Performance of a safety protocol for scuba diving in people with type 1 diabetes: 20 years of “Diabete Sommerso®” experience

Background and aims

Scuba diving for people with diabetes was discouraged due to hypoglycemia risks. However, evolving guidelines now enable safe diving for people with diabetes. Among them, the Diabete Sommerso® safety protocol. This study aims to describe data from 20 years of DS activities and evaluate the performance of the protocol in avoiding metabolic complications.

Research design and methods

During DS camps, participants are trained to monitor glycemia before and immediately after diving, aiming for stable levels between 150–250 mg/dl. Since 2004, glycemic data from dives conducted with DS/independently by its members have been collected.

Results

DS issued diving licenses to 74 type 1 diabetic people. Data are available for 68: median age was 32 years (IQR 22 yrs), diabetes duration 18 years (IQR 16 yrs), HbA1c 7 % (IQR 1 %). 34 used insulin pumps, 43 continuous glucose monitoring. A total of 1179 dives were analyzed, showing a median reduction in glycemia of −38 mg/dl during dives (IQR 92 mg/dl, p < 0.0001). Post-dive hypoglycemia occurred in 23 cases, 45 % of which involved protocol non-adherence. Hypoglycemia prevalence was 1.7 % when the protocol was followed. No severe hypoglycemic episodes occoured during/after diving.

Conclusions

Data from 1179 dives indicate that, with adherence to the safety protocol, scuba diving is safe and poses no risk of severe hypoglycemia for people with type 1 diabetes.