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Who do diabetic men work for? Diavzglyad: By whom and how can a patient with diabetes work

Choosing a profession with diabetes must avoid two extremes: you can’t underestimate the seriousness of your illness and dashingly rush to storm unbearable heights, but you shouldn’t absolutize the exclusivity of your position, running away from everything that requires you to spend your mind and energy.

Thousands of people with diabetes mellitus left their mark in science, art, contributed to the technical progress of society with their work. french artist Paul Cezanne, English writer H. G. Wells, medical academics A. Nesterov and V. Baranov- this list can go on and on. Yes, and you yourself could name dozens of names of people who successfully do what they love, despite the disease. The only pity is that those around are not always attentive to those who work nearby, and do not realize why their colleague is “ridiculously punctual” in eating or by hook or by crook fights off business trips and agricultural work. And he, it turns out, is sick, but once again he does not want to remind about it.

When talking with a diabetic about choosing a profession, doctors advise choosing one that does not require a sharp change in physical and mental stress. It, of course, should be safe for the health of the patient himself and not threaten with unexpected "state of emergency" for others. It is not difficult to imagine what is fraught with, for example, hypoglycemia or a driver's coma for bus passengers. And is it possible, without fear for the life of a diabetic, to “bless” him on the path of a climber-fitter or a policeman?

In any case, we can talk about a systematic approach in choosing a profession in the absence of severe complications and compensation of carbohydrate metabolism regardless of the type of treatment used.

The head of the enterprise or institution where you are employed or where you worked before the disease must be informed of your diagnosis. This will save you from possible misunderstandings, help you organize

work and rest schedule

You must have the ability to inject insulin or take pills, and not just “grab on the go” what you have to, but strictly on time to eat the food you need.

Why do people with diabetes need refuse shift work? In this case, the regimen of insulin administration is violated and timely correction of previously used doses of drugs is required. Your manager must know in advance that any overtime, even if you seem to be indispensable, is not for you, and if he appreciates you as a specialist, he must come to terms with this.

By the way, there is another very curious and extremely useful recommendation: so that you are appreciated at work, and you yourself do not get stuck when you discover that your disease and your profession interfere with each other, try to master them as much as possible from the beginning. If your child is sick - take this as a guideline in order to ensure his future with his own head and his own hands.

What exactly should be the professional orientation of a patient with diabetes mellitus?

the development of such professions as a teacher, librarian, agronomist, trade worker, physician (but not a surgeon), economist, painter, parquet floor, television and radio master, clerk, assistant secretary. But even in the case of choosing these seemingly calm professions, one should take into account the severity of diabetes, complications, concomitant diseases.

With a mild form of diabetes, except for the conditions mentioned above (exemption from night shifts, business trips, loads that require high energy costs), work in hot shops and underground is excluded.

At an average degree, it is added to this a ban on work that requires attention(conveyor), movement of mechanisms, transport.

In severe diabetes, professional work becomes almost impossible and, as a rule, is reduced to work at home.

Recommended: a doctor, preferably a therapist and dentist, pharmacist, laboratory assistant, nurse, nutritionist and dietitian, administrative staff of hospitals, school and university teacher, mechanic, technician, economist, accountant, gardener, decorator, tailor and others.

Contraindicated

professions related to extreme situations: soldiers of privates and sergeants of the military service, operational police officers, mine rescuers, athletes and artists whose performances are fraught with risk, roofers, stokers, installers.

There can be no question of working in infectious diseases hospitals, bacteriological and chemical laboratories, in general, wherever there is heat or cold, dampness, harm to the eyes, mucous membranes and skin. Someone may surprise undesirability of work in canteens, bakeries, confectioneries, buffets, and this immediately becomes clear, given that one cannot do without sample tastings. Where this prohibition is ignored by force or unknowingly, breakdowns and complications are inevitable. As statistics show, the most “generous” for diabetes in women is the food industry, where, compared with other traditionally female industries, the incidence of diabetes mellitus three times higher.

It is difficult, and sometimes impossible

leave the profession

which determines your life status, the prevailing system of values. But after all, firstly, it is not always necessary to leave if the disease has caught you already at the top or the end of your life path - here, even with a severe form, adjustments to the regimen, mitigation of the requirements are possible. And secondly, the same driver (and leaving the steering wheel or remote control in this case is mandatory) can become a dispatcher or auto mechanic, a policeman - an inspector of the personnel department, etc.

