Diabetes what group of disability. The frequency of re-examination of patients. Social benefits for diabetics

People who have diabetes know that this disease is not curable, but thanks to complex treatment can only alleviate the symptoms of the disease. This disease has several degrees, but after its acquisition, a person is not assigned a disability. In order to receive it, complications must occur against the background of this disease. Type 1 diabetes mellitus, which disability group should be assigned to the patient - about this will be discussed in this article.

In the event that a doctor limits the performance of his patient, this does not mean that he has been assigned a disability group. Type 1 diabetes can be of two types: autoimmune and idiopathic.

Disability group and type 1 diabetes

Any person, even who does not have a disability, knows that there are several degrees. The medical commission can assign the first degree to patients with the following complaints:

• heart failure of the third degree;
• blindness in both eyes;
• hypoglycemic coma;
• kidney failure;
• neuropathy;
• paralysis.

Important! Disability of the first degree is assigned to patients who cannot do without outside help, this is the most serious degree that relies on people with complex complications. Although patients are allowed to perform household chores, communicate with others and move independently.

The second group is assigned to patients with the following complaints:

• chronic renal failure;
• change in the psyche;
• ritinopathy, which manifests itself less severe symptoms than with the first degree of disability;
• neuropathy of the second degree.

This group of disabilities can be called moderate. Patients should be supervised, but not always. Some patients can easily move around, do light work and take care of themselves.

As a rule, the most common disability groups are the first and second. The third group is assigned to people with the development of a labile course of the disease, with simple disorders.

Fact! Often, such a disability group is assigned to young people during internship or mastering a new profession in order to reduce mental and physical activity.

How to get a group?

Many people want to apply for a disability group just to get free medicines and social benefits. Indeed, for most patients, it is not affordable to be treated for diabetes, since the cost of drugs is very high. And as it shows medical practice, most often, diabetes mellitus of the first type makes out disability. The decision on whether or not to assign a disability group to a patient is decided by a medical and social examination, which accepts it based on the available data.

To qualify for a disability group, a patient must meet the following conditions:

• the ability to take care of oneself, navigate in space and move around has been completely or partially lost;
• the patient needs rehabilitation and social assistance;
• the patient has not only complaints, but also failures in the operation of many systems;
• the patient cannot communicate with others;
• the person cannot work.

In order to get a disability, you will have to collect a lot of documents and wait for the decision of the medical commission. First of all, you need to contact a therapist so that he writes out a referral for tests. In some cases, the doctor will also give directions to narrow specialists.

Important! If the medical commission does not assign you a disability, and your disease has acquired the character of complications, you need to go to court to appeal the decision. In medical practice, such and unreasonable refusals are often encountered.

To get a group for type 1 diabetes, you need to collect and provide the following documents:

• statement;
• outpatient card;
• referral or certificate for the assignment of disability;
• the passport;
• open sick leave;
• characteristics from the place of work or study;
• education data;
• a copy of the work book - for working citizens;
• certificate of disability and certificate of rehabilitation - upon re-applying.

But it is worth noting that, once having received a group, you will have to regularly confirm your position. So, for example, for the first degree of disability, it is necessary to collect certificates and undergo an examination every two years, for the second group every year.

As the statistics show, recent times this disease develops in children, and it is precisely the first degree.

Important! Children under 18 years of age, when type 1 diabetes mellitus is diagnosed, are immediately assigned a disability that does not have a group. But if complications appear, then the child can be assigned a group number and then the range of benefits and benefits will be larger.

Privileges

The benefits that a person with a diagnosis of diabetes mellitus can count on when assigning a disability group to him are as follows:

• free medicine;
• issuance of syringes;
• free test strips, counting 3 strips for one day;
• delivery of insulin;
• issuance of a glucometer.

Many of the benefits on this list should be available to patients, whether or not they have a disability. But, unfortunately, many people do not know this, and therefore spend money on treatment out of their own pocket.

For children with disabilities with diabetes, the number of benefits is wider, they can claim free rest in a sanatorium once a year, receive a pension and take advantage of preferential places when entering universities. If the child is sent to Spa treatment, then in addition to the cost of the voucher, the state pays for the two-way trip and the payment for the accommodation of the parent or accompanying child.

