Safety of recreational scuba diving in type 1 diabetic patients: The Deep Monitoring programme

Bonomo, Matteo; Cairoli, Roberto; Verde, G.; Morelli, L.; Moreo, Antonella; Grottaglie, M. Delle; Brambilla, Massimiliano; Meneghini, Elena; Aghemo, P.; Corigliano, Gerardo; Marroni, Alessandro

doi:10.1016/j.diabet.2008.08.007

Cited by 22 publications

(8 citation statements)

References 7 publications

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“…The exclusion criteria included the occurrence of diabetes complications in patients and loss of consciousness or hospitalisation due to severe hypoglycaemia. Most patients were also very well balanced (HbA1c<7.5%), with many of them treated with intensive insulin therapy or a personal insulin pump [7][8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Diabetic Patients Who are Amateur Divers

Ługowska

Ługowski

Krzywińska

et al. 2018

Polish Hyperbaric Research

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Diabetes is an “epidemic of the 21st century” and it is estimated that in 2011 6.7% of Poland’s population suffered from diabetes, one quarter of which was unaware of the disease. Such a high prevalence of diabetes mellitus results in an increasing number of physicians being confronted with the problem of qualifying patient with diabetes to partake in amateur sports, including diving. This publication presents the most important information concerning risk assessment, admission of diabetic patients to amateur diving and some proposed protocols of management before and during sport practice.

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Section: Discussionmentioning

confidence: 99%

Diabetic Patients Who are Amateur Divers

Ługowska

Ługowski

Krzywińska

et al. 2018

Polish Hyperbaric Research

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“…A different study (Bonomo et al., 2009), including 12 individuals with T1D (90 dives in total), showed poorer sensor durability (56%). However, it should be noted that due to technical reasons reported in the study (e.g.…”

Section: Continuous Glucose Monitoring Systems: a Valuable Diving Par...mentioning

confidence: 94%

Into the deep blue sea: A review of the safety of recreational diving in people with diabetes mellitus

Koufakis

Karras

Mustafa

et al. 2019

European Journal of Sport Science

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People with diabetes, particularly those being insulin treated, have been for many years considered ineligible for diving, because of the high risk of adverse events. Blood glucose levels tend to decline during diving, probably because of changes in insulin requirements and resistance, due to increased physical activity and effects of hyperbaric environment on glucose tolerance. Strict adherence to safety protocols, in conjunction with optimal physical status, lack of diabetic complications (especially impaired awareness of hypoglycaemia) and satisfactory baseline glycaemic control, seem to minimise the risk of complications during diving. The integration of modern technology into diabetes management, providing potential for underwater continuous glucose monitoring, can be useful in optimising metabolic control before, during and after diving. Despite the significant progress been made on safety issues, there is still a need to implement the relevant recommendations into divers' everyday practice. Existing evidence is mainly derived from small studies and there is a wide heterogeneity in terms of study designs and explored outcomes, rendering the extraction of definitive conclusions challenging. The aim of this review is to present and critically evaluate available evidence, use of technology, and gaps in existing knowledge that deserve further evaluation by future studies.

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“…spinning [74], long-distance races [75], cycling, swimming [76], cross-country skiing [77], and scuba diving [78,79]. The use of CGM in residential sports camps has made it possible to investigate mixed sports, like football or hockey [77], and in some experimental protocols the athletes alternated medium-intensity exercise with short bouts of intense effort [80].…”

Section: Rtcgm and Sportmentioning

confidence: 99%

Real-Time Continuous Glucose Monitoring in Adult Outpatients

Bonomo¹,

Grassi²,

Bartolo³

et al. 2014

Frontiers in Diabetes

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With real-time continuous glucose monitoring (RTCGM), the patient has a continuous picture of glucose concentrations -dynamic information with important predictive value. It is in fact a typical 'patient-oriented' tool that permits a more aggressive therapeutic approach and makes it easier to adapt therapy immediately. Currently approved RTCGM devices consist of three main components: a glucose sensor, a transmitter, and a receiver monitor. The system is defined as minimally invasive because it requires insertion into the subcutaneous cellular tissue of a fine needle to measure the glucose in the interstitial fluid directly or via an external sensor. A correct selection of patients is one of the most important factors in determining a successful application of this innovative technology. For this purpose, there are already consensus statements in a number of countries with regard to the indications of these systems. The criteria for identification of candidates are usually divided into three main categories: pediatric/adolescent, adult patients (both in the general population of type 1 diabetes and in specific settings), and pregnant women or women in the preconception period. RTCGM opens up extremely interesting prospects that are destined to radically change the concept of clinical self-management of diabetes. Considering the technical progress towards overcoming the current limitations (essentially: not optimal accuracy, invasiveness, and costs) which currently prevent its widespread use, we can expect wide diffusion of this form of monitoring in the coming years.

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Safety of recreational scuba diving in type 1 diabetic patients: The Deep Monitoring programme

Cited by 22 publications

References 7 publications

Diabetic Patients Who are Amateur Divers

Diabetic Patients Who are Amateur Divers

Into the deep blue sea: A review of the safety of recreational diving in people with diabetes mellitus

Real-Time Continuous Glucose Monitoring in Adult Outpatients

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