Diabetes management at sea

Type 2 diabetes is increasingly common among senior officers. STCW medical compatibility, medication management, and monitoring.

STCW A-I/9 accepts well-controlled diabetes; HbA1c <7% is the typical fitness threshold. Type 2 diabetes with oral medication + diet control is generally STCW-medical-compatible; insulin-dependent diabetes can be but with restrictions. Onboard management challenges: irregular meal times during cargo operations, temperature-sensitive medication storage, and limited exercise options during long-sea-leg voyages.

Practical steps

• Bring 4-month supply of medication + 30% margin for contract extensions.
• Refrigerated storage for insulin (2-8°C); confirm with ship's steward before joining.
• Continuous glucose monitor (CGM) is now compatible with most STCW medicals; discuss with company medical.
• Ship's galley: request low-GI options + carbohydrate-controlled portion sizes.
• Blood glucose meter + strips + lancets in ship's medicine cabinet as backup.

When to escalate

• Blood glucose >15 mmol/L for 6+ hours despite medication — TMAS consultation.
• Hypoglycaemia (blood glucose <4.0 mmol/L) with confusion — immediate treatment with fast-acting carbs; TMAS if not responding.
• Diabetic foot ulceration or infection — shore-side podiatry consultation urgent.

Last verified 3 months ago