If the disease develops in pregnant women, then another 16 days must be added to the parental leave. If diabetes is hereditary disease, a newborn child is also entitled to free food. In addition, you can receive the following benefits:

• discount on travel in suburban transport;
• discount on payment of tax for real estate;
• exemption from payment of state duty for the services of a notary and a lawyer;
• service out of turn in different institutions;
• 50% subsidy for utility bills;
• exemption from paying land tax;
• receiving a social apartment in the order of the general queue.

If a disabled child is brought up in the family, then the state must pay a monthly allowance for his maintenance, in addition to the benefits described above.

Important! Diabetics of the first insulin type are completely disabled.

To answer the question: what group of disability is assigned for type 1 diabetes, it will definitely not work. Since in the first place it depends on how the disease proceeds. As medical practice shows, when diabetes of the first type, often all applicants are assigned a degree of disability in connection with serious condition sick person. Also, people have the right to receive disability in this disease due to the fact that it is chronic.

Diabetes mellitus is a very serious disease that, despite the rapid development of medicine, cannot be cured. The danger of this disease lies also in the fact that it is often the cause of dangerous complications and also affects important internal organs human body. How to get a disability for diabetes mellitus, how to properly apply for a disability for diabetes, read further in the article.

Why is a person eligible for diabetes disability?

A person who has been diagnosed with this diagnosis must strictly adhere to special diet, as well as a certain regimen, which together allow you to effectively control the level of sugar, and maintain it at acceptable level. Often, diabetes mellitus makes the patient dependent on insulin, and, consequently, the person suffering from given by disease should be able to receive the necessary injection at a certain time. Naturally, the above facts have a rather negative effect on the quality of life, and also somewhat complicate it. That is why the question of how to get disability for diabetes is of great concern not only to patients, but also to their relatives.

A person who has been diagnosed with diabetes mellitus partially loses his ability to work, has a tendency to many diseases, due to the complications that this disease has on the body. In the event that the diagnosis was made at an age when it is still quite far from retirement, you need to think about how to apply for disability for yourself.

Basic conditions how to get a disability for diabetes mellitus?

You can apply for disability subject to the availability of extracts on treatment, as well as certificates that confirm the presence of the disease. At the same time, it should be borne in mind that disability will be issued only if a person, as a result of an illness, has completely or partially lost his ability to work due to persistent health disorders.

In legislation Russian Federation it is clearly stated that a person who has lost his ability to work as a result of diabetes mellitus has the right to apply for disability. Depending on the degree of disruption internal organs caused by diabetes mellitus or its complications, medical commission can assign the first, second or third group of disability. In the event that diabetes mellitus requires constant use of insulin injections, disability is assigned on an indefinite basis, which eliminates the need for annual re-examination of the disease.

How to apply for diabetes disability?

The first step on the way to how to apply for a disability for diabetes is to contact a local doctor, who must write out a referral for a series of examinations to the patient. After an ECG examination has been completed, tests have been taken, and an extract from the medical history has been made, it will be necessary to undergo medical and social commission.

Having received a special extract from the head physician of the clinic you applied to, you must contact the medical and social commission of your district. In order to pass this examination, you must provide all available medical documents as well as a passport. The last step is the application for certification. Based on the documents and certificates you have, the members of the commission will make a decision and assign you one of the disability groups. In cases where the commission, or the doctors of the polyclinic, decided that in your case there are no grounds for registering a disability, it is possible to seek help from the courts, and you can also apply for consideration of your issue in the regional medical and social commission.

It is important to remember that you must fight for your rights and use all available means for this, since disability implies state support.

Diabetes is a very serious disease. If you do not properly control your blood sugar levels, your vital functions may be impaired. important organs, leading to partial or total loss human performance. Obtaining a disability requires contacting a local doctor.

Reasons for applying for diabetes disability

Disability (disability) in case of diabetes mellitus can be issued in view of the presence of serious reasons. To establish a disability group, one disease is not enough; for this, only the presence of complications that were obtained during the course of the disease is mandatory. They include dysfunction a separate body or the entire system of the human body. This state of affairs already suggests that the type of diabetes in the patient does not have any slightest significance. Violation of the normal functioning of the patient is the main reason for his application for disability registration.

Who gets disability for diabetes?

The assignment of disability to a child with diabetes mellitus (insulin-dependent) is possible only if he has not reached the age of majority. Then the registration of disability occurs without assigning a group. For all other patients, it is usually assigned, guided by the severity of the course of the disease, the nature of the complications that have appeared and the level of disability of the patient.

