Is type 1 diabetes a disability? Can an already established disability be reviewed? What rules and regulations apply

Diabetes mellitus is classified as a so-called social significant diseases. That is, their occurrence and distribution directly depends on the socio-economic conditions of the population. Difficult living conditions, low awareness of the population about disease prevention and poor nutrition contribute to the emergence of epidemics and high mortality.

Social diseases are also named so because of the speed of their spread among people. Diabetes mellitus is a socially significant disease due to its prevalence and the nature of the disease itself. The fact is that diabetes mellitus cannot be cured, only corrected throughout life. Prevent on early stages, only type 2 diabetes is possible, completely excluding from the diet simple carbohydrates and saturated fat. But even in this case, nutrition control must be maintained throughout life, because tissue resistance to insulin, characteristic of type 2 diabetes, will not go anywhere. Type 1 diabetes is not curable and those who suffer from it, as a rule, always get a disability.

III group of disability assigned to patients moderate and severe diabetes mellitus. However, their disorders are not so severe and patients are able to serve themselves. The severity of their disease imposes some restrictions on labor activity, which must be compensated by the state. Deterioration of the state of health in such patients is usually sudden and due to failure to stabilize the patient's glycemic status. In case it fails for a long time bring the patient back to normal sharp deterioration, there is a repeated medical social expertise, which will assign him new group disability.

Disability for children with diabetes

Children who suffer from insulin-dependent type 1 diabetes mellitus are assigned the status of a disabled person without a group. Upon reaching the age of 18, the patient must undergo a second medical and social examination, which will determine the number of the disability group, or for some time remove the status of a disabled person from the patient. It all depends on the severity of the course of the disease in each case.

In order to achieve the status of a disabled child for a child, it is necessary to take a referral from the district clinic at the place of residence for a medical and social examination. Beforehand, you need to hand over everything necessary tests and undergo examinations by a number of specialists. The list of specialists and analyzes always hangs in the clinics in the public domain. If this is not the case, then you can contact the head physician directly, he is obliged to provide the necessary assistance.

The final package of documents required for behavior medical and social expertise for the recognition of a child as a disabled person includes an application from the legal representative of the child to recognize him as disabled, a document proving the identity of the child, a referral from the clinic in the form No. 088 / y-06, outpatient card patient, with histories of hospital discharges, test results, etc., education documents and income statement if legal representative child works. At re-survey you need a certificate of disability and a mark on the implementation of an individual rehabilitation program.

Of course, it is necessary to approach the issue of solving problems with social diseases in a comprehensive manner. Today, the state provides disabled people with diabetes benefits and pensions. However, the level of diabetes mellitus with subsequent disability is still very high. Interestingly, diabetes is not socially recognized in all countries. significant illness. For example, in Japan, where diabetes is extremely common, the rate medical care and informing the population about self-care is so high that life expectancy, and most importantly its quality, in patients with diabetes is the same as in people who do not suffer from this disease.

Do they give disability in type 2 diabetes mellitus, what disability group is assigned in this case - such questions concern people who are diagnosed this disease. Not always with diabetes, a disability group is assigned. Let's see in what situations a person can apply for disability if he has an elevated blood sugar level.

Clinical picture

What doctors say about diabetes

Doctor medical sciences, professor Aronova S. M.

For many years I have been studying the problem of DIABETES. It's scary when so many people die and even more become disabled due to diabetes.

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The general trend

It should be noted that an elevated blood sugar level is not the basis for a decision by the relevant commission and the appointment of disability. It is provided only if various physiological and mental abnormalities develop, which lead to disability and the impossibility of self-service. The type of illness is not taken into account when assigning disability, only the fact how severely the disease proceeds is taken into account. associated complications and the consequences of the pathology and how much they prevent a person from maintaining working capacity at the proper level.

If we turn to statistics, we can see that in any developed country, from 4% to 8% of people who suffer from this disease are recorded. More than 60% of patients were assigned group 2 disability.

