Diabetes mellitus type 2 limitation in work. Professional orientation and work activity in patients with diabetes mellitus

The long-term, chronic course of diabetes mellitus leaves a significant imprint on social problems patient, first of all employment. The attending endocrinologist plays an important role in determining the professional employment of the patient, especially the young one who chooses his specialty. At the same time, the forms of the disease, the presence and severity of diabetic angiopathy, complications and concomitant diseases are of great importance. Exist general provisions for any form of diabetes. Almost all patients are contraindicated hard labour associated with emotional and physical stress. Patients with diabetes are contraindicated to work in hot shops, in conditions of extreme cold, as well as sharply changing temperatures, work associated with chemical or mechanical, irritating effects on the skin and mucous membranes. For patients with diabetes, professions associated with an increased risk to life or the need to constantly maintain their own safety (pilot, border guard, roofer, fireman, climber, etc.) are unsuitable.

Patients receiving insulin cannot be drivers of public or heavy trucks, work at moving, cutting mechanisms, at height. The right to drive private cars for patients with well-compensated stable diabetes without a tendency to hypoglycemia can be granted in individually subject to sufficient understanding by patients of the importance of treating their disease (WHO Expert Committee on Diabetes Mellitus, 1981). In addition to these restrictions, professions associated with irregular working hours and business trips are contraindicated for people in need of insulin therapy. Young patients should not choose professions that interfere with a strict diet (cook, confectioner).

The optimal profession is one that allows for a regular alternation of work and rest and is not associated with fluctuations in the expenditure of physical and mental strength.

Particularly carefully and individually should be assessed the possibility of changing the profession in people who fell ill in adulthood with an already formed professional position. In these cases, first of all, the state of health of the patient and the conditions that allow him to maintain satisfactory compensation for diabetes for many years should be taken into account.

There is another moral aspect professional problem. Some patients, especially younger ones, want to keep their illness a secret. Sparing the psyche of patients, the doctor is obliged to observe medical secrecy. At the same time, he must try to convince the patient of the uselessness and even the harm of such an idea about his illness. This is especially important for patients with labile diabetes, who may need assistance at work, and therefore, on the contrary, it would be necessary to instruct colleagues on the basic rules for emergency care for such a disease.

When deciding on the ability to work, the form of diabetes, the presence of diabetic angioneuropathies and concomitant diseases are taken into account. Mild diabetes usually does not cause permanent disability. The patient can be engaged in mental as well as physical labor, not associated with great stress. Some restrictions in labor activity in the form of the establishment of a normalized working day, the exclusion of night shifts, temporary transfer for other work can be carried out VKK.

In patients with moderate diabetes mellitus, especially with the addition of angiopathy, the ability to work is often reduced. Therefore, they should be advised to work with moderate physical and emotional stress, without night shifts, business trips, or additional workloads. Restrictions apply to all types of work that require constant attention, especially in patients receiving insulin (possibility of developing hypoglycemia). It is necessary to ensure the possibility of insulin injections and compliance with the dietary regimen in the production environment.

When transferring to a job with a lower qualification or with a significant reduction in the volume production activities patients determine the disability of group III. The working capacity of persons with mental and light physical labor is preserved, the necessary restrictions can be implemented by decision of the VKK of the medical institution.

With decompensation of diabetes, the patient is issued a sick leave certificate. Such conditions, which often occur and are difficult to treat, can cause permanent disability of patients and the need to establish disability group II.

Significant disability, characteristic of patients with severe diabetes, is due not only to the violation of all types of metabolism, but also to the addition and rapid progression of angio-neuropathies and concomitant diseases. With rare exceptions, when it comes to highly skilled, mainly intellectual work, patients are not capable of regular performance of duties in a normal production environment. Some persons may work in specially created conditions or at home. Limitation of working capacity and, in connection with this, a decrease in qualifications and the amount of work serve as a reason for the establishment of VTEK disability of group III. If it is not possible to regularly professional activity due to severe disorders of microcirculation and metabolism, disability of group II is determined.

The rapid progression of microangiopathies (nephropathy, retinopathy), atherosclerosis can lead to progressive loss of vision, severe renal failure, heart attack, stroke, gangrene, that is, to a dense and permanent disability and to the transfer to disability II and I groups. Evaluation of working capacity in patients with visual impairment due to diabetic retinopathy or diabetic cataracts is carried out after consultation with an expert ophthalmologist.

