胰岛素依赖型糖尿病青少年新手潜水员在休闲潜水时的血糖反应。

Plasma glucose response to recreational diving in novice teenage divers with insulin-requiring diabetes mellitus.

作者信息

Pollock N W, Uguccioni D M, Dear G deL, Bates S, Albushies T M, Prosterman S A

机构信息

Center for Hyperbaric Medicine and Environmental Physiology, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.

出版信息

Undersea Hyperb Med. 2006 Mar-Apr;33(2):125-33.

PMID:16716063

Abstract

A growing number of individuals with insulin-requiring diabetes mellitus (IRDM) dive, but data on plasma glucose (PG) response to diving are limited, particularly for adolescents. We report on seven 16-17 year old novice divers with IRDM participating in a tropical diving camp who had recent at least moderate PG control (HbA1c 7.3 +/- 1.1%) (mean +/- SD). PG was measured at 60, 30 and 10 min pre-dive and immediately following 42 dives. Maximum depth (17 +/- 6 msw) and total underwater times (44 +/- 14 min) were not extreme. Pre-dive PG exceeded 16.7 mmol x L(-1) (300 mg x dL(-1)) in 22% of dives. Males had significantly higher pre-dive levels (15.4 +/- 5.6 mmol x L(-1) [277 +/- 100 mg x dL(-1)] vs. 12.8 +/- 2.9 mmol x L(-1) [230 +/- 52 mg x dL(-1)], respectively) and greater pre-post-dive changes (-4.3 +/- 4.4 mmol x L(-1) [-78 +/- 79 mg x dL(-1)] vs. -0.5 +/- 4.3 mmol x L(-1) [-9 +/- 77 mg x dL(-1)], respectively). Post-dive PG was < 4.4 mmol x L(-1) [< 80 mg x dL(-1)] in two dives by two different males (3.4 and 3.9 mmol x L(-1) [61 and 70 mg x dL(-1)]). No symptoms or complications of hypoglycemia were reported. These data show that in a closely monitored situation, and with benign diving conditions, some diabetic adolescents with good control and no secondary complications may be able to dive safely. The impact of purposeful elevation of PG to protect against hypoglycemia during diving remains to be determined.

摘要

越来越多需要胰岛素治疗的糖尿病患者（IRDM）进行潜水活动，但关于潜水时血糖（PG）反应的数据有限，尤其是青少年。我们报告了7名16 - 17岁患有IRDM的新手潜水者，他们参加了一个热带潜水营地，近期血糖至少得到中度控制（糖化血红蛋白HbA1c 7.3±1.1%）（均值±标准差）。在潜水前60分钟、30分钟和10分钟以及42次潜水后立即测量血糖。最大深度（17±6米海水）和总水下时间（44±14分钟）并非极端。22%的潜水过程中，潜水前血糖超过16.7 mmol·L⁻¹（300 mg·dL⁻¹）。男性潜水前血糖水平显著更高（分别为15.4±5.6 mmol·L⁻¹ [277±100 mg·dL⁻¹] 与12.8±2.9 mmol·L⁻¹ [230±52 mg·dL⁻¹]），潜水前后血糖变化也更大（分别为 - 4.3±4.4 mmol·L⁻¹ [-78±79 mg·dL⁻¹] 与 - 0.5±4.3 mmol·L⁻¹ [-9±77 mg·dL⁻¹]）。两名不同男性在两次潜水中潜水后血糖<4.4 mmol·L⁻¹ [<80 mg·dL⁻¹]（分别为3.4和3.9 mmol·L⁻¹ [61和70 mg·dL⁻¹]）。未报告低血糖症状或并发症。这些数据表明，在密切监测的情况下，以及在良性潜水条件下，一些血糖控制良好且无继发性并发症的糖尿病青少年可能能够安全潜水。潜水期间有意提高血糖以预防低血糖的影响仍有待确定。