When talking about choosing a profession or mastering it in conditions of illness, one cannot avoid mentioning the need to create favorable moral and psychological climate in the workforce. Alas, not every manager easily puts up with the fact that the decrease in the working capacity of patients, even with uncomplicated diabetes mellitus, compensated only by diet, is an average of 20 percent. If the boss knows about the essence of the disease (and both the shop doctor and the patient himself should help him in this), it seems that the working life of a diabetic will not be overshadowed by the indifference of others.

But life is life. And bosses are different. It is no coincidence that the World Health Organization in its latest report on diabetes mellitus (Geneva, 1990) declares

non-discrimination

sick diabetics in getting a profession, work. This means that there are facts of discrimination - and how they manifest themselves, how to deal with them, apparently, should become a permanent topic for our magazine. In some countries education and employment opportunities for people with diabetes are protected by law. To protect their rights and guarantees, social formations of diabetics stand up, which are created all over the world, uniting patients on a scale of cities, towns - and up to a national scale. Among other problems, they manage to solve issues related to career guidance, vocational training for young people, and retraining of people with diabetes in adulthood. And although this experience is just beginning to be adopted in our republic, this fact gives reason for hope...

Nina CHUNTONOVA.
Journal "Diabetic" No. 1 for 1993.

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, jam.

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 follow certain rules that will help 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 scheme 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. Including diabetics should not drink alcoholic beverages of any strength. 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.

When compiling a diet, it is important to observe a balanced content of proteins, fats and carbohydrates - 16, 24 and 60 percent, respectively.
The calorie content of products is compiled based on the weight, age and energy consumption of the patient.
The doctor prescribes contraindications for refined carbohydrates, which must be replaced with high-quality sweeteners.
The daily diet should include the required amount of vitamins, minerals and dietary fiber.
It is recommended to reduce the consumption of animal fats.
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 foods. These include:

Fatty meat broths
Sausage, sausages, wieners,
Salted or smoked fish
Fatty types of poultry, meat or fish,
Margarine, butter, cooking and meat fat,
Salted or pickled vegetables
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 large quantities 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 find the best option for a daily diet.

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

Diabetes mellitus in men and women of working age is difficult to find a profession that could meet the professional skills of patients and not complicate the course of the disease.

An endocrinologist who treats young people can help you choose a career. In this case, the main thing to consider is the presence and severity of complications of diabetes mellitus, the degree of compensation, the presence of concomitant diseases and the psychological status of patients.

There are general restrictions on occupational factors that can have a negative impact on the treatment of this disease. All patients with diabetes severe physical and emotional stress are contraindicated.

Occupational problems of diabetics

The problem of combining diabetes mellitus and work is that professional excessive workload reduces the effectiveness of the treatment and can lead to an uncompensated course of the disease. Optimal professions for diabetics should allow them to take a rest break during the day, and, if necessary, administer insulin.

At the same time, many patients would like to keep their disease and treatment under wraps, as there is a fear that they will be considered unsuitable for the activities performed. This tactic can be dangerous, especially for patients with severe blood sugar fluctuations, as they may need the help of colleagues.

Patients in adulthood face a particular difficulty when the disease occurs. Restrictions in work related to the state of health arise when a professional position has already been formed and retraining is not advisable. In such cases, it is necessary to take into account the state of health and put it in the first place.

Work with diabetes should be chosen taking into account such factors:

Regular working day.
No frequent business trips.
Measured rhythm of work.
Occupational hazards are excluded: toxic substances, dustiness.
There shouldn't be night shifts.
It is not recommended to work in conditions of sharp temperature fluctuations.
There should be no tension of attention, physical and mental overload.
During the working day, it should be possible to inject insulin, eat on time and measure blood glucose levels.

What professions are contraindicated in diabetes

Sugar level

Patients with diabetes are not recommended to work in hot shops or in the cold in winter, as well as those associated with constant temperature changes, in drafts. Such professions include builders, janitors, kiosk sellers and traders from stalls, land workers, and facade finishers.

Occupational activities involving toxic chemicals for diabetic patients should be prohibited. These specialties include the preparation of chemical compositions and mixtures, the processing of raw materials, and the metallurgical industry. Working with chemical reagents can also be in research laboratories.

Conditions with a strong psychophysical load are considered no less harmful. For example, working with prisoners, seriously ill, mentally retarded people can negatively affect the health of a diabetic.

Such professions include employees of drug and cancer centers, psychiatric clinics, boarding houses for military personnel from hot spots, surgeons, police officers, prison service workers, and the military.