A.Efimov, N.Skrobonskaya, A.Cheban

"Employability in diabetes mellitus" - an article from the section

Work is an integral part of the life of almost any person. It is also part of the life of a diabetic. With proper care, including an appropriate diet, exercise, exercise, regular sugar control, etc., a diabetic's lifestyle can be classified as normal. It is important to simply adapt to the characteristics of this disease and continue to be active in your own life, then work with diabetes will be a joy. The main thing is to know who can work with diabetes, and who can not.

When choosing a job, a diabetic should consider 2 factors: Firstly be aware of the extent and severity of the disease; Secondly choose a job that avoids the kind of activity that would endanger your life and the lives of others

(Professions of a pilot, a driver are not allowed public transport, high-rise, etc.). It is inappropriate to avoid reasonable mental, physical exertion and an active lifestyle, suppressing the will to live in oneself.

Remember, with diabetes, you can easily lead a full life, it's all up to you. Proof of this are many examples of gifted famous people suffering from diabetes. Despite the seriousness of this disease, they were able to reach heights in the field of science, art, etc. Be observant, and you will notice a lot of diabetics living in their usual rhythm, not deprived of activity and efficiency. There is not always a desire to talk about your illness, but sticking to a diet, using drugs, is vital, as a result work and diabetes will be compatible enough.

In order to avoid misunderstandings, tell your superiors about your illness and related procedures, such as hourly diets, insulin injections, or taking pills at work. Avoid with diabetes work at night, business trips, psycho-emotional stress. It is advisable to master several professions so that during employment there is no confusion and despair that you cannot get a job.

Professions with diabetes mellitus that minimally provoke stress and do not aggravate the course of the disease are welcome. In severe diabetes, home work is recommended. Extreme professions are unacceptable. The most acceptable professions are economist, librarian, tailor, laboratory assistant, general practitioner, nurse, pharmacist, teacher, designer, technician, etc. The profession of a pastry chef, or work related to tasting is not an option ...

When work is the meaning of life, or you have devoted your whole life to it, then it is reasonable not to leave your favorite pastime, but to review working conditions, to make them the most acceptable for your illness. And if you agree with the leadership of some of the nuances, you can move to a less dangerous and suitable position.

It happens that diabetics are faced with the issue of discrimination, and they are forced to stand up for their rights in connection with their disease. There are countries where this issue is resolved at the state level, allowing diabetics to get education and work. All kinds of schools, forums, groups have been created to support diabetics. With their help, issues of employment and education are resolved, so work with diabetes there will always be, if there is a desire.

What's your job? Write comments.

After the patient is diagnosed with diabetes, the doctor prescribes a strict therapeutic diet. The choice of food primarily depends on the type of diabetes.

Type 1 diabetes

Since the blood sugar level in type 1 diabetes is normalized by the introduction of insulin into the body, the diet of diabetics is not much different from the diet of a healthy person. Meanwhile, patients need to control the amount of easily digestible carbohydrates they eat in order to accurately calculate the required amount of hormone to be administered.

With the help of proper nutrition, you can achieve a uniform intake of carbohydrates in the body, which is necessary for type 1 diabetes. Diabetic patients with malnutrition can have serious complications.

To carefully monitor the indicators, you need to keep a diary, where all the dishes and foods that the patient ate are recorded. Based on the records, you can calculate the calorie content and the total amount eaten per day.

In general, the treatment is individual for each person and is usually compiled with the help of the attending physician. It is important to take into account the age, gender, weight of the patient, the presence of physical activity. Based on the data obtained, a diet is compiled, which takes into account the energy value of all products.

For good nutrition per day, a diabetic should eat 20-25 percent of proteins, the same amount of fat and 50 percent of carbohydrates. If translated into weight parameters, the daily diet should include 400 grams of carbohydrate-rich foods, 110 grams of meat dishes and 80 grams of fat.

The main feature of the therapeutic diet for type 1 diabetes is the limited intake of fast carbohydrates. The patient is forbidden to eat sweets, chocolate, confectionery, ice cream, cooking.

The diet must include dairy products and low-fat milk dishes. It is also important to get the right amount of vitamins and minerals from food.

At the same time, a diabetic with type 1 diabetes must observe certain rules which will help to get rid of complications.

• You need to eat often, four to six times a day. You can eat no more than 8 bread units per day, which are distributed over the total number of meals. The amount and time of the meal depends on which insulin is used for type 1 diabetes.
• In particular, it is important to focus on the regimen of insulin administration. The main part of carbohydrates should be eaten in the morning and lunchtime.
• Since insulin levels and needs can change each time, the dosage of insulin in type 1 diabetes should be calculated at each meal.
• If you have a workout or an active walk, you need to increase the amount of carbohydrates in the diet, since people need more carbohydrates during increased physical exertion.
• In type 1 diabetes, it is forbidden to skip meals or, conversely, overeat. A single serving can contain no more than 600 calories.

In type 1 diabetes, the doctor may prescribe contraindications for fatty, smoked, spicy and salty foods. Not suitable for diabetics, including alcoholic drinks any fortress. Dishes are recommended to be steamed in the oven. Meat and fish dishes should be stewed, not fried.

If you are overweight, you should be careful when eating foods that contain sweeteners. The fact is that some substitutes can have a much higher calorie content than regular refined sugar.

Type 2 diabetes

The therapeutic diet for type 2 diabetes is aimed at reducing the excess load from the pancreas and weight loss in a diabetic.

1. When compiling a diet, it is important to observe a balanced content of proteins, fats and carbohydrates - 16, 24 and 60 percent, respectively.
2. The calorie content of products is compiled based on the weight, age and energy consumption of the patient.
3. The doctor prescribes contraindications for refined carbohydrates, which must be replaced with high-quality sweeteners.
4. The daily diet should include the required amount of vitamins, minerals and dietary fiber.
5. It is recommended to reduce the consumption of animal fats.
6. It is necessary to eat at least five times a day at the same time, while the diet must be based on physical activity and the intake of hypoglycemic drugs.

With type 2 diabetes, it is necessary to completely exclude dishes in which there is an increased amount of fast carbohydrates. These dishes include:

• ice cream,
• cakes,
• chocolate,
• cakes,
• sweet flour products,
• candies,
• bananas,
• grape,
• raisin.

Including there are contraindications for eating fried, smoked, salty, spicy and spicy dishes. These include:

1. Fatty meat broths
2. Sausage, sausages, wieners,
3. Fish in salted or smoked form,
4. Fatty types of poultry, meat or fish,
5. Margarine, butter, cooking and meat fat,
6. Salted or pickled vegetables
7. High-fat sour cream, cheese, cottage cheese curds.

Also, porridge from semolina, rice cereal, pasta is contraindicated for diabetics and is also completely excluded.

It is necessary that in the diet of diabetics there must be dishes containing fiber. This substance lowers the level of sugar and lipids in the blood, helps to reduce weight.

It inhibits the absorption of glucose and fats in the intestines, reduces patients' need for insulin, and creates a feeling of satiety.

As for carbohydrates, you need not to reduce the quantity of their consumption, but to replace their quality. The fact is that a sharp decrease in carbohydrates can lead to loss of efficiency and rapid fatigue. For this reason, it is important to swap high glycemic index carbs for lower glycemic carbs.

Diet plan for diabetes

To get complete information on foods with a high and low glycemic index, you should use a special table that every diabetic should have. It is advisable to find it on the Internet, print it out on a printer and hang it on the refrigerator in order to control your diet.

At first, you will have to strictly monitor each dish introduced into the diet, counting carbohydrates. However, when the blood glucose level returns to normal, the patient can expand the therapeutic diet and introduce previously unused foods.

It is important to enter only one dish, after which it is necessary to conduct a blood test for sugar. The study is best done two hours after the product is absorbed.

If blood sugar remains normal, the experiment should be repeated several times to ensure the safety of the administered product.

You can do the same with other dishes. Meanwhile, you can not introduce new dishes in in large numbers and often. If blood glucose levels begin to increase, you need to return to the previous diet. Meals can be supplemented with physical activity to pick up best option daily diet.

The main thing is to change your diet consistently and slowly, following a clear plan.

