Registrato: Jul 05, 2008 Messaggi: 1714 Localitŕ: RM (prov) - moderatore dal Set09 al Nov10
Inviato: Mar Mar 30, 2010 9:58 pm Oggetto:
ti dice male Fabione...
Grongo č un pň che non si affaccia..
mi sembra sia medico pure Gspclecco (ma non ci giuro) ma pure lui lo vedo poco..
sperem..
GavNo _________________ "Il gav č per il subacqueo come il salvagente per chi non sa nuotare " (COM.TE RAIMONDO BUCHER)
Ciao Fabione,
ci sono online molti articoli in materia.
se fai una ricerca sul sito della Rubicon Foundation trovi decine di articoli scientifici in materia http://rubicon-foundation.org/
Il Dan insieme a UHMS (Undersea and Hyperbaric Medicine Society) nel 2005 pubblica questa lista di controllo
1: Guidelines for Recreational Diving with Diabetes.
--Selection and Surveillance
• 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)
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