our "basic" stuff, I want the technical stuff which means 4 - 6 hr dives at less than 30ft and very little physical working like when we do propeller repairs (cold static bending). That's the times when I think the thing might be beneficial. If I can make it work.

I still have to wait and see what limitations they put on me. I think it's just going to be no deco which I can live with. Your thoughts on all of this?
Loads of info in your post.

The problem in welding and cutting is the magnetic field created by the lead and the work, not the electricity. High intensity magnetic fields tend to screw up electronic gizmos. And the magnetic effects go right through plastic housings. I accidentally wore my dive watch into a room with an MRI and it got fried. Same deal with 2/0 welding leads, the arc, and the work. They all create high intensity magnetic fields. Ever wear a dive watch while cutting? Not more than once. We used to call that a newbie boo-boo.

There is no difference between between cardio at depth and at the surface. If you run 5 miles in the morning before breakfast in a cold rain, well, it's the same thing as diving. Depth has no affect at all on your glucose depletion rate. None. Period. From what I remember, though, hard hats are the original testosterone poisoned tough guys, and I have seen men push themselves really hard to get the job done. Call it pride at doing a good job, and a good supervisor understands the hazards.

The trick with the Kirby-Morgan gear sounds like a good idea. I assume you are referring to the helmet and not the bandmask. I wore the Kirby-Morgan bandmask and a Swindell helmet.

Being aware of your body and how close or far away you are from a hypoglycemic event is, in my humble opinion, a lot more valuable to you than an electronic GCM. I see no reason you can't wear one inside a dry habitat with no welding going on. Just make sure the electronic case is vented. I would put the whole thing inside a pressure proof Pelican case to get it in and out of the chamber.

I would be willing to bet that the guys that spend four to six hours in this dry habitat, bending propellers, are bringing their lunch bucket with them. I know I would. If you are doing this work in cold Canadian water (ah, but the beer is so good!) then I would suggest a dry suit. Mount a CamelBak on your chest and run the hose up past your neck dam and put the bite valve where it needs to be. I would also suggest an enormous high protein, high fat breakfast, and dress warm. Thinking it over, these were common sense measures we all took "back in the day", when I was a hard hat. Except we didn't have CamelBaks, and just got thirsty from breathing the dry air. Hence the need for "medicinal" beer after work.

My endo gave me a little chart that helps adjust my basal dose for the night shot. During my last trip to the Bahamas on a charter boat, I did four to five dives a day. Hey, it was eat, sleep, dive, repeat.. I loved it. But I wound up reducing my night basal dose to compensate for the extra physical activity. I also ate every meal served. I was careful about what I ate, and how much. In your case, you probably can't anticipate what is going to happen the next day on the job. I suggest carrying Power Bars or some sort of reasonably high calorie snack.

Also understand that the "guys on the boards" have very little understanding of our disease and even less understanding about the effects of a hyperbaric environment. They will be cautious about things they don't understand. I don't think you are on a "honeymoon", I think you are a diabetic diver with a very good understanding of cause and effect and how you feel. If you had glucose readings swinging between 40 and 400 on a daily basis, ate the wrong things, took too much or too little insulin, then you probably shouldn't dive. But if your glucose readings are reasonable, you don't suffer from "traumatic" low glucose events, and have the ability to listen and understand what your body is telling you, then there is no good reason to keep you from your work.

And, believe me, those "green guys" you talked about need somebody with your experience to keep them out of trouble and still get the job done. Every day a ship spends in a repair yard getting fixed is a day it cannot be out making money for the owner, and the pressure can get tough.

Hang in there, listen to your body, and give me a call if you ever want to dive in warm water and look at pretty fish.
If it helps, my kids continue to insist that I learned to dive right after God invented water.

Rock, the Ancient Diver
Silly diver, expensive watches are for impressing girls not for measuring depth lol.

All we have are KM's, some 17's, 27's, 37's and 57's. We only wear bandmasks for getting in and out of the habitats as it's always cold and well the harbors around here aren't what you would call diver friendly from a sanitary point of view. Drysuits are a must. With the tides and such, it really doesn't get too warm around here, especially in the Bay of Fundy with 30' tides. Putting a camel back on my chest would keep it cold (oh the applications), it just might be uncomfortable running through the neck dam. Forgot to mention the business end of the hose is attached to the nose block so it can be slid in and out and not be in the way until its needed.

You're right about pride and ego's. Not much has changed. When it comes down to it though, I think my ego would be hurt a lot more actually having to implement the contingency plan on my behalf. Not to mention Ministry of labour investigations, probably never being cleared for a medical again and possibly hurting others to get medicals if they come into the same situation. I feel a pretty strong sense of responsibility being certified medically fit to dive. Definitely a right, not a privilege.

I think when diving with my team in my backyard, all the guys have a decent understanding as they've asked a lot of questions. It's when we get called to do the international jobs that I'll have some 'splainin to do with our sister companies. It wouldn't be out of the realm of normal to know no one else on the dive site.

One correction though... the prop jobs are not in the habitat. They are 4 - 6 in the wet. I'd make it a point to squeak out every 2 - 3 hrs to check my GL though. And ya, everything goes in the habitat via those small pressure cooker vessels (Hey they work and can be vented). You name it, its been there.

That chart the MD gave you, was it tailored to you? Or was it something off the shelf he found? I'll ask me endo. He's a diver too so he has a pretty good knowledge, more so than most. He should be able to give me a ball park to work with and I can trial and error.

I appreciate all your feedback and thoughts. You've helped and put me more at ease than you know. It's gonna take me some easy dives and lots of trending to get my confidence level back. Last thing I want is to put myself, my team or the company at risk.

Cooter

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