Only patients with such complications of the disease have the right to apply for disability (disability) in diabetes:

• Diabetic foot (common in diabetics). Occurs due to circulatory disorders lower extremities, which leads to suppuration and necrosis, and subsequently to amputation of the foot or part of it.
• All kinds of paralysis that occurs when damaged nerve fibers and disruption of innervation.
• Unstable functioning of the urinary system.
• Visual impairment - from a decrease in acuity up to blindness.

How to draw up a disability for diabetes and a list of documents?

To figure out how to properly apply for disability for diabetes, first of all, study the list required documents, and then follow the instructions below.

• an extract from your medical history with the conclusion of examinations;
• direction;
• the passport;
• medical policy;
• pension insurance certificate;
• statement.

Step-by-step instructions: how to get a disability for diabetes

First of all, in order to correctly issue a disability for diabetes, consult a doctor. If your illness is already quite long, then your attending physician is aware of this, which means that you have all the marks on the treatment completed in your card. Diabetes is an area that endocrinologists are in charge of, however, a referral to an expert medical and social commission should be written by a district therapist.

You will receive a referral for general tests, blood sugar tests, urine tests (with exercise, without exercise), ECG, examination of organs affected by an excess of sugar.

To correctly issue a disability for diabetes, after the examination, go back to the therapist. The doctor will record the results on a card that you later present to the commission and make an extract from the medical history with brief description diseases and courses of treatment. With a new direction. With a new direction, you must get an appointment with the head physician, and certify the form with the necessary seals at the registry.

Since the tests are only valid for 14 days, during this time you must have time to pass the commission in order to avoid re-taking the tests.

For the commission, you provide an application, a passport, a medical policy, an insurance pension certificate, a referral and an extract from the medical history.

After reviewing the results of the examinations and personally talking with you, the commission will determine the disability group provided to you, and it depends on the degree of organ damage and the level of disability.

Diabetes mellitus type 1 and 2 is a pandemic of the 21st century, which leads to disability of groups I, II, III, depending on the complications of the disease.

Type 1 diabetes is hereditary. They are most often affected by children, young people or adults. Older people who tend to be overweight usually have type 2 diabetes. Diabetes mellitus can occur after nervous breakdowns, physical overwork, mental trauma.

Diabetes mellitus (DM) is a chronic disease characterized by metabolic disorders of all kinds, primarily carbohydrates. Occurs as a result of many exogenous and genetic factors.

Many factors influence the epidemiology of diabetes: age, gender, environment, geographical position, characteristics of the population (genetic, demographic).

3 million people do not know that they have diabetes mellitus, 15-19% of patients first learn about diabetes with gangrene of the lower limb, 75% die from micro- and macrovascular complications.

Pathogenesis

There are 6 stages: I - genetic predisposition, II - damaging effect of various external factors, III - autoimmune active process, IV - progressive decrease in insulin secretion, V - overt diabetes mellitus, VI - complete destruction of beta cells. Insulin deficiency occurs due to its insufficient use by insulin-dependent tissues (muscle, liver, fat).

Clinical classification:

I. Clinical forms:

1. Primary: genetic (with or without obesity).
2. Symptomatic (secondary): steroid, pancreatic, thyroid, pituitary.
3. Diabetes in pregnant women.
4. Violation carbohydrate metabolism.
5. Risk factors (pre-diabetes).

II. Types of Diabetes:

• type 1 - insulin dependent;
• Type 2 - insulin-independent.

III. Severity:

• Light.
• Medium.
• Heavy.

IV. Payment status:

• compensation
• subcompensation
• decompensation

V. Angiopathy (I - II - III stage) and neuropathy:

1. Micro-angiopathy.
2. Macro-angiopathy.
3. Universal micro-, macro-angiopathy.
4. Neuropathy.

VI. Acute complications of diabetes - coma:

• Ketoacidotic.
• Hypoglycemic.
• Hyperosmolar.
• Hyperlactacidemic.

The main clinical manifestations of DM: polyuria, polydipsia, weight loss, polyphagia, glycosuria, hyperketonemia, hyperglycemia. Damage to organs and systems: cardiovascular (CHD, arterial hypertension); respiratory (tuberculosis); excretory urine (diabetic nephropathy); skin (dermatopathy); digestion (steatohepatitis, diabetic gastroparesis, etc.); osteoarthritis (osteoarthropathy). The diagnosis of diabetes is established when the blood glucose level is 6.1 mmol / l or more, this is if the previous fasting lasted 8–12 hours, or studies during the day - more than 11 mmol / l. To confirm the results, the tests must be repeated two or three times on the remaining days.

