Diavzglyad: Who and how can a person with diabetes work? What makes it difficult to choose a profession if you have diabetes? Where can you work with diabetes?

Prof. Ilya Nikberg
Sydney, Australia

The daily life of a patient with diabetes mellitus (on average it affects 3 to 5% of the population, in old age this figure increases to 10-15%) should be subject to a certain treatment, preventive and hygienic regime. Only its careful observance can allow people suffering from this serious illness to be socially active and lead a lifestyle as close to normal as possible.

One of the most important components of such a life is work. An activity that is exciting and compatible with the requirements of an individual treatment and preventive regimen is a powerful factor in maintaining the patient’s vital activity, his social usefulness and satisfaction.

However, the specific features of many types of such activities negatively affect the course of the disease, make it difficult to compensate, increase the risk of severe complications, lead to early disability, and in some cases are simply contraindicated for a diabetic patient.

Therefore, the problem of combining this activity with restrictions due to the nature of the disease often arises from childhood, when choosing a profession, during study and work, and even at retirement age.

In the era of the modern scientific and technological revolution, along with long-known ones, many new professions have emerged that have expanded and diversified the types of human labor activity. But, unfortunately, not all professions are suitable for a person with diabetes. Some are clearly contraindicated; admission to many others has strict restrictions.

From the point of view of the suitability of a particular profession for a person with diabetes mellitus to work in it, the initial requirement is as follows: the nature and characteristics of work activity must allow the patient to fully combine it with compliance (without compromising work or danger to others) of the treatment and preventive regimen necessary for this patient (times for taking medications, permitted foods, self-monitoring of blood glucose levels, prevention of hypoglycemic conditions and emergency care for them, normal rest and sleep, etc.).

Based on this general requirement, the following specific tips and recommendations arise (first and foremost, they are addressed to patients suffering from type 1 diabetes, although to a greater or lesser extent they also apply to patients with type 2):

• Exclusion of work with a shift schedule, in the evening and at night.
• Refusal or limitation of work associated with increased physical activity and harmful working conditions (unfavorable microclimate of work premises, hazardous physical, chemical and biological influences, strong psycho-emotional stress)
• Exclusion of work in extreme conditions (underwater, underground, in emergency situations, in isolated rooms, etc.).
• Exclusion (limitation) of work on managing ground, air, underground and other public transport and construction mechanisms.
• Limiting the time of work requiring prolonged visual strain.

In resolving the issue of professional guidance and work activity of a diabetic patient, not a formal (presence of the disease) but an individual approach is required. He must take into account not only (and in some cases not so much) the very fact of the presence of the disease, but also its very important personal characteristics: the form, severity and nature of the disease, the means and treatment regimen, the presence and severity of complications, the “diabetological” literacy of the patient , possession of means of self-control and emergency self-help, understanding and level of self-discipline and responsibility for oneself and others, age and work experience (professional experience) of the patient, moral and psychological significance of work in the life of the patient, etc.

When providing professional guidance to a child with diabetes, parents and teachers should tactfully, gradually, with the least damage to the child’s psyche, without contributing to the formation of an inferiority complex, explain to him the personal and

social expediency of the preferential choice of one or another “suitable” profession, give arguments for its attractiveness and prospects, etc. Similar arguments should be used in communication with young people who fell ill with diabetes during their studies, or who still have little work experience in their specialty, etc., who still have many years of work ahead and a full-fledged “life with diabetes”, for which they need compatibility with the relevant profession.

When a person becomes ill with diabetes at a more mature age and has solid professional experience and experience (most often at this age the disease occurs in type 2, which in most cases does not require insulin injections), the issue of further professional activity is decided purely individually. If the nature of this activity makes it possible to combine it with compliance with the necessary treatment and preventive recommendations, then the patient can continue to work in his specialty, limiting himself to only unburdensome correction of its schedule and duration, diet, etc. In such situations, it is often advisable to change a profession to one that is similar in profile (for example, the transition of a sick bus driver to the position of a repairman in a vehicle fleet).

From the point of view of acceptability for a diabetic patient, all types of professions can be divided into three main groups.

Contraindicated. Drivers of public transport (buses, trams, trolleybuses, taxis, etc.), pilots, cosmonauts, submariners, divers, miners working in caissons, builders and installers - high-altitude workers, drivers and operators of moving construction and other machinery, repairmen of external electrical networks, mine rescuers , work in enterprises with a high level of physical, chemical or biological hazards, work in places remote from the possibility of providing emergency medical care and other professions with a high risk of extreme situations, at night, requiring special attention and responsibility, excluding the possibility of complying with the required medical treatment for the patient -preventive regimen.