Often, a person who has been diagnosed with diabetes (type 2), who adheres to all the prescriptions of the medical staff, proper nutrition and controlling glucose levels may not acquire the group.

What deviations should be present

The first group is prescribed if there is a severe form of the disease, which is characterized by retinopathy, neuropathy, ataxia, cardiomyopathy, encephalopathy, nephropathy. If repeated hypoglycemic coma was present, a person cannot move on his own, serve himself, then in this case a disability group is not assigned. Patients with such deviations need constant help.

The grounds for the second group are obvious mental and physiological deviations. These include loss of vision (first and second stages), neuropathy (second degree), encephalopathy, resulting in persistent mental changes. In the presence of such pathologies and complications, some people can move independently and serve themselves. In this case, disability is not assigned, but only when it is possible to stabilize the glucose level.

Grounds for the third group. Experts prescribe disability for mild or moderate pathology, if the violations of the functioning of body systems are moderate.

Diabetes mellitus of the 1st degree of a compensated type, in which insulin injections are not needed, which is not accompanied by pronounced consequences, is the basis for a negative decision of the expert commission.

be careful

According to the World Health Organization, 2 million people die every year from diabetes and its complications. In the absence of qualified body support, diabetes leads to various kinds complications, gradually destroying the human body.

The most common complications are: diabetic gangrene, nephropathy, retinopathy, trophic ulcers, hypoglycemia, ketoacidosis. Diabetes can also lead to the development cancerous tumors. In almost all cases, a diabetic either dies while struggling with a painful disease, or turns into a real invalid.

What should people with diabetes do? The Endocrinological Research Center of the Russian Academy of Medical Sciences succeeded make a remedy completely curing diabetes.

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Important! Adolescents under the age of majority are assigned disability without a group, regardless of the type of disease. To arrange a group for small children, teenagers, an extract and referral from a local hospital, further medical and social examination are necessary. In the course of it, the cause and group of disability will be established, taking into account how much disability has been lost. At the same time, specialists will determine the type, volume, term rehabilitation period, social security criteria.

When can you expect to receive

How to get disability with diabetes? Experts will make a positive decision if they diagnose severe manifestations consequences of elevated sugar levels, characterized by severe disorders, physiological and mental disorders. That is, if the disease is accompanied by:

less pronounced loss of vision than in type 2 diabetes;
chronic renal failure;
neuropathy II degree (if paresis is present);
encephalopathy.

If high blood sugar and lack of insulin are the cause limited ability II degree to movement, a person cannot independently serve himself, is disabled, then disability of the 2nd group with elevated level sugar will be given.

For people with any type of diabetes, disability group 2 is assigned only in cases where insulin treatment is necessary and this is evidenced by the relevant documentation. The question of people whether they give disability in diabetes mellitus cannot be answered unambiguously. It all depends on the general condition of the person, and on how strong the consequences of the pathology are. Disability is for those who need help from loved ones.

Our readers write

Topic: Defeated diabetes

From: Lyudmila S ( [email protected])

To: Administration my-diabet.ru

At 47, I was diagnosed with type 2 diabetes. In a few weeks I gained almost 15 kg. Constant fatigue, drowsiness, feeling of weakness, vision began to sit down. When I turned 66 years old, I was already steadily injecting myself with insulin, everything was very bad ...

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What documents need to be collected

You will need the following:

a statement from a person who has a pathology of any type (for children - a statement from parents, guardians);
proof of identity (passport, birth certificate);
extract and referral from the local medical hospital, court order;
to obtain a type 2 disability, you must have an outpatient card and all medical documentation that confirms the history of the disease;
if a person is officially employed - a photocopy employment contract, books (necessarily certified by an employee of the personnel department);
diploma of education;
for employed persons - an extract issued by the personnel department, indicating the nature and working conditions;
for students - documents from the place of study, characterizing educational activities;
if the examination is repeated, you should provide a certificate of disability, an individual rehabilitation course program (marks on the procedures performed must be present).

