An activity that is exciting and compatible with the requirements of an individual treatment and preventive regimen is a powerful factor in maintaining the patient’s vital activity, his social usefulness and satisfaction. However, the specific features of many types of such activities negatively affect the course of the disease, make it difficult to compensate, increase the risk of severe complications, lead to early disability, and in some cases are simply contraindicated for the patient diabetes. Therefore, the problem of combining this activity with restrictions due to the nature of the disease often arises from childhood, when choosing a profession, during study and work, and even at retirement age. In the era of the modern scientific and technological revolution, along with long-known ones, many new professions have emerged that have expanded and diversified the types of human labor activity. But, unfortunately, not all professions are acceptable for the patient diabetes mellitus. Some are clearly contraindicated; admission to many others has strict restrictions.
From the point of view of the professional suitability of a person suffering from diabetes, the initial requirement is as follows: the nature and characteristics of work activity must allow the patient to fully combine it with compliance (without compromising work or danger to others) of the treatment and preventive regimen necessary for a diabetic (time of taking medications and food , self-monitoring of blood glucose levels, prevention of hypoglycemic conditions and emergency care for them, normal rest and sleep, etc.).
Based on this requirement, the following specific tips and recommendations arise (first and foremost, they are addressed to patients suffering from type 1 diabetes, although to a greater or lesser extent they also apply to patients with type 2):
In resolving the issue of professional guidance and work activity of a diabetic patient, not a formal (presence of the disease) but an individual approach is required. This approach 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 disease, means and treatment regimen, the presence and severity of complications, “diabetological” literacy 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), as well as the moral and psychological significance of work in the life of a diabetic, etc. During the professional guidance of a child with diabetes diabetes, parents and teachers must tactfully, gradually, with the least damage to the child’s psyche, without contributing to the formation of an inferiority complex, explain to him the personal and social expediency of the preferential choice of one or another “suitable” profession, give arguments for its attractiveness and prospects, etc. Similar arguments should be used in communication with young people who fell ill with diabetes during their studies, or who still have little work experience in their specialty, etc., who still have many years of work ahead and a full-fledged “life with diabetes”, for which they need compatibility with the relevant profession. When a person becomes ill with diabetes at a more mature age and has solid professional experience and experience (most often at this age the disease occurs in type 2, which in most cases does not require insulin injections), the question of further professional activity is decided purely individually. If the nature of this activity allows it to be combined with compliance with the necessary treatment and preventive recommendations, then the diabetic can continue to work in his specialty, limiting himself to only unburdensome correction of its schedule and duration, diet, etc. In other situations, it is often advisable to change a profession to one that is similar in profile (for example, the transition of a sick bus driver to the position of a repairman in a vehicle fleet).
From the point of view of acceptability for a diabetic patient, all types of professions can be divided into three main groups.
Contraindicated . Drivers of public transport (buses, trams, trolleybuses, taxis, etc.), pilots, cosmonauts, submariners, divers, miners working in caissons, builders and installers - high-altitude workers, drivers and operators of moving construction and other machinery, repairmen of external electrical networks, mine rescuers , work in enterprises with a high level of physical, chemical or biological hazards, work in places remote from the possibility of providing emergency medical care and other professions with a high risk of extreme situations, at night, requiring special attention and responsibility, excluding the possibility of complying with the required medical treatment for the patient -preventive regimen.
Relatively contraindicated . Works and professions associated with frequent business trips, work involving exposure to industrial environmental pollution (physical, chemical, biological), prolonged eye strain, actors, cooks, tour guides, confectioners, professional sports, work in isolated rooms without partners, with long working hours, high psycho-emotional stress and the like.
Featured . Teachers of secondary and higher schools, researchers and laboratory assistants (with the exception of exposure to harmful environmental factors and the need for frequent business trips), doctors (except for surgical specialties, infectious disease specialists, emergency medical care), pharmacists, nutritionists, storekeepers, financial workers, economists , programmers, builders and interior repairmen, librarians, various types of administrative, economic and management work and a number of other professions that do not interfere with compliance with the treatment and preventive regime required for a given patient.
Like any other person, for a person with diabetes, work should not be a burden, but a joy.