Relatively contraindicated. Works and professions associated with frequent business trips, work involving exposure to industrial environmental pollution (physical, chemical, biological), prolonged eye strain, actors, cooks, tour guides, confectioners, professional sports, work in isolated rooms without partners, with long working hours, high psycho-emotional stress and the like.

Recommended. Teachers of secondary and higher schools, researchers and laboratory assistants (with the exception of exposure to harmful environmental factors and the need for frequent business trips), doctors (except for surgical specialties, infectious disease specialists, emergency medical care), pharmacists, nutritionists, storekeepers, financial workers, economists , programmers, builders and interior repairmen, librarians, various types of administrative, economic and management work and a number of other professions that do not interfere with compliance with the treatment and preventive regime required for a given patient.

Like any other person, for a person with diabetes, work should not be a burden, but a joy.

Concluding the story about the professional orientation and activities of a patient with diabetes, we will briefly dwell on the issue of using personal vehicles, indirectly related to this problem.

The number of private car owners is steadily increasing all over the world, and among them there are many people with diabetes. The desire of a diabetic patient to “live like everyone else” is understandable and largely feasible. Therefore, for those patients who do not have medical contraindications related to the severity and nature of the disease, there is no reason to restrict the right to drive a personal car. In most cases, patients with type 2 diabetes can use cars. It is more difficult to resolve this issue in relation to patients of the first type who take insulin injections. As an exception, and provided that the disease is well compensated, the patient is not prone to frequent hypoglycemic reactions and the resulting confusion and loss of consciousness, such patients may also be allowed to drive a personal car. But only on “quiet” highways, where there is no heavy traffic and pedestrian traffic.

In any case, a driver with diabetes must:

* Do not violate the prescribed diet and medication regimen (including insulin injections).

* Get behind the wheel and drive a car after the prescribed meal and no later than an hour before the next meal.

* Have with you (in the car) an individual glucometer, glucose-lowering medications used, devices for administering insulin, glucagon, a sandwich, some sweets, glucose tablets, plain and sweet (sugar-based) water.

* At the slightest sign of incipient hypoglycemia or other manifestations of poor health, confusion and orientation, etc. immediately stop the car and check your blood sugar level, take glucose tablets if necessary, drink sweet water, etc.

* It is advisable that the patient have a medallion (bracelet) indicating that he has diabetes, or another similar certificate containing information about the addresses and telephone numbers of persons who need to be notified in case of need (seeking emergency medical care, accident, etc.) .P.)

* During a long trip, make rest stops at least every 1.5-2.0 hours.

Travel companions accompanying a patient on a trip should be aware of his illness and the measures that must be taken in the event of a sudden onset of a hypoglycemic state. Some patients do the right thing by having a clearly visible sign in their cars containing the appropriate instructions.

Diabetes mellitus is characterized by serious complications, especially if a person has been suffering from this endocrine disease for many years. As a result, the question arises: what types of work activities are indicated for people with diabetes? In other words, what kind of job can you get without fearing for your health and the lives of those around you?

All diabetics who have mild to moderate severity of the disease are considered able to work, so if you are able to take care of yourself and move on your own two feet, then you should look for an appropriate job.

Such work for patients with diabetes should not be harmful to health and should not be too tiring for a person. Next, you will learn the existing work restrictions, contraindications, as well as some useful recommendations when looking for work for people suffering from this dangerous disease.

Work with mild illness

Mild severity is the initial stage of diabetes development, so the person is still in fairly good health. There are no special complications, blood sugar levels are easily regulated, the functions of the main organs are not destroyed or impaired. Also, a mild degree may be characteristic of those people who have type 2 of the disease.

The following types of work are contraindicated in this case:

1. Hard physical labor. For example, diabetics are strictly prohibited from working as loaders, miners, or working night shifts.
2. When a person has to deal with chemical and industrial poisons.
3. Business trips are not allowed for diabetics, at least without the consent of the patient himself.
4. It is not recommended to find an additional or full-time second job, which will greatly tire the diabetic’s body.

IMPORTANT: The optimal professions for this degree of severity are: salesperson, teacher, physician, assistant secretary, etc.

Moderate work

Moderate severity is already characterized by some serious complications, due to which many types of work are absolutely contraindicated for diabetics. It is also worth refusing such activities due to the fact that it may cause an accident.