Diabetes is a limitation to a number of specialties. Basically, these are professions associated with an increased risk to human life and others, such as drivers, pilots, machinists, climbers. A patient with impaired carbohydrate metabolism should keep this in mind when choosing the type of activity.

Anyone can develop diabetes. This raises the question of whether it is possible to work as a driver with diabetes. It is important to understand that there is no need to rush to make a decision to abandon this profession, especially when it comes to type 2 pathology. But you should think about finding yourself in a different occupation for a number of reasons. First you need to find out who can work with such a disease, after which a decision is already made to change the type of activity.

What should the patient consider

With diabetes, there are two main factors to consider. The first of these is the study of the characteristics of the disease that has arisen, the risks associated with it. For example, to understand the reasons for the possible decompensation of carbohydrate metabolism, what it can threaten for a person. The second factor is the choice of a profession that does not pose a real threat, first of all, to the patient himself and the people who may surround him at the time of performing professional manipulations.

Working as a public transport driver with diabetes is unacceptable. There are a number of other professions that are also considered prohibited:

• pilot;
• driver;
• high-altitude, industrial climber;
• any other work that involves an increased concentration of attention, the difficulty of operating professional equipment or a large and heavy mechanism (for example, a welder or an electric and gas welder).

Based on this, it is easy to answer the question of whether people with diabetes can work as a driver. However, the decision is based on the severity of the pathology, the presence of complications of the process. When diagnosing a disease in childhood, this fact should be taken into account when choosing educational institution. This will avoid possible failure from employment.

How to keep a job as a driver

The doctor should inform patients that the presence of diabetes is not considered a contraindication to driving. But this is possible with adequate control of the pathology, and with the slightest destabilization of the state, measures should be taken. An important aspect is a certificate of a diabetic, which will allow you to quickly orient others in case of loss of consciousness.

A person working as a driver should be aware that there may be some difficulties due to the diet, insulin injections. Sometimes these nuances make such work impossible.

The second type of pathology is somewhat simpler in this regard, but you should still minimize the number of stressful situations to normalize the mode of work and rest. Patients with severe diabetes are encouraged to work from home.

The best professions for such patients are:

• librarian;
• teacher;
• economist;
• therapeutic profile doctor;
• laboratory assistant;
• designer;
• medical hospital nurse.

With mild severity

The mild form of diabetes implies a slight fluctuation in carbohydrate metabolism, while it is easy to regulate. Symptoms do not bother the patient constantly. With a mild form, it is not forbidden to drive a car or some complex mechanisms. However, such a development is possible in early stages disease, when it was detected in a timely manner, treatment was prescribed. This implies the absence of any complications of the process. Most often, this situation occurs in type 2 diabetes. Particular attention should be paid to the preventive examination of these patients.

Exist certain types activities that are prohibited for any patient with diabetes:

• physical labor of increased severity;
• contact during work with poisonous, poisonous substances;
• processing;
• business trips for patients are allowed with their written consent.

Patients with diabetes should choose a more gentle mode of work than healthy ones. You should take into account your well-being, the state of carbohydrate metabolism, and take steps to prevent complications.

With moderate severity

Medium severity causes a ban on work associated with regular force majeure or accidents. It primarily includes machinists and drivers. This is due to the likely sharp change in the health of the employee, which will lead to fatal consequences for strangers in the worst case. You should always pay attention to the level of blood sugar, because the average severity of diabetes means its drastic changes.

Persons with this form of the disease are contraindicated in such work:

• increased physical or severe mental stress;
• stressful situations at work;
• management of any vehicles;
• with strain on the eyes or vision;
• standing work.

People with diabetes in the presence of complications of the disease are given disability. It is caused by damage to other organs, vascular defects, including ischemic defects of the lower extremities. This means a decrease in professional suitability and the undesirability of working as a driver or operating other more complex mechanisms. Violation of this principle leads to tragic consequences for the patient and his environment.

Whom to work

An erroneous opinion is that it is contraindicated to work with diabetes. There are activities that do not prohibit such patients from working:

• teacher;
• medical activity;
• librarian;
• programmer;
• secretary;
• copywriter;
• psychologist.