Concluding the story about the professional orientation and activities of a patient with diabetes, we will briefly dwell on the issue of using personal vehicles, indirectly related to this problem. The number of private car owners is steadily increasing all over the world, and among them there are many people with diabetes. The desire of a diabetic patient to “live like everyone else” is understandable and largely feasible. Therefore, for those patients who do not have medical contraindications related to the severity and nature of the disease, there is no reason to restrict the right to drive a personal car. In most cases, patients with type 2 diabetes can use cars. It is more difficult to resolve this issue in relation to patients of the first type who take insulin injections. As an exception, and provided that the disease is well compensated, the patient is not prone to frequent hypoglycemic reactions and the resulting confusion and loss of consciousness, such patients may also be allowed to drive a personal car. In any case, a driver with diabetes must:
· Do not violate the prescribed diet and medication regimen (including insulin injections).
· Get behind the wheel and drive a car after the prescribed meal and no later than an hour before the next meal.
· Have with you (in the car) an individual glucometer, the glucose-lowering medications used, devices for administering insulin, the drug glucagon, a sandwich, some sweets, glucose tablets, plain and sweet (sugar-based) water.
· At the slightest sign of incipient hypoglycemia or other manifestations of poor health, confusion and orientation, etc. immediately stop the car and check your blood sugar level, take glucose tablets if necessary, drink sweet water, etc.
· It is advisable that the patient have a medallion (bracelet) indicating that he has diabetes, or another similar certificate containing information about the addresses and telephone numbers of persons who need to be notified in case of need (seeking emergency medical care, accident, etc.). P.)
· During a long trip, make rest stops at least every 1.5-2.0 hours.
Travel companions accompanying a patient on a trip should be aware of his illness and the measures that must be taken in the event of a sudden onset of a hypoglycemic state. Some patients do the right thing by having a clearly visible sign in their cars containing the appropriate instructions.
Original article on drugme.ru
After a patient is diagnosed with diabetes, the doctor prescribes a strict therapeutic diet. The choice of nutrition primarily depends on the type of diabetes.
Since blood sugar levels in type 1 diabetes are normalized by introducing insulin into the body, the diet of diabetics is not much different from the diet of a healthy person. Meanwhile, patients need to monitor the amount of easily digestible carbohydrates they eat in order to accurately calculate the required amount of hormone 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. Dietary disorders can cause serious complications in diabetics.
To carefully monitor indicators, you need to keep a diary where you record all the dishes and products that the patient ate. Based on the records, you can calculate the calorie content and the total amount eaten per day.
In general, 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 patient’s age, gender, weight, and physical activity. Based on the data obtained, a diet is drawn up, which takes into account the energy value of all products.
For adequate nutrition per day, a diabetic should eat 20-25 percent of proteins, the same amount of fats and 50 percent of carbohydrates. If translated into weight parameters, the daily diet should include 400 grams of foods rich in carbohydrates, 110 grams of meat dishes and 80 grams of fat.
The main feature of a therapeutic diet for type 1 diabetes is limited consumption of fast carbohydrates. The patient is prohibited from eating sweets, chocolate, confectionery, ice cream, and jam.
The diet must include dairy products and dishes made from low-fat milk. It is also important that you get the required amount of vitamins and minerals with your food.
At the same time, a diabetic with type 1 diabetes must follow certain rules that will help get rid of complications.
For type 1 diabetes, the doctor may prescribe contraindications for fatty, smoked, spicy and salty foods. Diabetics should not drink alcoholic beverages of any strength. It is recommended to steam the dishes in the oven. Meat and fish dishes should be stewed, not fried.
If you are overweight, you should be careful when consuming foods that contain sweeteners. The fact is that some substitutes can have a much higher calorie content than regular refined sugar.
The therapeutic diet for type 2 diabetes is aimed at reducing excess load on the pancreas and reducing weight in the diabetic.
For type 2 diabetes, it is necessary to completely exclude dishes that contain an increased amount of fast carbohydrates. These dishes include:
There are also contraindications for eating fried, smoked, salty, hot and spicy foods. These include:
Also, porridges made from semolina, rice cereals, pasta are contraindicated for diabetics and are also completely excluded.