For example, working as a driver of a minibus or other public transport, or working in a hot shop is contraindicated because its unexpected stop can lead to the death of many people. And cessation of work can occur due to sudden jumps in blood sugar, hypoglycemia and other symptoms that occur with an insidious endocrine disease.

The following types of work activities are contraindicated:

1. Work that involves heavy physical or mental labor. This can include all types of work where you encounter nervous tension.
2. Working as a driver with diabetes. In most cases, you will be able to drive a personal vehicle, but working as a driver means endangering not only your life, but also the lives of those around you, so you should immediately abandon such activity.
3. With moderate severity, many people have certain problems with the vessels of the lower extremities, as a result of which the diabetic cannot stand on his feet for a long time. As a consequence of this, work that requires standing for a long time is contraindicated, for example, working as a security guard in a store or as a seller of small goods on the street.
4. It is not recommended to work in a job that will require you to work hard all day long. This is usually an office job where the employee has to spend the whole day in front of a computer screen.

IMPORTANT: If you have diabetes, then initially set a goal for yourself - to find a suitable and well-paid job that will not harm your health. Even if you find a job with a high salary, but you understand that this will worsen your health, you should refuse this option. Remember that diabetes is not something to joke about. If even healthy people suffer serious complications due to certain types of work, then a person with diabetes mellitus even risks his own life.

So what kind of job should you look for if there are so many contraindications? Many diabetics are interested in this question, for whom it is time to look for a job, and now you will find out a detailed answer.

• teacher at school or college;
• librarian;
• medical service employee (preferably a private clinic);
• TV and radio master, computer repair specialist;
• assistant secretary;
• work on the Internet (rewriter, copywriter, selling goods through an online store, etc.).

IMPORTANT: But even in all these works, a diabetic should remember some aspects. For example, you should not spend a lot of time in front of a computer, which damages your eyesight, you should refuse shift work, which disrupts your insulin injection schedule, and you should give yourself a mandatory break at work.

And finally, you should familiarize yourself with useful tips on what your work and rest schedule should be. Remember also that restrictions on working with diabetes are not someone’s whim or something that was invented by entrepreneurs in order not to hire you.

These restrictions help protect your health, prevent the development of complications and protect you and the people around you from accidents at work.

1. Never forget to take insulin or pills with you to work. Feel free to inject yourself wherever you are.
2. Do not hide from your co-workers the fact that you have diabetes. Explain to them what to do if they experience hyperglycemia or hypoglycemia.
3. If you have had diabetes since childhood, then immediately choose a profession that will not have contraindications for this disease. Moreover, you have special benefits when passing exams at a university and when applying for a job.

MEDICAL AND SOCIAL EXAMINATION AND INDICATIONS FOR RATIONAL EMPLOYMENT ARRANGEMENT
An expert opinion on the state of vital activity of patients with diabetes and a correct assessment of their clinical and work prognosis should be based on medical, social and psychological factors.