Expert opinion

It is possible to assign a disability group if type 1 diabetes mellitus is detected only after carrying out the appropriate laboratory research and studying the medical history. This procedure is carried out by experts of medical and social expertise.

It should be noted that it is carried out not only to establish a disability group, but also in order to determine in the course how much a person has professional working capacity and the duration of the rehabilitation period if type 1 diabetes is diagnosed. Conclusions and results will be issued on the basis of diagnostics and research:

blood and urine, sugar, glycosylated hemoglobin, acetone;
renal and hepatic biochemical tests;
electrocardiograms.

For the appointment of disability in without fail held ophthalmological examination for blindness. It is mandatory to examine a neurologist with all necessary research for condition assessment nervous system and the extent of her injury.

Stories from our readers

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Patients are examined by a surgeon, a specialist does dopplerography, rheovasography (to detect diabetic foot, gangrene, trophic ulcers).

Therapeutic conclusions are taken into account - echocardiography, pressure indicators and cardiograms, if symptoms of diabetic cardiomyopathy are present.

To reveal diabetic nephropathy, tests of Zimnitsky and Rehberg are carried out.

If any violations are identified or total absence disability experts can give a disability group.

Disability is not only a way of social protection for people who suffer from diabetes. patients after careful diagnostic examination they are sent for rehabilitation, in which all the recommendations and prescriptions of doctors should be followed. In some cases, patients require treatment in sanatoriums, resorts. Expert opinion makes it possible to pass free course rehabilitation.

To date, pharmacology has not developed a cure for diabetes. All methods of treatment are aimed at prolonging the life of patients and improving its quality. But sometimes disability with such a pathology is an inevitable consequence.

Drawing conclusions

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With the progression of the disease, the quality of life of a person worsens: the patient often loses the ability to move independently, work, and serve himself. Diabetes is incurable chronic illness Therefore, if there are indications, a diabetic is recognized as permanently disabled.

Do diabetes give disability?

A pathology in which the regulation of blood glucose levels is disturbed is called diabetes mellitus (DM). The disease has several types, differing in causes and mechanisms of development. Pathology may be associated with a violation of the secretion of the hormone insulin, which reduces glucose levels (insulin-dependent or type 1 disease) or with a violation of the hormone (type 2). Increased amount blood sugar leads to damage to blood vessels and the nervous system, as a result of which, over time, each of the forms of the disease leads to complications.

What does disability depend on?

A group for diabetes mellitus is assigned after examining the patient's condition according to certain criteria. The patient is assessed by a special medical and social examination. The evaluation criteria include:

Employability. At the same time, the patient's ability to engage in not only habitual activities, but also light work is determined.
The ability to self-care and the ability to move independently. Due to complications, some patients lose their limbs and vision.
The presence of dementia. severe forms pathologies are accompanied by serious mental disorders up to dementia.
The degree of compensation general state organism. Assessed using the results of a laboratory examination.

Groups of disability in diabetes mellitus

In total there are three groups of disability. Medico-Social Commission distributes patients into categories according to certain criteria: the severity of the condition general health, the presence and degree of compensation of the disease. The size of state payments, various benefits, and the opportunity to get a job depend on which group is assigned to a diabetic. Among the conditions for registration of disability, there are restrictions on self-service, movement, and communication. Disability in type 2 diabetes is assigned several times more often.

First

When determining the degree of disability, the commission takes into account the peculiarities of the course different forms diseases. To establish the first group, the patient must have serious violations in the functioning of organs, systems, the impossibility of independent movement, self-service. In addition, the first group is assigned in the presence of the following complications:

complete blindness in both eyes;
neuropathy;
heart failure in the stage of decompensation;
severe angiopathy and gangrene;
frequent diabetic coma.