It is necessary for diabetics to include foods containing fiber in their diet. This substance lowers blood sugar and lipids and helps 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 do not need to reduce the quantity of their consumption, but replace their quality. The fact is that a sharp decrease in carbohydrates can lead to loss of performance and rapid fatigue. For this reason, it is important to swap carbohydrates with a high glycemic index for carbohydrates with a lower glycemic index.
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 and hang it on the refrigerator 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.
In this case, it is important to introduce only one dish at a time, after which it is necessary to conduct a blood sugar test. It is best to conduct the study two hours after the product has been absorbed.
If blood sugar remains normal, the experiment must be repeated several times to ensure the safety of the administered product.
You can do the same with other dishes. Meanwhile, new dishes cannot be introduced in large quantities and often. If blood glucose levels begin to increase, you need to return to your previous diet. Meals can be supplemented with physical activity to choose the best option for your daily diet.
The main thing is to change your diet consistently and slowly, following a clear plan.
Working overtime if you have diabetes is highly undesirable. The restriction also includes physical work, professions associated with stressful situations, risk to life and difficult working conditions. Despite work restrictions, a person diagnosed with diabetes can build a career if they choose the right specialty.
It is important to realistically assess your own capabilities and strengths: not every profession gives you a chance to measure your sugar levels on time or eat when necessary. However, there is no point in hiding from society. There are many diabetics, and hiring someone with the disease is not an exceptional phenomenon. Recommendations for choosing a job depending on the type of diabetes:
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, you must take into account the diagnosis.
For diabetics, working in rooms with sudden temperature changes is contraindicated. The following are prohibited:
- wipers;
- street vendors;
- earth workers;
- hot shop workers;
- thermists;
- builders;
- metallurgists;
- miners.
Regardless of the type of diabetes, employees should not be exposed to excessive physical activity. The following industries and specialties fall under absolute contraindications:
- mechanical engineering;
- shipbuilding;
- mining industry;
- Oil and gas;
- logging;
- electrical industry (working with electrical networks on a lifting device).
People with diabetes are unable to withstand physical activity.
Involving diabetics in this work is fraught with the development of decompensation: sick people are not able to withstand physical stress. It is prohibited to work as a driver if you have diabetes. This especially applies to insulin-dependent patients. It is not allowed to drive cargo or public transport, or work with moving machinery at height. You can obtain rights only after confirmation of stable compensation for the disease.
You cannot choose professions that involve risk to life and require control over your own safety:
- stokers;
- roofers;
- climbers;
- border guards;
- pilots.
Harmful conditions
Specialties with constant psychological stress and stress are contraindicated for diabetics. They are subject to restrictions in the following professions:
- correctional institutions;
- hospices;
- boarding schools for mentally retarded people;
- drug treatment clinics, centers;
- cancer centers;
- psychiatric institutions;
- rehabilitation centers for military personnel from hot spots;
- military;
- police officers;
- bailiffs.
Dangerous specialties
Occupations involving toxic chemicals are considered dangerous. To avoid serious complications, it is better for a diabetic to refuse such specialization. Metallurgical production, raw material procurement, production of varnishes and paints, and chemical procurement are prohibited. Since most research institutes use SDYAV in laboratories, such work should be abandoned.
Diabetics need to choose work that is not hard and without 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;
- household appliance repair specialist;
- medical worker;
- secretary;
- literary editor;
- teacher, university lecturer;
- online work (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 a full meal on time, receive a dose of medication or take an insulin injection. He should be able to periodically change his body position (for example, a teacher will be able to teach a lesson standing or sitting) and leave work on time to fully relax.
When working in shifts, it is easy to disrupt the drug administration regimen, which results in the need to adjust the insulin already administered. Working overtime can have a negative impact on your health. A competent manager will not keep a specialist at work for too long, because this is fraught with loss of ability to work for a long time.
Diabetes mellitus is a limitation in a number of specialties. Basically, these are professions associated with an increased risk to human life and others, such as drivers, pilots, machinists, climbers. A patient with carbohydrate metabolism disorders should remember this when choosing an activity.
Anyone can develop diabetes mellitus. This raises the question of whether it is possible to work as a driver with diabetes. It is important to understand that there is no need to rush into making a decision to abandon this profession, especially if we are talking about type 2 pathology. But you should consider finding yourself in a different occupation for a number of reasons. First, you should find out who can work with such a disease, after which a decision is made to change the type of activity.
In diabetes mellitus, two main factors need to be taken into account. The first of these is to study the characteristics of the disease that has arisen and the risks associated with it. For example, to understand the reasons for possible decompensation of carbohydrate metabolism and what this could mean for a person. The second factor is the choice of a profession that does not pose a real threat, first of all, to the patient himself and the people who may surround him at the time of performing professional manipulations.
Working as a public transport driver with diabetes is unacceptable. There are a number of other professions that are also considered prohibited:
Based on this, it is easy to answer the question of whether people with diabetes can work as a driver. However, the decision is based on the severity of the pathology and the presence of complications of the process. When diagnosing a disease in childhood, this fact should be taken into account when choosing an educational institution. This will avoid possible refusal of employment.
The doctor should inform patients that the presence of diabetes mellitus is not considered a contraindication to driving. But this is possible with adequate control of the pathology, and at the slightest destabilization of the condition, measures should be taken. An important aspect is a diabetic certificate, which will allow others to quickly find their way in case of loss of consciousness.
A person working as a driver must be aware that some difficulties are possible due to diet and insulin injections. Sometimes these nuances make such work impossible.
The second type of pathology is somewhat simpler in this regard, but you should still minimize the number of stressful situations and normalize the work and rest regime. Patients with severe diabetes are advised to work from home.
The best professions for such patients are:
A mild form of diabetes involves slight fluctuations in carbohydrate metabolism, and it is easy to regulate. The symptoms do not bother the patient constantly. With a mild form, it is not prohibited to drive a car or operate any complex machinery. However, such a development of events is possible in the initial stages of the disease, when it was detected in a timely manner and treatment was prescribed. This implies the absence of any complications of the process. This situation most often occurs in type 2 diabetes. Particular attention should be paid to preventive examination of these patients.
There are certain activities that are prohibited for anyone with diabetes:
Patients with diabetes should choose a more gentle work regimen than healthy people. You should take into account your well-being, the state of carbohydrate metabolism, and take steps to prevent complications.
Moderate severity causes a ban on work associated with regular force majeure or accidents. This includes, first of all, machinists and drivers. This is due to the likely sharp change in the employee’s well-being, which will lead to fatal consequences for strangers in the worst case scenario. You should always pay attention to your blood sugar levels, since the average severity of diabetes implies its sharp changes.
The following work is contraindicated for persons with this form of the disease:
People with diabetes who have complications of the disease are entitled to disability. It is caused by damage to other organs, vascular defects, including ischemic defects of the lower extremities. This means a decrease in professional suitability and undesirability of working as a driver or operating other more complex mechanisms. Violation of this principle leads to tragic consequences for the patient and his environment.
A misconception is that working with diabetes is contraindicated. There are types of activities that do not prohibit such patients from working:
Patients should take into account the presence of pathology when choosing a profession, since each job requires a certain regime or routine. But not all of them are suitable for diabetics. It is important to avoid working at night. To improve quality of life indicators, it is recommended to adhere to the following advice from doctors:
Sometimes patients may claim that they continue to work as a train driver or public transport driver. In such a situation, the degree of severity of the process should be clarified, since in severe cases of the disease this is contrary to common sense.
For some patients, diabetes is simply a way of life. It does not present a specific unsolvable problem. Such people live full lives and are very active. This situation is possible. But there are some conditions for it that require mandatory fulfillment.
These include:
There are sports that are allowed for diabetics - light fitness, swimming, moderate cardio (jogging, orbitrek), gymnastic exercises. And heavy exercises such as squats with a barbell and deadlifts should be abandoned. Some patients are allowed cross-country activities, boxing, and mountaineering.
To ensure the adequacy of the chosen sport, you need to consult with your treating endocrinologist. The doctor will tell you exactly what contraindications you have for physical activity and what you should pay attention to.
Despite all the arguments presented, some diabetics continue to work in conditions that are not indicated for them. These include work as a driver or driver. Such a step is possible only when diabetes is in the earliest stages, strong surges in sugar levels have not begun, and complications have not yet had time to form. Other cases require abandoning these professions.