Groups of disability in diabetes mellitus.

To establish disability, type 1 and 2 diabetes take into account the complications that arise as a result of the disease, their nature and severity of the course, the impact on work, and the patient's life.

Insulin-dependent diabetic children under the age of 18 are granted the status of disabled children without assigning them to any disability group.

Signs of disability groups:

• Ability to self-service, movement, orientation, communication; control of their behavior, learning; fulfillment labor activity.
• typical complications.
• The need for outside care.

Group I (the most severe form) of disability includes patients:

• diabetic encephalopathy;
• Diabetic cardiomyopathy HF IIIst.
• Diabetic nephropathy - chronic renal failure (CRF) severe stage.
• Frequent relapses of hypoglycemic coma.
• Diabetic retinopathy (impaired vision that can lead to blindness);
• Diabetic neuropathy (paralysis, ataxia).

Patients with group I disability need constant medical care and the care of strangers.

II group of disability (severe stage of DM) is characterized by damage to several body systems, although not as pronounced as in group I:

• Diabetic neuropathy with paresis and damage to the digestive system.
• Diabetic encephalopathy.
• Presence of retinopathy.
• CRF ( terminal stage after dialysis or successful kidney transport).

Patients with group II disability need outside help, but are capable of self-care, movement due to aids.

Disability group III (DM of moderate severity) is provided when the existing functional stages of angiopathy or without their clinical manifestations, if rational employment leads to a decrease in qualifications or volume of activity.

Sick Group III disabilities are capable of self-care with the help of assistive devices; to move on their own with a long investment of time; perform labor activities in other specialties in the absence of a reduction in qualifications; inability to perform work in their former profession.

So, having discovered SD, it is necessary comprehensive examination for the presence of hypertension, coronary artery disease, lipid metabolism disorders, in order to prevent detrimental complications that will lead to disability in time.

Patients with diabetes mellitus (DM) with the following signs are sent for medical and social examination:

1. Type 1 or 2 diabetes of mild or moderate severity, to provide the patient with work with low level the necessary qualifications.
2. Poorly compensating moderate diabetes mellitus.
3. With an unstable course of the disease, which is manifested by ketoacidosis or an attack of hypoglycemia.
4. SD severe form with significant health impairment.

Form of disability.

A set of documents required for registration of disability:

• Citizen's passport; if minor - birth certificate, passport of parents or legal guardian.
• Referral from a doctor.
• Patient application for disability registration.
• Hospital extract, outpatient card with a history of the course of the disease and the results of all laboratory and instrumental examinations: fasting blood glucose test, after meals, general analysis urine (presence of acetone, sugar), kidney and liver tests, lipogram, electrocardiogram, Echo-KG; examinations of specialists (cardiologist, ophthalmologist, nephrologist, surgeon, neurologist).
• Evidence of education received.
• Employment book (certified copy).
• Description of the nature of the work or learning process to be performed.
• Certificate of disability (if you re-confirm the group).

Work restrictions.

Distributed relative to groups of patients: mild form, which prohibits work on night shifts, excessive physical activity; work with poisons; in adverse conditions.

With the severity of moderate type 2 diabetes is prohibited mental activity associated with stress, physical work of moderate severity. With moderate severity of type 1 diabetes, work is prohibited that requires mental concentration and dangerous species activities; light mental and physical labor is allowed.

The severe form includes disabled people of the 1st group, who are completely disabled.

The growth in the population of patients with diabetes leads to severe disability, especially among the able-bodied contingent.

Rehabilitation activities for diabetics include: healing procedures, healthy eating, resort and sanatorium treatment, professional retraining, employment assistance. Properly carried out complex rehabilitation measures help to reduce the progression of the disease and the disability of the population.

Timely treatment and early diagnosis of type 1 or 2 diabetes will help you avoid many complications of the body that lead to disability, observing the system of preventive and therapeutic measures.

It is necessary to carry out the prevention of diabetes, if it is known that blood relatives were ill with diabetes. People prone to diabetes should limit their intake of foods with large quantity Sahara.

Compliance with the principles rational nutrition, control over body weight, adequate physical activity and rejection bad habits avoids many diseases. Should be carried out preventive actions among the population on the topic of diabetes mellitus

Citizens should undergo an annual examination of the whole body to prevent the occurrence of any disease.

Everyone should remember that there is nothing more precious than our health in this life, so we should always value every minute of our lives, avoid psycho-emotional stress, and look at life more positively.