Second

The conditions for assigning the first and second categories of disability for complications of diabetes are different. Patients with the second group suffer from the same pathologies, but in a milder form. In addition, the patient must have a first-degree limitation on working capacity, movement and self-care, so patients need partial care. Medical and social examination assigns the second group of disability in the presence of the following pathologies:

third degree retinopathy;
chronic renal failure;
second or third degree neuropathy (general strength muscle tissue less than 2 points);
encephalopathy;
mental disorders;
mild angiopathy without trophic disorders.

Third

In the presence of complications that occur in a mild or moderate form, but affect the ability to work and worsen the patient's quality of life, a third disability group is assigned. In this case, the patient has no pronounced pathological changes organ systems. For self-service, operability should be determined by the first degree of limitation. The third group is assigned to those patients who need a change in working conditions and the elimination of contraindicated factors. In diabetes mellitus, third-degree disability is often prescribed temporarily.

About children

For a child under the age of 18, members of the medical and social examination (MSEK) establish a state of disability without specifying the status. After reaching the age of majority, you should undergo a re-examination and re-examination to establish a certain disability group. The following documents are required for registration:

passport (if available) or birth certificate;
parent's statement
medical card with survey results;
referral from the local pediatrician to MSEC (the design must comply with the form No. 088 / y-06).

How to get a disability

The issue of disability is decided by a special medical commission after evaluating the results of tests, examining the patient different specialists. During the examination, the degree, timing of the loss of working capacity, the volume necessary rehabilitation. The procedure for establishing disability is often lengthy and laborious. The disability group for type 1 diabetes mellitus is indicated in the following cases:

serious condition the patient;
frequent hypoglycemic coma, states of ketoacidosis;
violations normal operation internal organs.

AT Russian Federation exists normative act(Order of the Ministry of Labor), which regulates disability in diabetes and the procedure for referring patients with permanent disability for examination. In accordance with the document, the severity of the disease and its complications is assessed as follows:

insignificant;
moderate;
pronounced persistent violations;
significant violations.

Surveys

To pass an examination for the assignment of a disability, you should contact a local therapist who will issue the necessary referrals to narrow specialists (endocrinologist, neurologist, ophthalmologist, surgeon, etc.). During examinations, doctors assess the presence of indications and the possibility of obtaining the status of a disabled person. In addition, during the examination, a number of instrumental research and clinical analyzes:

blood tests (biochemistry, sugar analysis, glycated hemoglobin, sugar load test);
urinalysis according to Zimnitsky;
electrocardiogram;
echocardiogram;
arteriography;
rheovasography;

Unfortunately, doctors have not found such a medicine that would completely get rid of diabetes. modern medicine helps to make life easier for diabetics, but does not completely cure this disease.

Diabetes is a common disease, and every year more and more children and adults suffer from it. severe consequence this disease is a disability. But the disease itself cannot serve as a basis for confirming a disability group. It does not matter what degree of diabetes the patient has, it all depends on the severity of the disease and the presence of certain complications that entail deep violations vital important functions human body.

Disability Criteria

Let's take a closer look at how disability is determined in case of different groups diabetes.

Disability of the first group appointed upon detection of the following severe complications:

Chronic kidney failure (final stages).
Blindness in both eyes or.
Paralysis.
Stage III cardiomyopathy caused by diabetes.
Hypoglycemic coma.
Gangrene of the feet.
Encephalopathy with mental disorders.

If all these complications affect the fact that a person is not able to serve himself and fully move around, communicate, there are third-degree restrictions - he is assigned a disability of the first group.

The second group of disability prescribed to those diabetics whose disease occurs with such severe complications:

Encephalopathy with mental disorders.
Less pronounced retinopathy than in the first group.
Diabetic neuropathy of the second degree (presence of paresis).
Chronic renal failure.

In the presence of these complications, the following is also taken into account: violation of labor function - restriction of the second or third degree, violation of the ability to fully serve oneself and move around - restriction of the second degree, a person needs periodic care - in this case, disability of the second group is assigned.