For patients with diabetes mellitus, heavy physical exertion is a threat. The list of specialties for which there are absolute contraindications for such patients includes:

Installation, repair of electrical network.
Shipbuilding, mechanical engineering.
Extraction and processing of coal.
Oil, gas industry.
Forestry work.

Men cannot be involved in these types of work, and they are especially dangerous for women with diabetes, because due to the low level of physical strength, overstrain quickly occurs, leading to decompensation of the disease.

It is forbidden for diabetics to work in conditions with a possible increased risk to life, as well as with the need to observe their own safety: pilots, border guards, stokers, climbers, roofers.

Patients on insulin therapy cannot drive public or heavy trucks, work with moving, cutting mechanisms and at height. The right to drive a car can be granted with stable compensation for illness.

In this case, patients should be prepared for the development of sudden attacks of hypoglycemia.

Determination of working capacity in diabetes mellitus

Employability in diabetes mellitus depends on the form of the disease, the severity, the presence of angiopathy or diabetic polyneuropathy, changes in vision and kidney function, as well as the frequency of acute complications of diabetes in the form of coma.

Mild diabetes usually does not cause permanent disability. The patient is recommended mental as well as physical activity, which is not associated with great stress. Such professions for women can be: a secretary, a librarian, an analyst, a consultant, a teacher, men can work in the banking sector, as notaries.

Employment in such specialties usually involves a normal working day and the absence of night shifts, if necessary, these conditions can be additionally specified when applying for a job. If necessary, a temporary transfer to another job can be made by the commission (VKK) for the examination of temporary disability.

If work with diabetes cannot be performed in the same qualification category or a significant reduction in the volume of production activities may be required, then a third disability group may be determined by decision of the medical board. The patient is considered able-bodied and is recommended mental or light physical work.

In case of decompensation of diabetes, the patient is issued a sick leave certificate. Disability can occur with frequent conditions requiring outpatient or inpatient treatment, difficulties in selecting therapy to compensate for diabetes. This can cause permanent disability of diabetics, as well as the need to establish a disability group 2.

A severe form of diabetes mellitus involves the introduction of a ban on work. Criteria for the transfer of patients to the second group of disability:

Visual impairment or complete on the background of diabetic retinopathy.
Renal failure with the need for hemodialysis.
Diabetic polyneuropathy with limited movement of the limbs.
Diabetic encephalopathy.
Limited mobility, self-service.

In rare cases, the question of whether it is possible to work with high qualifications and predominantly intellectual work is resolved positively. In this case, the best option for the patient would be if he is allowed to work at home or in specially created conditions.

If a patient's microcirculation disorder and manifestations of atherosclerosis progress rapidly, this leads to a permanent loss of the ability to work.

To determine the disability group, such patients undergo a complete diagnostic examination with the involvement of an oculist, surgeon, neuropathologist, after which the degree of disability is established.

The first group of disability is determined in the presence of such a pathology:

Diabetic retinopathy with blindness in both eyes.
Diabetic polyneuropathy with limb immobility.
Diabetic cardiomyopathy with manifestations of heart failure of the 3rd degree.
Impaired psyche or dementia as a result of diabetic encephalopathy.
End stage renal failure in diabetic nephropathy.
Multiple coma.

In the presence of such conditions, patients lose the ability to self-service and need outside help and care. Therefore, they should be assigned a guardian from among relatives or close people. The video in this article will help you choose a profession with diabetes.

Overtime work with diabetes is highly undesirable. The restriction also includes physical labor, professions associated with stressful situations, risk to life and difficult working conditions. Despite the restrictions on work, a person diagnosed with diabetes can build a career with the right choice of specialty.

Features of choosing a profession

It is important to realistically assess your own capabilities and strengths: not every profession gives you a chance to measure your sugar level on time or eat when you need it. However, hiding from society is not worth it. There are many diabetics, and hiring a person with a disease is not an exceptional phenomenon. Recommendations for choosing a job depending on the type of diabetes:

Work with type 1 diabetes should be calm, with a strictly regulated schedule, without overtime and business trips. It is important for a sick person to have lunch on time, to take a break. Stress, hot production, temperature changes and drafts fall under contraindications.
For type 2 diabetes, the requirements are not so severe: a person is allowed to work in all areas of commerce and science. The main conditions are the absence of physical overstrain and the ability to eat normally.

A person has to put up with diabetes for the rest of his life. Work is an integral part of it, and when choosing an occupation, one must take into account the diagnosis.
For diabetics, work in rooms with sharp temperature fluctuations is contraindicated. The following are under the ban:
wipers;
street vendors;
earth workers;
hot shop workers;
thermists;
builders;
metallurgists;
miners.