The formulation of clinical expert diagnosis should reflect the main clinical manifestations of the disease. An example would be the following statements:
Diabetes mellitus type I (insulin dependent) severe form, labile course; stage I retinopathy, stage I nephropathy, stage I neuropathy (moderate distal polyneuropathy);
Diabetes mellitus type II (non-insulin dependent) of moderate severity; stage I retinopathy (mild distal polyneuropathy).
Patients are sent to MSEC after an inpatient examination in therapeutic or specialized endocrinology departments of hospitals, in endocrinology offices of dispensaries, having with them a detailed extract from the medical history and completed form N 88. All persons suffering from diabetes mellitus must be examined by an ophthalmologist, neurologist, surgeon, orthopedist and a psychiatrist.
Clinical criteria for assessing the state of vital activity are: type of diabetes (I or II), form of severity (mild, moderate or severe), course of the disease (stable, labile), presence and frequency of hypoglycemic conditions, ketoacidosis, coma, presence and severity of late complications (retinopathy, nephropathy, neuropathy, osteoarthropathy), type and effectiveness of glucose-lowering therapy, presence of insulin resistance, concomitant diseases.
Social criteria include education, profession, position, employment opportunities in the patient’s place of residence.
The age of the patient is of great importance.
During the medical and social examination, contraindicated types of work should be taken into account, which include: heavy physical work, types of work associated with significant neuropsychic stress, work associated with the operation of transport (switchmen, conductors), vibration, near moving mechanisms, on conveyor belt, in contact with toxic substances (vascular poisons, alkalis, acids), driving professions, work at height.
In most cases, with a mild form of the disease, disability is not established. Necessary restrictions in operation are provided by
VKK recommendations (exemption from business trips, night shifts, night duty, additional workloads).
When making a work recommendation, one should take into account the fact that the development of hypoglycemic conditions may threaten the safety of both the patient himself and those around him. It is necessary to take into account that patients with diabetes must have the opportunity to eat while working and, if necessary, administer insulin.
In moderate diabetes mellitus, the state of vital activity largely depends on the severity of complications and the type of work performed.
In most cases, with moderate diabetes mellitus without complications, disability is not established. For such patients, the types of work listed above are contraindicated.
In diabetes mellitus type I of moderate severity, there is a need for constant insulin replacement therapy, which should be taken into account during medical and social examination and work recommendations for patients.
With stage I retinopathy, although visual function does not suffer, nevertheless, patients should not perform work associated with constant strain on the organ of vision, for example, they should not work as watchmakers or perform types of work associated with constant work with a microscope (microbiologists, workers clinical laboratory), on a computer, etc.
With retinopathy of the second degree, visual acuity suffers, exudates and pinpoint hemorrhages appear on the fundus of the eye; patients should not perform work that requires a significant portion of their working time under visual strain (for example, accountants, bookkeepers, statisticians, etc.).
In case of ophthalmoplegia (impaired function of the oculomotor muscles caused by damage to the III, IV and VI pairs of cranial oculomotor nerves), which is characterized by diplopia and ptosis, which is more common in patients with type I diabetes mellitus, work that requires even occasional visual strain is contraindicated ( for example, working with precision instruments, microscopes, etc.).
The most common form of peripheral diabetic neuropathy is polyneuropathy, which is characterized by distal, symmetrical sensory disturbances, as well as a decrease in vibration, tactile, pain and temperature sensitivity. Patients may experience paresthesia and severe pain.
Such patients should not perform work that involves standing for long periods of time or walking for long periods of time.
The same types of work are contraindicated in the presence of neuroarthropathy (“diabetic foot,” which is characterized by progressive destruction of one or more joints of the foot).
The presence of stage I diabetic nephropathy is a contraindication for work in unfavorable climatic conditions (low ambient temperature, high humidity, work with vascular poisons).
With stage II nephropathy, patients can only perform light types of work in a warm room.
Patients with moderate diabetes mellitus in the presence of these complications should not perform the contraindicated types of work indicated above. If, when transferred to another job, they lose their profession, it is necessary to establish disability group III.
Young people performing contraindicated work should be recommended retraining.
Disability group Ill is established for the period of training and rational employment.
A severe form of diabetes in the presence of severe complications (neuropathy with severe motor disorders, nephropathy with stage II renal failure, stage II retinopathy with a significant decrease in visual acuity in both eyes - 0.08 D, etc.) is the basis for establishing disability group II.
The second disability group is also established for persons with a labile course of severe diabetes mellitus with a chaotic alternation of hypoglycemic, ketoacidotic, hyperosmolar or lactic acidotic comatose states for the period of treatment (correction with insulin therapy).
If a severe form of diabetes mellitus has led to severe complications (retinopathy of the third degree, blindness in both eyes, nephropathy with renal failure of the third degree, neuropathy of the third degree with pronounced paresis) or is accompanied by very frequent comatose states (4-5 times a month), set I disability group.

Medical and social examination of diabetes mellitus in persons exposed to radiation

Based on our observations of the characteristics of the clinical manifestations and course of diabetes among liquidators, the basic principles for determining the disability group and the percentage of loss of professional ability have been developed.
In mild forms of diabetes mellitus, 10% to 20% loss of professional ability is determined.
In case of moderate form of diabetes mellitus type I, disability group III was established, the percentage of loss of ability to work was from 40% to 50%. With a labile course of the disease, regardless of the severity of complications, the percentage of disability is from 50% to 60%. Such patients can perform small-volume physical activity under an intensive insulin therapy regimen, with mandatory daily monitoring of glycemic levels.
With a moderate form of diabetes mellitus II and the presence of minor complications (microangiopathy stage I, polyneuropathy stage I), 25% loss of professional ability can be determined. The disability group is not established. In the case of the development of moderate and severe complications, patients are recognized as group III disabled and 30-40% loss of professional ability is determined.
In severe forms of diabetes mellitus of both types and the presence of moderate complications with an initial degree of organ dysfunction (for example, retinal angiopathy stage II, retinopathy stage I-II, angiopathy of the lower extremities stage II, CAN I-II), group III is determined disability and 60% loss of professional ability to work. In the presence of severe complications with impairment of organ functions of stage II, or in cases of frequent decompensation of the disease, frequent hypoglycemic states, states of ketosis and ketoacidosis, disability group II and 70-80% loss of professional ability are determined. In case of persistent decompensation of the disease, severe (grade III) complications and a sharp decrease in organ functions (blindness, stage II-III chronic renal failure, stage III chronic renal failure), disability group I is determined. The percentage of loss of professional ability to work is 90%.