The third group of disability is assigned to patients suffering from moderate and mild form diabetes. If there are minor disturbances in the functioning of the organs and systems of the body that cause difficulties in performing any work and self-service - a restriction of the first degree, then such a patient is assigned a third disability group.

Medical examination of diabetics

Disability is assigned after the examination of the patient by a special commission. The commission not only establishes the disability group, but also determines the degree of loss professional activity, its terms and time for the necessary rehabilitation.

Patients are referred to the ITU in the presence of such indications:

Frequent hypoglycemic coma or states of ketoacidosis, which characterizes the unstable course of the disease.
A severe form of type I or II diabetes, in which there is a pronounced disruption of the work of all organs and systems.
Difficult-to-compensate type 1 or type 2 diabetes of moderate severity;
Diabetes mellitus of mild or moderate severity (regardless of type), if the patient needs employment with a decrease in the amount of work and qualifications.

The commission will also need certificates with the results of the patient's tests, a passport, a referral from the attending physician, a patient's statement, an outpatient card, extracts from hospitals, a copy of the work book (duly certified), a diploma of education, a description of working conditions. And at the secondary examination - an individual rehabilitation program and a certificate of disability.

You should know that the appointment of a disability to a patient determines not only the social protection of a diabetic. This is rehabilitation, which includes comfortable conditions life and work, convenient work schedule, compliance with special diet, constant monitoring by an endocrinologist, adequate and regular treatment and proper adherence to the recommendations of a specialist. Early detection of complications initial stage development of diabetes slows the progression of the disease and prolongs the patient's life.

Unfortunately, doctors have not yet learned how to cure diabetes completely. Modern methods therapy can prolong the life of diabetics and significantly improve its quality. However, sometimes disability in diabetes mellitus is an inevitable consequence of this serious illness.

By itself, diabetes mellitus is not a basis for establishing a disability group. A diabetic can receive a group only if there are certain complications of diabetes that entail severe violations vital functions of the body.

Disability in different types of diabetes

It doesn’t matter if a person suffers from type 1 or type 2 diabetes, it is only taken into account how severe its complications are and how they interfere with the patient’s normal life and work. The disability group is necessarily given taking into account the degree of disability of the diabetic in connection with this disease. This is the basis for the difference between the first, second and third groups.

Children under 18 with diabetes (mostly insulin-dependent) receive the status of disabled children, without reference to a particular group.

Disability groups and their causes

Consider separately the groups of disability, as well as their causes: the presence of complications, the degree of limitation of functions and the need for outside care.

Group 1 disability is given to patients with severe diabetes if the following parameters are present:

Severe disorders of body functions associated with severe diabetes mellitus:

blindness in both eyes - diabetic retinopathy;
diabetic neuropathy - ataxia, paralysis;
diabetic cardiomyopathy - heart failure of the 3rd degree;
diabetic encephalopathy - mental disorders, dementia;
repeated hypoglycemic coma;
diabetic nephropathy - the last stages of chronic renal failure;

The presence of restrictions of the 3rd degree to movement, self-service, communication, orientation;

These patients need outside care and constant help.

Disability 2 groups are given under the following conditions:

A severe form of diabetes mellitus, which caused pronounced disorders in the functioning of organs and systems:

less pronounced retinopathy than in group 1;
chronic renal failure in terminal stage with a successful kidney transplant or adequate dialysis;
diabetic neuropathy of the 2nd degree (presence of paresis);
diabetic encephalopathy.

Limited abilities of the 2nd degree for movement, self-service, labor activity.

Such diabetics to help strangers, but permanent care(as in group 1) they do not need.

Group 3 disability is given to diabetics with:

Moderate disturbances in the functioning of organs and systems:

labile course of the disease;
mild or moderate diabetes.

These violations cause 1 degree of limitation of the ability to self-service and labor activity. Provided that the work of a diabetic by profession is contraindicated, rational employment will lead to significant reduction qualifications and performance.