Disability is a condition in which a person's normal functioning is limited in one way or another due to physical, mental, cognitive or sensory impairments. In diabetes, as in other diseases, this status is established by the patient on the basis of an assessment medical and social expertise(ITU). Which group of disability in type 1 diabetes mellitus can a patient apply for? The fact is that the very fact of the presence of this disease in an adult is not a reason for obtaining such a status. Disability can be issued only if the disease proceeds with severe complications and imposes significant restrictions on the diabetic.

Establishment procedure

If a person suffers from insulin-dependent diabetes mellitus, and this disease progresses and significantly affects his normal lifestyle, he can consult a doctor for a series of examinations and possible disability registration. Initially, the patient visits a therapist who issues referrals for consultations with narrow specialists (endocrinologist, ophthalmologist, cardiologist, neurologist, surgeon, etc.). from laboratory and instrumental methods examinations to the patient can be assigned:

• general blood and urine tests;
• blood sugar test;
• Ultrasound of the vessels of the lower extremities with dopplerography (with angiopathy);
• glycated hemoglobin;
• examination of the fundus, perimetry (determination of the completeness of the visual fields);
• specific urine tests to detect sugar, protein, acetone in it;
• electroencephalography and rheoencephalography;
• lipidogram;
• blood chemistry;
• Ultrasound of the heart and ECG.

Depending on the condition of the patient and his complaints, he may be prescribed additional research and consultations of other narrow-profile doctors. When passing the commission, the degree of available functional disorders in the body of a patient caused by diabetes. The reason for referring the patient to the MSE may be poorly compensated diabetes mellitus of moderate or severe severity, frequent bouts of hypoglycemia and (or) ketoacidosis, and others. severe complications ailment.

To apply for disability, the patient will need the following documents:

• the passport;
• extracts from hospitals where the patient received inpatient treatment;
• results of all laboratory and instrumental studies;
• advisory opinions with seals and diagnoses of all doctors visited by the patient during the medical examination;
• application of the patient for disability registration and referral of the therapist to the ITU;
• outpatient card;
• work book and documents evidencing the education received;
• certificate of disability (in the event that the patient confirms the group again).

If the patient works, he needs to obtain a certificate from the employer, which describes the conditions and nature of the work. If the patient is studying, then a similar document is required from the university. If the decision of the commission is positive, the diabetic receives a certificate of a disabled person, which indicates the group. Repeated passing ITU it is not necessary only if the patient has 1 group. In the second and third groups of disability, despite the fact that diabetes mellitus is an incurable and chronic disease, the patient must regularly undergo a second confirmatory examination.

If the doctor refuses to issue a referral to the ITU (which happens extremely rarely), the patient can independently go through all the examinations and submit a package of documents for consideration by the commission

What to do in case of a negative decision of the ITU?

If the ITU has made a negative decision, and the patient has not received any disability group, he has the right to appeal this decision. It is important for the patient to understand that this is a lengthy process, but if he is sure that the assessment of his state of health is unfair, he needs to try to prove the opposite. A diabetic may appeal the results by contacting month with a written statement to the main ITU bureau where a re-examination will take place.

If the patient is denied disability registration there, he can apply to the Federal Bureau, which is obliged to organize its own commission within a month to make a decision. The last instance that a diabetic can apply to is the court. It may appeal against the results of the ITU, held in Federal Bureau in accordance with the procedure established by the state.

First group

The most severe disability group is the first. It is assigned to the patient in the event that, against the background of diabetes, he developed severe complications of the disease that interfere not only with his work activity, but also daily care behind you. These states include:

• unilateral or bilateral loss of vision due to severe;
• limb amputation due to syndrome diabetic foot;
• severe neuropathy, which adversely affects the functionality of organs and limbs;
• end stage of chronic kidney failure, which arose against the background of nephropathy;
• paralysis;
• heart failure of the 3rd degree;
• neglected mental disorders that arose due to;
• recurrent hypoglycemic coma.

Such patients cannot take care of themselves, they need outside help from relatives or medical (social) workers. They are not able to navigate normally in space, fully communicate with other people and conduct any kind of labor activity. Often such patients cannot control their behavior, and their condition is completely dependent on the help of other people.