Regardless of the type of diabetes, an employee should not be subjected to excessive physical exertion. The following industries and specialties fall under absolute contraindications:
mechanical engineering;
shipbuilding;
mining industry;
Oil and gas;
logging;
electrical industry (work with electrical networks on a lifting device).

Patients with diabetes are not able to withstand physical activity.
Involving diabetics in these works is fraught with the development of decompensation: sick people are not able to withstand physical stress. It is forbidden to work as a driver with diabetes. This is especially true for insulin dependent patients. It is not allowed to drive cargo or public transport, work with moving mechanisms at height. Rights can only be obtained after confirmation of stable compensation for the disease.
You can not choose professions associated with a risk to life and requiring control over their own safety:
firemen;
roofers;
climbers;
border guards;
pilots.

Harmful Conditions
Specialties with constant psychological stress and stress are contraindicated for diabetics. They are subject to restrictions on the following professions:
correctional institutions;
hospices;
boarding schools for mentally retarded people;
narcological clinics, centers;
cancer centers;
psychiatric institutions;
rehabilitation centers for the military from hot spots;
military;
policemen;
bailiffs.

Dangerous specialties
Occupations associated with toxic chemicals are considered hazardous. To avoid serious complications, it is better for a diabetic to abandon such specialization. Metallurgical production, raw material procurement, the manufacture of varnishes and paints, and the procurement of chemicals are prohibited. Since most research institutes use SDYAV in laboratories, such work should be abandoned.
Diabetics need to choose a job that is not heavy and does not involve physical exertion.
Diabetes and work are not interchangeable concepts. With the right choice of specialty, you can competently build a career. Diabetics are advised to pay attention to the following professions:
System Administrator;
appliance repair specialist
medical worker;
secretary;
literary editor;
teacher, lecturer at the university;
networking (online store consultant, copywriter, blogger);
librarian.

Regime and diabetes
Such a number of restrictions is often associated precisely with the inability to comply with the regime. It is important for a sick person to eat well on time, get a dose of medication or inject insulin. He should be able to periodically change the position of the body (for example, the teacher will be able to conduct a lesson standing or sitting) and leave work in time to have a good rest.
When working in shifts, it is easy to disrupt the regimen of drug administration, as a result, adjustment of already administered insulin is required. Overtime work can be detrimental to your health. A competent leader will not keep a specialist at work for too long, because this is fraught with loss of ability to work for a long time.

Prof. Ilya Nikberg
Sydney, Australia

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

One of the most important components of such a life is labor activity. Fascinating and compatible with the requirements of an individual treatment and prophylactic regimen, activity is a powerful factor in maintaining the patient's vital activity, his social usefulness and satisfaction.

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

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

In the era of the modern scientific and technological revolution, along with long-known ones, many new professions have appeared that have expanded and diversified the types of human labor activity. But, unfortunately, not all professions are acceptable for a patient with diabetes. Some are clearly contraindicated, access to many others has severe restrictions.

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

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

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

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

During the professional orientation of a child with diabetes mellitus, parents and teachers should tactfully, gradually, with the least damage to the child's psyche, without contributing to the formation of an inferiority complex, explain to him personal and

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

When a person becomes ill with diabetes at a more mature age, having a solid professional experience and experience (most often at this age the disease proceeds according to type 2, in most cases not requiring insulin injections), the question of further professional activity is decided purely individually. If the nature of this activity allows it to be combined with the observance of the necessary medical and preventive recommendations, then the patient can continue to work in the specialty, limiting himself only to an easy correction of its schedule and duration, diet, etc. In such situations, it is often advisable to change the profession to a close one in its profile (for example, the transfer of a sick bus driver to the position of a repairman in a car fleet).

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

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

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

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

As for any other person, for a diabetic, work should not be a burden, but a joy.

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

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

In any case, a diabetic driver must:

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

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

* To have with you (in the car) an individual glucometer, used hypoglycemic agents, devices for administering insulin, the drug "glucagon", a sandwich, some sweets, glucose tablets, plain and sweet (on sugar) water.

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

* It is desirable that the patient has a medallion (bracelet) indicating that he has diabetes, or another similar certificate with information about the addresses and telephone numbers of persons who need to be notified if necessary (applying for emergency medical care, accident, etc.) .P.)

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

Companions accompanying the patient on the trip should be aware of his illness and the measures to be taken in the event of a sudden onset of a hypoglycemic state. Some patients do the right thing, in whose cars there is a clearly visible sign containing the appropriate instructions in a conspicuous place.