Application
LIST OF NECESSARY STUDIES WHEN REFERRING PATIENTS WITH DIABETES TO MSEC
Dynamics of glycemia and glucosuria levels for each month.

1. For patients with type I diabetes mellitus - glycemia for every 2-3 weeks, glucosuria, glycemic profile for every 2-3 weeks.
2. Complete liver complex, Rehberg test, urea.
3. Level of proteinuria and its dynamics over the year, Zimnitsky, Nechiporenko tests.
4. ECG; RVG; REG (according to indications).
5. Examination by an ophthalmologist - indicating the severity of complications, determining visual acuity, biomicroscopy of the anterior part of the eye - identifying vascular disorders of the conjunctiva, limbus, iris, degree of lens opacity. Ophthalmoscopy - fluorescein angiography - ultrasound.
6. Examination by a neurologist, surgeon, cardiologist, nephrologist, etc. (if indicated).

Conclusion of an endocrinologist, discharge from the hospital (reflect the presence and frequency of hypoglycemic, ketoacidotic conditions, including persistent ketonuria).

Diavzglyad: who and how a person with diabetes can work - article on the portal

Although, it must be admitted, the awareness of the entire population about sugar disease here is quite high. There is also a special public organization that deals with the problems of children and adolescents, sick diabetes, in terms of their studies and work. It is noteworthy that the majority of patients with diabetes, both young and adults, thanks largely to the active popularization of knowledge about diabetes and promoting a healthy lifestyle do not hide their illness. And, of course, they are not shy about performing their daily tasks in full view of others.

So, I have repeatedly seen young people, most likely students, doing a blood test on a glucometer or injecting insulin by using syringe pen in cafes, metro stations and other public places. What will they become tomorrow? Wouldn't it hurt them? diabetes achieve your goals?

After all, he did not prevent many world-famous athletes, scientists, artists, writers, and politicians from writing their glorious page in history. Among them are hockey player Bobby Clarke and football player Harry Mabbutt, artists Fyodor Chaliapin and Lyudmila Zykina, Elizabeth Taylor and Elvis Presley, artist Paul Cézanne, scientist Thomas Edison, writers H.G. Wells and Mikhail Sholokhov, Marshal Fyodor Tolbukhin, politicians Nasser and Sadat, Tito and Gorbachev and many other representatives of different countries and nationalities. It is curious that in the list of American record holders with SD 33 athletes are listed; The list of artists and singers is even more impressive. The example of these people is clear evidence that the disease diabetes It’s not the collapse of all hopes of doing what you love.

Are all professions available?

However, the daily life of the patient diabetes must be subject to a certain treatment, preventive and hygienic regime. Only its careful observance can allow people suffering from this disease to be socially active, lead a lifestyle as close to normal as possible, and engage in interesting and useful work. It is also important that an activity that is exciting and compatible with the requirements of an individual regimen is undoubtedly a powerful factor in maintaining the patient’s vital activity and social satisfaction.

However, how diabetologist With many years of experience, I can confirm: the specific features of certain types of work activity negatively affect the course of the disease, make it difficult to compensate, increase the risk of severe complications, lead to early disability, and in some cases are simply contraindicated for the patient diabetes.

Therefore, the problem of combining work activity with restrictions due to the nature of the disease is not removed from the agenda when choosing a profession, during study, work, and even at retirement age.

In our time of scientific progress and high technology, many new professions have emerged that expand the types of work activities. Thus, in the Classifier of Professions operating in Russia we find several thousand names of a wide variety of professions (there are more than a thousand of them starting with the letter A alone!). But, unfortunately, not everything is acceptable for diabetes. Some specialties are clearly contraindicated; admission to many others has strict restrictions. And, of course, statements that sometimes appear in the media that, with good SD compensation and without complications, you can master any profession. (By the way, does the much-desired compensation always remain stable?)