Young people are assigned group 3 for the period of acquisition new work associated with mental or mild physical labor activity and without mental stress.

From the foregoing, we can conclude that the presence of compensated diabetes without severe complications cannot be a reason for assigning a disability. You should consult a doctor if there are complications that lead to disability to timely determine the degree of disability.

Diabetes Compensation Criteria

Ideally compensated diabetes is one in which, under the condition of treatment, there is normal level blood glucose at any time of the day. As well as the absence of sugar in the urine and a normal level of glycated hemoglobin. Such compensation is the goal of treating any stage and form of diabetes.

Satisfactory compensation or subcompensation fasting blood sugar - 6.2-7.8 mmol / l, after meals - up to 10 mmol / l, glycosylated hemoglobin - 6.5-7.5%, sugar in urine up to 0.5%.

If the data is higher than with satisfactory compensation, then diabetes mellitus is called decompensated. This course of the disease leads to frequent complications and is taken into account when predicting and establishing a disability group.

Medical and social examination of diabetics

Disability is assigned after examination of the patient by a special commission. An examination is carried out not only to establish a disability group, but also to determine the degree of loss of professional ability to work, its timing, and the necessary rehabilitation.

Indications for referral to ITU:

severe type 1 or type 2 diabetes pronounced violation work of organs and systems;
unstable course of diabetes - frequent hypoglycemic coma or states of ketoacidosis;
difficult to compensate for type 1 or type 2 diabetes of moderate severity;
mild or moderate diabetes mellitus (regardless of type 1 or 2), if the patient needs rational employment with a decrease in qualifications and workload.

Required examinations: general analysis blood and urine, fasting blood sugar and after meals during the day, glycosylated hemoglobin, urine analysis for sugar and acetone, lipogram, renal and liver biochemical tests, electrocardiogram.

Examination by an ophthalmologist - to detect retinopathy of the eye. Examination by a neurologist, EEG, REG - to determine the state of the nervous system and its damage. Surgeon's examination, dopplerography, rheovasography at diabetic foot, gangrene, trophic ulcers. Physician's examination, echocardiography, daily monitoring pressure and ECG for symptoms of diabetic cardiomyopathy. Zimnitsky and Reberg's test for the detection of diabetic nephropathy.

Documents for applying to ITU:

patient statement;
the passport;
referral from the attending physician;
extracts from hospitals, tests, outpatient card and extract from it;
diploma of education;
a certified copy of the work book;
characteristics of working or study conditions (for a child);
upon re-examination, a certificate of disability, an individual rehabilitation program completed.

Contraindicated working conditions

Patients with a mild form of diabetes should not engage in any severe physical labor, work at enterprises associated with the use of industrial poisons or located in adverse microclimatic conditions. Night shifts, business trips, irregular working hours are contraindicated for such diabetics.

Patients with medium degree severity of type 2 diabetes, one should not engage in moderate physical labor, as well as mental labor with frequent neuropsychic unrest. Type 1 diabetics (who are on insulin) are contraindicated in all types of dangerous work and where needed increased attention and fast response. For example, work at moving mechanisms or on a conveyor, in hot shops, at height, all types of dispatching work, etc.

Such patients are allowed light physical or intellectual work, administrative work, sometimes with a decrease in its volume. With diabetic eye damage, work that leads to prolonged visual strain is contraindicated. And when defeated lower extremities you will have to give up work associated with vibration, long walking or standing.

In severe diabetes, patients are given 1 disability group, which indicates a persistent and complete disability.

Disability is not only social protection diabetics, but also the rehabilitation of all types of this disease. It consists of following a diet proper treatment, supervision of the attending physician, as well as in the prevention and early detection complications. Patients with type 1 and 2 diabetes need Spa treatment, teaching in schools for diabetics the rules of life with diabetes and caring for your body. All this leads to a slowdown in the progression of the disease, and hence the degree of disability.

It's important to know: