Sir.— The article "Evaluating the Potential Pediatric Scuba Diver" by Dembert and Keith1 stated that a an absolute disqualification to scuba diving is insulin-dependent diabetes mellitus (IDDM). We certainly concur with the auhors that "if a hypoglycemic episode occurs underwater or away from shore, the results could be incapacitating and tragic." However, this same warning applies to almost any activity in which the insulin-dependent diabetic chooses to participate (eg, driving a car). It would be unfair to disallow those responsible adolescents to participate in an activity they choose without some individualization. Although editorial space limitations may not have permitted the authors elaborate on conditions for disqualifications, absolute prohibition of this activity for a person with IDDM is inappropriate.
As with any physical activity that may potentiate hypoglycemia, bolicrol should be as good as sible, glucose levels should be monitored before the activity is taken, and an appropriate plan of action should be taken to prevent hypoglycemia during the activity. Furthermore, sufficient training in a more protected environment (eg, swimming pool) should allow the person with diabetes to know what to expect and the degree to which such activity will affect the blood glucose level. As with any strenuous exercise, a "buddy system"