Of course, in resolving the issue of professional orientation and work activity of the patient diabetes What is needed is not a formal (presence of disease), but an individual approach. He must take into account not only and not so much the fact of the presence of the disease, but also its important personal characteristics: the form, severity and nature of the course, means and treatment regimen, the presence and severity of complications, diabetological the patient's literacy, possession of self-control and emergency self-help, level of self-discipline and responsibility for oneself and others.

Step by step&

According to many diabetologists in Australia, it is optimal if, in the process of raising a sick person, diabetes the child will unobtrusively instill in him an interest in such activities, which he himself, out of his own aspirations, and not forcedly, will subsequently consider as a priority, most desirable for him in terms of professional activity.

Tactfully, competently, from childhood, a child can be introduced to such areas of life as musical art, engineering design (the range of possibilities here is huge!), professional work with a computer, the study of foreign languages ​​(translation), theoretical physics, mathematics, pedagogy, financial and economic management and so on.

As the child grows up, while searching for his professional orientation, parents and teachers can gradually explain to him the personal and social expediency of the preferential choice of a particular suitable profession, and provide arguments for its attractiveness and prospects. Similar arguments can be used in communication with young people who are sick diabetes during their studies at the institute or those who still have a short work experience in their specialty, those who still have many years of a full life with diabetes ahead, and for the sake of such a life they can consciously change their future profession from the right angle.

By the way, sick young people themselves can often act as bearers and promoters of such reasonable decisions diabetes. A recent Internet message from the International Diabetes Federation (IDF) featured a message from the Sick Students Support Group. Among its authors are Anna Ostergre (23 years old, student at the University of Copenhagen, type 1 diabetes since 1999), Dana Lewis (student at the University of Alabama, 19 years old, ill since age 14), Quitlin McEnery (student at Georgetown University, 22 years old, ill from 3 years old)&

When a person becomes ill with diabetes at a more mature age and has a solid professional record and experience (most often the disease then proceeds in the second type), the question of further professional activity is decided purely individually, taking into account many factors, including psychological ones.

If the nature of this activity allows it to be combined with the implementation of the necessary therapeutic and preventive measures, then the patient can continue to work in his specialty, limiting himself only to unburdensome correction of its schedule and duration, diet and physical activity. Most often this is possible with type 2 diabetes. Much less often, but not at all excluded, and when type 1 diabetes. Sometimes a sick person definitely has to stop working in his usual position and field.

If, due to existing attachments, accumulated knowledge and experience, it is difficult for a person to move to another area of ​​professional work or to stop it altogether, then in such situations it is advisable to change a specialty to one that is similar in profile to the previous one. For example, an ill bus or taxi driver can be retrained as a repairman or dispatcher in the same fleet; an active professional athlete can become a youth team coach or a sports school administrator; a policeman transfers to non-operational work in his own department; military officer to work at the military registration and enlistment office, military educational institution

Medical angles

Of course, such retraining or initial choice of profession should be based on basic medical requirements. They are:

exclusion of work with a shift schedule, in the late evening and at night;

refusal of work (or limitation thereof) associated with increased physical activity and harmful working conditions (unfavorable microclimate of working premises, hazardous physical, chemical and biological influences, prolonged visual and strong psycho-emotional stress);

exclusion of work in extreme conditions (underwater, underground, in emergency circumstances, in isolated rooms, etc.);

exclusion (limitation) of work on managing ground, air, underground and other public transport, construction and other dangerous and complex mechanisms;

exclusion (limitation) of work in conditions that do not allow or make it difficult to seek help from others or provide emergency medical care.

Taking into account these initial requirements and from the point of view of acceptability for the patient diabetes All types of professions can be divided into three main groups.

Contraindicated.

Drivers of public transport (buses, trams, trolleybuses, taxis), pilots, cosmonauts, submariners, divers, miners working in caissons, builders and high-altitude installers, drivers and operators of moving construction and other machinery, repairmen of external electrical networks, mine rescuers; work with a high level of physical, chemical or biological (infectious) hazards, work in difficult (extreme) temperature and humidity conditions, work in places remote from the possibility of providing emergency medical care; other high-risk professions associated with the occurrence of extreme situations, requiring special attention and responsibility, excluding the possibility of complying with the treatment and prophylactic regimen necessary for the patient.

Relatively contraindicated.

Works and professions associated with frequent business trips, associated with exposure to industrial environmental pollution, requiring prolonged visual strain; professional sports; working in isolated rooms without partners, with irregular working hours, high psycho-emotional stress.

Teachers of secondary and higher schools, researchers and laboratory assistants (with the exception of exposure to harmful environmental factors), doctors (except for surgical specialties, infectious disease specialists, emergency medical care), pharmacists, financial workers, economists, programmers, builders and repairmen of interior spaces, librarians , various types of administrative, economic and managerial work and a number of other professions that do not interfere with compliance with the regime required for a given patient.

Driving your car

The question of using personal vehicles is somewhat beyond the scope of our topic. Naturally, for those patients who do not have medical contraindications related to advanced age, the severity and nature of the disease, there is no reason to restrict the right to drive a personal car. In most cases, they can drive a car without restrictions. patients with type 2 diabetes. As for patients with Type 1 diabetes, then they are also allowed to drive their car, provided that the disease is well compensated, they are not prone to frequent hypoglycemic reactions and caused by hypo fog and loss of consciousness. But preferably on quiet highways, where there is no heavy traffic and pedestrians.

In any case, the driver must:

not to violate the prescribed diet and medications (injections) insulin);

drive after the prescribed meal and no later than an hour before the next meal;

have with you glucometer, hypoglycemic agents And syringe pen, a drug glucagon, a sandwich, some sweets, glucose tablets, plain and sweet (sugar) water;

at the slightest sign of beginning hypoglycemia stop the car immediately and check blood sugar level, if necessary, take glucose tablets, drink sweet water, etc.;

it is advisable to have with you a medallion (bracelet) indicating that he has a diabetes mellitus or other similar identification with the addresses and telephone numbers of persons who need to be notified in case of need (seeking emergency medical care, accident);

during a long trip, make rest stops at least every one and a half to two hours.

Professor Ilya Nikberg, Sydney

The original article can be found on the official website of the newspaper DiaNews

How to choose a profession if you have diabetes - a modern medical encyclopedia

Professions that are certainly contraindicated for insulin-dependent diabetic patients include those of drivers of all types of passenger and freight transport (pilots, drivers, machinists, etc.); workers of services with unregulated work schedules, significant stress and the possibility of extreme situations (military personnel of private and non-commissioned officers, combat service, operational police officers, high-rise builders, assemblers, mountain rescuers, climbers); athletes and artists with high physical stress of professional risk; workers servicing machines and devices in isolated rooms if frequent business trips are necessary, or work at night.

Relatively contraindicated are professions in which labor activity makes it difficult to adhere to the regime, nutrition and rest: cooks, bartenders, artists and musicians (especially during evening performances, part of tours), as well as work with a changing rhythm of work, strong visual strain, unfavorable production conditions environment (presence of toxic impurities in the air of industrial premises, high or low temperature, high levels of noise and vibration, forced posture, work with moving mechanisms).

Work associated with prolonged psycho-emotional stress, as well as the risk of contracting an infectious disease or injury, is undesirable.

Patients with diabetes mellitus can be oriented toward study and subsequent work in the following professions: library workers, lawyers, economists, teachers, higher school teachers, craftsmen and installers of television and radio equipment, repairmen in workshops, instrument and machine adjusters, seamstresses, motorists, salesmen shops, cashiers, clerical workers, medical workers (except for operating surgeons and operating room nurses), construction workers, painters, parquet floor workers, joiners, carpenters, drillers, turners, scientists (not exposed to constant contact with harmful chemicals), editorial staff and publishing houses, administrative and economic personnel, field farmers, etc.

The list is indicative in nature and in each specific case the choice of profession should be decided individually, taking into account the totality of the factors indicated above (age, work experience, severity and nature of the disease).

In case of diabetes in middle and old age, even in severe form, the patient can continue his previous work (with the exception of drivers). However, this is only possible if there are conditions for timely, strictly prescribed food intake, sugar-lowering medications, exclusion of night work and frequent business trips.

During the course of the disease, complications may arise that require a medical occupational examination (VTE).

Kostya 19 Jan, 2013

Elena Liskovskaya Kyiv 19 Jan, 2013

Igor Klimenko 21 Jan, 2013

About working for a diabetic

Chef - great job! And as for the sake of dia, I’ll share the information.

Officially (traditional) medicine does not recommend that diabetics work in the kitchen, because... the cook uses many systems, including the exchange of substances, which leaves much to be desired. This leads to overeating against the background of uncontrolled nutrition - then it is clear what will happen to sugars.