Registration of disability allows not only to receive a monthly monetary compensation but also to participate in the program of social and medical rehabilitation disabled people

Second group

The second group is established for diabetics who periodically need outside help, but they can perform simple self-care actions themselves. Below is a list of pathologies that can lead to this:

• severe retinopathy without complete blindness (with proliferation of blood vessels and the formation of vascular anomalies in this area, which lead to a strong increase intraocular pressure and disruption of the optic nerve);
• the end stage of chronic renal failure, which developed against the background of nephropathy (but subject to continuous successful dialysis or kidney transplant);
• mental illness against the background of encephalopathy, difficult to treat with medication;
• partial loss of the ability to move (paresis, but not complete paralysis).

In addition to the above pathologies, the conditions for registering disability of group 2 are the impossibility of working (or the need to create special conditions for this), as well as difficulties in performing household activities.

If the patient is often forced to resort to the help of strangers, taking care of himself, or he is limited in movement, in combination with the complications of diabetes, this may be the reason for establishing the second group.

Most often, people with the 2nd group do not work or work at home, because workplace should be adapted to them, and working conditions should be as gentle as possible. Although some organizations with high social responsibility provide separate special jobs for the disabled. Physical activity, business trips and overtime work are prohibited for such employees. They, like all diabetics, are entitled to legal breaks for insulin administration and frequent use food. Such patients need to remember their rights and not allow the employer to violate labor laws.

Third group

The third group of disability is given to patients with moderate diabetes, with moderate functional impairments, which lead to a complication of the usual work activity and difficulties with self-care. Sometimes the third group is made out to patients with type 1 diabetes at a young age for successful adaptation to a new place of work or study, as well as during a period of increased psycho-emotional stress. Most often, with the normalization of the patient's condition, the third group is removed.

Disability in children

All children with diabetes mellitus, after the diagnosis is established, a disability is issued without a specific group. Upon reaching a certain age (most often the age of majority), the child must pass an expert commission, which decides on the further assignment of the group. Provided that during the illness the patient did not develop serious complications diseases, he is able to work and trained in the skills of calculating insulin doses, disability in type 1 diabetes can be removed.

A sick child with an insulin-dependent type of diabetes mellitus is assigned the status of a "disabled child". Except outpatient card and research results, for its registration you need to provide a birth certificate of the child and a document of one of the parents.

To apply for a disability when a child reaches the age of majority, 3 factors must be present:

• persistent violations of body functions, confirmed instrumentally and laboratory;
• partial or complete limitation of the ability to work, interact with other people, independently serve oneself and navigate what is happening;
• the need for social care and recovery (rehabilitation).

The state provides children with disabilities with full social package. Includes insulin and expendable materials for its introduction, financial assistance, spa treatment, etc.

Features of employment

Diabetics with the 1st group of disability cannot work, because they have severe complications of the disease and pronounced violations health. In many ways, they are completely dependent on other people and are not able to independently serve themselves, therefore, about any work activity in this case there can be no talk.

Patients with the 2nd and 3rd groups can work, but the working conditions must be adapted and suitable for diabetics. Such patients are prohibited from:

• work the night shift and stay overtime;
• carry out labor activities at enterprises where toxic and aggressive chemicals are released;
• engage in physically demanding work;
• go on business trips.

Disabled diabetics should not be allowed to hold positions associated with high psycho-emotional load. They may work in the field of intellectual labor or light physical activity, but at the same time it is important that a person does not overwork and does not overwork above the prescribed norm. Patients may not perform work that risks their lives or the lives of others. This is due to the need for insulin injections and the theoretical possibility of the sudden development of complications of diabetes (eg, hypoglycemia).

Disabled people with diabetes should avoid work that strains the eyes, as this can cause a sharp progression of retinopathy. In order not to aggravate the course of neuropathy and diabetic foot syndrome, patients should choose professions that do not require constant standing on their feet or contact with vibrating equipment.

Disability in type 1 diabetes is not a sentence, but rather a social protection sick and help from the state. During the commission, it is important not to hide anything, but to honestly tell the doctors about your symptoms. Based on an objective examination and the results of examinations, specialists will be able to make the right decision and issue the disability group that is required in this case.

Diabetes - serious illness endocrine system due to an absolute or relative lack of insulin - a hormone that ensures the passage of glucose through cell membranes. Diabetes is of the first and second types. In type 1 diabetes, the beta cells responsible for insulin production and located in the endocrine portion of the pancreas various reasons die or fail to perform their duties. As a result, an acute insulin dependence occurs in the body, which can only be compensated by the introduction of the hormone from the outside. In type 2 diabetes, insulin is synthesized in beta cells, but either the body receives less than it needs, or insulin resistance increases in organs and tissues and the biochemical mechanism stops working correctly. Type 2 diabetes is less acute, the disease develops over years and decades, but in the end, no less severe symptoms occur in the body. pathological changes than in type 1 diabetes. These changes lead to a permanent loss of ability to work and often with them the patient is assigned one or another group of disability. There is also gestational diabetes or diabetes in pregnancy.

Like most system chronic diseases, diabetes mellitus is not dangerous in itself, but by the complications that it causes. Persistent disorders of carbohydrate metabolism negatively affect all organs and tissues, but most of all suffer:

• heart and peripheral blood vessels(macroangiopathy, diabetic myocardiopathy, diabetic foot, resulting in gangrene and amputation of the lower extremities);
• kidneys - microangiopathy and chronic renal failure varying degrees occur in 60% of diabetic patients;
• nervous system - diabetic neuropathy, which leads to mental disorders, dementia, paresis and paralysis;
• eyes - diabetic retinopathy causes 10% of cases of blindness and 36% of cases of permanent visual impairment in the elderly.

With insulin-dependent type 1 diabetes, everything is both worse and better at the same time. If the patient does not receive insulin injections or refuses them, he simply will not live to the state of blindness or a diabetic foot. Only 100 years ago (before the invention of compensatory therapy), patients with type 1 diabetes rarely lived to even 30 years of age, dying from ketoacidosis and diabetic coma.

If the therapy is on schedule, then the prognosis for the course of the disease is even more favorable than with SD-2, the main thing is to regularly monitor blood sugar levels, adhere to a special diet and always have a supply of insulin for injections and an “emergency” candy. It is important to follow correct dosage drug and adapt to the course of current events. Insulin overdose or combination of injection with excessive physical activity, stress, nervous tension fraught with backfire- the development of acute hypoglycemia and the same coma, only from a lack of sugar. Such emergency cases The mentioned candy is exactly what you need.

Is there a disability for diabetes?

Almost all diabetics and people at risk (fasting sugar level 6-7 mmol per liter) are quite reasonably interested in whether diabetes mellitus entails disability, which group is given with different types and on different stages development of the disease and what benefits can be expected.

Last in Russia normative act regulating the procedure for referring patients with permanent or temporary disability for medical and social examination (ITU) is the order of the Ministry of Labor No. 1024n dated December 15, 2015. It entered into force after approval by the Ministry of Justice on January 20, 2016 under No. 40560.

In accordance with this order, the severity of all functional disorders in the human body is actually assessed on a ten-point scale - as a percentage, but with a step of 10%. In this case, four degrees of pathology are distinguished:

1. Insignificant - the severity of violations ranges from 10-30%.
2. Moderate - 40-60%.
3. Persistent pronounced violations - 70-80%.
4. Significant violations - 90-100%.

Doctors and researchers subjected this system to justified criticism, since it practically does not make it possible to take into account combinations of several pathologies, but in general, the practice of institutions of social medical expertise per recent months formed. Disability is given in the presence of at least one pathology attributable to the second, third or fourth categories of complexity or in the presence of two or more diseases, defects or injuries of the first category.

Disability in childhood diabetes

Disability in type 1 diabetes is certainly indicated for children under 14 years of age, and it does not matter whether the child is able to independently control his behavior, instrumentally check blood sugar and inject insulin, or all this lies on the shoulders of the parents. Bodies of medical expertise and social protection, as a rule, are in the position of parents and their sick children and the third group of disability is given without any special questions. The second group can be obtained only in the presence of severe symptoms of ketoacidosis, repeated diabetic coma, persistent disorders of the heart, central nervous system, kidneys, the need for hemodialysis and permanent hospitalization, etc. The reason may be the difficulty of selecting compensatory therapy - when the child fails to prescribe a clear plan for insulin therapy and all the time you need insurance from adults, including medical workers.

Diabetes in young people

In youth and young age When assigning a disability, not only the severity of the disease, the level of damage to organs and systems, but also the impact of the disease on the ability to learn, master the profession, and acquire work skills come to the fore when assigning a disability. For young people with type 1 diabetes, disability of the third group is given for the period of study in secondary, secondary specialized and higher educational institutions.

At the same time, the diagnosis of diabetes often imposes restrictions on the right to engage in a particular activity. This may be due to both the risk for the diabetic himself and the social danger that the disease causes. So, it is quite obvious that a patient with SD-1 cannot work as a confectionery taster or a loader - in such work, the patient runs the risk of seriously (if not fatally) harming himself. At the same time, a diabetic cannot be allowed to drive a bus or plane - an unexpected attack of hyper- or hypoglycemia can bring to the brink of death not only the patient himself, but also dozens of passengers for whom he is responsible. Patients with insulin dependence should not work in hot shops, on assembly lines, in control centers where concentration is important and there is no time for strip tests and injections. The only way out can be the use of an insulin pump, but this must first be discussed with your doctor.

type 2 diabetes

If disability in type 1 diabetes directly depends on the lability (acuteness) of the course of the disease, the age of the patient and his ability to take care of himself and conduct independent compensatory therapy, then disability in type 2 diabetes mellitus, due to the prolonged course of the disease and the blurring of symptoms, in most cases is already prescribed for late stages of the development of the disease, when complications have entered a severe and even terminal stage.

It is no coincidence that type 2 diabetics are rarely given a light third group. The patient himself is in no hurry for a medical and social examination, confident that a slight indisposition will soon pass and that retirement is still far away. Doctors also do not want to spoil the statistics and do not send the patient to the ITU, but only recommend him to give up severe physical and significant mental stress, bad habits and change the diet.

A careless attitude to one’s own health is superimposed on a psychological stereotype, according to which disabled people in Russia are second-class people, and if a person “follows the group” for such an insignificant reason as excess blood sugar, then he is also a loafer, striving to to cash in at the expense of the people and receive undeserved benefits. Unfortunately, some elements social policy our state is still not given the opportunity to get rid of such a stereotype.

The really acute question of whether type 2 diabetes is a disability arises when the disease affects all target organs that are in the body.

heart and coronary vessels affected by myocardiopathy.

From the side of the kidneys - severe chronic insufficiency, the need for dialysis or urgent transplantation (and it is not yet known whether it will take root donor kidney in a weakened body or not).

As a result of neuropathy, the limbs are affected by paresis and paralysis, dementia progresses. The vessels of the retina of the eyes are destroyed, the angle of vision is steadily decreasing until complete blindness occurs.

The vessels of the legs lose their ability to nourish tissues, necrosis and gangrene occur. At the same time, even a successful amputation does not guarantee the possibility of prosthetics - tissues eaten away by diabetes stubbornly refuse to accept an artificial leg, rejection, inflammation, and sepsis occur.

Are you asking if type 2 diabetes is disabled? Of course, it is supposed to, but it is better not to bring it to it! Especially since modern methods treatments are quite capable of coping with the negative course of the disease and preventing the development of formidable insurmountable complications.

How to get disability with diabetes?

If a we are talking about an adult patient, then in order to undergo a medical and social examination, it is necessary to obtain a referral from the attending physician or a local therapist to undergo the MSE. After that, the patient goes the following tests and surveys:

1. General blood test, fasting glucose and after meals, content of 3-lipoproteins, cholesterol, urea, creatinine, hemoglobin.
2. Urinalysis for sugar, acetone and ketone bodies.
3. Electrocardiogram.
4. Oculist examination (symptoms of rheitnopathy and diabetic cataract),
5. Examination by a neurologist - diagnoses damage to the central and peripheral nervous system, checks the sensitivity of the skin).
6. Examination of the surgeon (diagnosis of the condition of the lower extremities).
7. Special studies for severe lesions of specific organs and systems. In case of renal insufficiency, the Zimnitsky-Reberg test and the determination of daily microalbuminuria, with neuropathy, an encephalogram, and with diabetic foot syndrome, dopplerography of the lower extremities. In some cases, more complex studies are prescribed, for example, an MRI of the foot, heart, or CT of the brain.

Attached are the results of daily monitoring blood pressure and cardiac activity, carried out at home or in a hospital.

The decision to assign a disability group is made on the basis of a study of the clinical picture as a whole, including the results of tests and patient interviews. The most severe disability group I is assigned when critical condition the patient, when he practically cannot move independently and take care of himself. The most characteristic sad example is the amputation of one or both legs above the knee with the impossibility of prosthetics.

Even a severe disability of the first group can be corrected if the patient's condition improves, for example, after a successful kidney transplant with diabetic nephropathy. Unfortunately, as we have noted, most often the discussion of disability comes too late.

Diabetes cannot be completely cured, but it can be managed active life, work, have a family, engage in creativity and sports. The main thing is to believe in yourself and remember that you should help yourself first of all.