Patients should take into account the presence of pathology when choosing a profession, since each job requires a certain regime or routine. Not all of them are suitable for diabetics. It is important to avoid working at night. To improve the quality of life indicators, it is recommended to follow the following advice from doctors:

1. Keep with you funds that can quickly affect carbohydrate metabolism - insulin, hypoglycemic drugs, sweets or sugar;
2. Colleagues should be aware that you have such a pathology. This is necessary so that they can quickly provide emergency assistance and call an ambulance;
3. Patients with diabetes mellitus have some social benefits - the duration of vacation increases, the working day is reduced.

Sometimes patients may claim that they continue to work as a train driver or public transport driver. In such a situation, the severity of the process should be clarified, since in the case of a severe course of the disease, this is contrary to common sense.

For some patients, diabetes is simply a way of life. It does not present a definite unsolvable problem. Such people live a full life, behave very actively. Such a situation is possible. But for her there are some conditions that require mandatory implementation.

These include:

• carefully listening to the signals of your own body;
• following the instructions of the attending physician;
• maintaining a proper diet;
• physical culture lessons.

There are sports that are allowed for diabetics - light fitness, swimming, medium cardio (jogging, orbit track), gymnastic exercises. And from heavy exercises, such as squats with a barbell, deadlift should be abandoned. Some patients are allowed cross-country, boxing, mountaineering.

To make sure the adequacy of the chosen sport, you need to get a consultation from the attending endocrinologist. The doctor will tell you exactly what contraindications you have for physical activity, what it is better to pay attention to.

Despite all the arguments given, some diabetics continue to work in conditions that are not intended for them. These include work as a driver or driver. Such a step is possible only when diabetes is at its earliest stages, strong jumps in sugars have not begun, complications have not yet had time to form. The remaining cases require the abandonment of these professions.

On the other hand, a person with diabetes can safely continue to drive their own vehicles. However, if we are talking about some kind of long journeys, then it is better to take with you a person who also knows how to drive a car so that you can regularly replace each other. Traveling at night is undesirable. Reduced vision of such patients implies a refusal to drive motorcycles. It is important to remember that sudden sugar spikes while driving can cause emergency or disaster. Therefore, driving a car must be approached with special responsibility and attention.

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 work can you get without fear for your health and for the lives of the people around you?

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

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

Working with mild illness

Mild severity is the initial stage in the development of diabetes, so a person is still doing quite well with health. There are no special complications, the level of sugar in the blood is 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 the 2nd type of the disease.

The following types of work are contraindicated in this case:

1. Hard physical labor. For example, diabetics are strictly forbidden to work as loaders, miners, and work on the night shift.
2. When a person has to deal with chemical and industrial poisons.
3. Business trips are not provided for diabetics, at least without the consent of the patient himself.
4. It is not recommended to find an additional or full-fledged second job that will greatly tire the body of a diabetic.

IMPORTANT: The optimal professions for this degree of severity are considered to be: a salesperson, a teacher, a doctor, an 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 abandoning such activities due to the fact that this can cause an accident.

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

Contraindicated the following types labor activity:

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

IMPORTANT: If you have diabetes, then initially set a goal - to find a suitable and high paying job which will not harm your health. Even if you have found a job with high earnings, but you understand that your health will worsen because of this, you should refuse this option. Remember that diabetes is not to be trifled with. Even if healthy people get serious complications due to certain types of work, then a diabetic patient risks his own life.

So what kind of work then to 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 the detailed answer.

• a teacher at a school or institute;
• librarian;
• medical officer (preferably a private clinic);
• television and radio master, computer repair specialist;
• secretary-referent;
• work on the Internet (rewriter, copywriter, sale of 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 much time in front of a computer that damages your eyesight, you should refuse to work in shifts, because of which insulin injections are violated, you should take a mandatory break from work.

And finally, you should check out useful tips about what should be the mode of your work and rest. Remember, too, that diabetic work restrictions are not a whim or something that entrepreneurs have come up with to keep you out of work.

These restrictions protect your own health, prevent complications, and protect you and those around you from accidents at work.

1. Never forget to take insulin or tablets with you to work. Feel free to inject yourself wherever you are.
2. Do not hide from your colleagues that you have diabetes. Explain to them what to do if they have an episode of hyperglycemia or hypoglycemia.
3. If you have been suffering from 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.