But there are ways of SELF-ADJUSTMENT (you have to learn) when the cook cooks and does not taste the food.
In this case, the process of cooking is a spiritual process, and the finished food always has perfect taste and other parameters.
I am familiar with such technologies and have been using them for more than 30 years. When I “work in the kitchen,” the result is dishes that everyone who eats, including me, is delighted with, while my health is in order.

According to the legislation of Ukraine, enterprises are required to have a certain number of able-bodied disabled people. By spreading your network through acquaintances, acquaintances, acquaintances, you can always find such an enterprise and get a job (also my proven example).

And for the most extraordinary.
Anyone looking for a JOB is ready to sell their time to someone. But it is always reasonable for people who have knowledge, experience, skills, and abilities to take responsibility and organize their activities. At the same time, the labor regime is in the hands of these people. And I have mastered this path

Oksana Malysheva Jan 30, 2013

According to the testimony of a medical social examination, patients with diabetes mellitus are considered able to work if they have a mild to moderate severity of this disease, which proceeds without complications and severe damage to systems and internal organs, as well as without concomitant pathologies, but provided that the type of work activity is not suitable for the patient. contraindicated.

In case of mild diabetes mellitus, heavy physical labor is contraindicated, as well as any type of work associated with industrial poisons. Such patients should not be assigned business trips and overtime work, night shifts and duty, and the work schedule should not be irregular. Another contraindication is the unfavorable microclimate in which a diabetic patient works.

For moderate diabetes mellitus, the following contraindications exist:

1. Patients who live without insulin should not engage in moderate physical activity, as well as mental work, which is associated with high nervous and mental stress.

2. For insulin-dependent patients, when the course of diabetes mellitus is labile, work is not recommended, which, if suddenly stopped, can lead to accidents or disruption of the production process - this is work on a conveyor or control panel, with moving mechanisms, in a hot shop or at height , working as a driver and other similar areas of activity. Such patients can engage in economic or administrative activities, light physical and intellectual labor. In some cases, it is necessary to reduce the volume of production labor.

3. For patients with damaged leg vessels, types of work that involve long walking, standing or vibration are contraindicated. And those who have damaged retina should not strain their eyesight for a long time.

In addition, workers with diabetes need regular treatment in specialized sanatoriums.

Young people suffering from diabetes are recommended to undergo vocational guidance and retraining with further rational employment, which should take into account that a hypoglycemic state is dangerous not only for the patient, but also for the people around him, therefore a working diabetic should be able to stop work in order to eat or administer an insulin injection.

Reviews and comments

I have type 2 diabetes - non-insulin dependent. A friend advised me to lower my blood sugar levels with DiabeNot. I ordered it online. Started the appointment. I follow a relaxed diet and started walking 2-3 kilometers every morning. Over the past two weeks, I have noticed a gradual decrease in sugar on the glucometer in the morning before breakfast from 9.3 to 7.1, and yesterday even to 6.1! I continue the preventive course. I'll write about my successes.

Margarita Pavlovna, I’m also on Diabenot now. DM 2. I really don’t have time for a diet and walks, but I don’t abuse sweets and carbohydrates, I think XE, but due to age, sugar is still elevated. The results are not as good as yours, but sugar hasn’t gone beyond 7.0 for a week now. What glucometer do you use to measure your sugar? Does it show you using plasma or whole blood? I would like to compare the results of taking the drug.

I ordered diabetes and I’m thinking, what can I do to be insulin dependent? How much insulin to inject? Is there no endocrinologist nearby or is this for type 2?

Elena- 15 Sep 2015, 15:00

With type 2 diabetes, no matter whether he is on insulin or not, it is very, very difficult to get a disability group (even a third), since this type is what doctors and scientists call Lifestyle, which implies a strict diet and a possible complete cure for the disease . Well, if, as people say, a person with type 2 diabetes is transferred to insulin, it is only because of his incorrect lifestyle, in nutrition, in physical activity, drinking alcohol, not following diet No. 9, and so on... Simple In other words, type 2 diabetes is “fucked up” diabetes in an impudent manner and people going to the medical examination to establish type 2 disability should be ashamed of it! And type 1 diabetes is an autoimmune, lifelong, chronic and disabling serious disease in 99.9% of cases! Type 2 diabetes makes up 90-93% of all people with this disease as diabetes mellitus, and type 1 diabetes makes up only 7-10%. So, gentlemen and ladies, second-types and second-types, you need to eat less and go to work with moderate physical labor, since you need to lose weight and compensate for your ridiculous diabetes, and not eat and not achieve complications, and then go with it to the ITU - make people laugh.