On the other hand, a person with diabetes can safely continue to drive their own transport. However, if we are talking about some long journeys, then it is better to take with you a person who also knows how to drive a car, so that you can change each other regularly. Traveling at night is not advisable. Reduced vision of such patients implies a refusal to drive motorcycles. It is important to remember that sudden jumps in sugar while driving can cause an emergency or disaster. Therefore, driving a car must be approached with special responsibility and attention.
Choosing a profession with diabetes must avoid two extremes: you cannot underestimate the seriousness of your illness and dashingly rush to storm unbearable heights, but you should not absolutize the exclusivity of your position, running away from everything that requires you to spend your mind and energy.
Thousands of people with diabetes have left their mark in science, art, and 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 goes on and on. And you yourself could name dozens of names of people who successfully do what they love, despite illness. It’s only a pity that those around them 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 he doesn’t want to remind him of it again.
When talking with a diabetic patient about choosing a profession, doctors advise choosing one that does not require sudden changes in physical and mental stress. It, of course, should be safe for the health of the patient himself and not threaten unexpected “emergencies” for others. It’s not hard to imagine what hypoglycemia or a driver’s coma could mean, for example, for bus passengers. And is it possible, without fear for the life of a diabetic, to “bless” him to become a steeplejack-rigger or a policeman?
In any case, we can talk about a systematic approach to 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 and help you organize things correctly.
You must have the ability to inject insulin or take pills, and not just “grab on the go” what you have to, but eat the food you need strictly on time.
Why do people with diabetes need refuse shift work? In this case, the insulin administration regimen is disrupted and timely correction of previously used doses of medications is required. Your manager should know in advance that any overtime, even if you are seemingly indispensable, is not for you, and if he values you as a specialist, he must come to terms with it.
By the way, there is another very interesting and extremely useful recommendation: so that you are valued at work, and you yourself do not get stuck, having discovered that your illness and your profession interfere with each other, try to master as many of them as possible initially. 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 the professional guidance of a patient with diabetes mellitus be reduced to?
mastering such professions as teacher, librarian, agronomist, trade worker, physician (but not surgeon), economist, painter, parquet floor worker, TV and radio technician, clerk, secretary-assistant. But even in the case of choosing these seemingly calm professions, one should take into account the severity of diabetes, complications, and concomitant diseases.
With a mild form of diabetes, in addition to 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, this is added prohibition 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 home work.
Recommended: a doctor, preferably a therapist and a dentist, a pharmacist, a laboratory assistant, a nurse, a nutritionist and a nutritionist, hospital administrative staff, a school and university teacher, a mechanic, a technician, an economist, an accountant, a gardener, a decorator, a tailor and others.
professions related to extreme situations: private and non-commissioned military personnel, police officers, mine rescuers, athletes and artists whose performances involve risk, roofers, stokers, installers.
There can be no talk of working in infectious diseases hospitals, bacteriological and chemical laboratories, or in general anywhere where there is heat or cold, dampness, harm to the eyes, mucous membranes and skin. It may surprise some undesirability of working in canteens, bakeries, confectioneries, buffets, but this immediately becomes clear if you consider that here you can’t do without sample tastings. Where this prohibition is ignored, either forced or out of ignorance, breakdowns and complications are inevitable. As statistics show, the food industry is the most “generous” for diabetes in women, where, compared to other traditionally female industries, the incidence of diabetes mellitus three times higher.
It can be difficult or even impossible
which determines your status in life, the existing value system. But, firstly, it is not always necessary to leave if the illness has caught you already at the peak or end of life’s path - here, even in severe forms, adjustments to the regime and mitigation of the requirements are possible. And secondly, the same driver (and moving away from the steering wheel or remote control in this case is mandatory) can become a dispatcher or a car mechanic, a police officer - 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 work team. Alas, not every manager easily comes to terms with the fact that the decrease in the ability to work of patients, even with uncomplicated diabetes mellitus, compensated only by diet, amounts to on average 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
sick diabetics in obtaining a profession, work. This means that there are facts of discrimination - and how they manifest themselves, how to combat them, apparently should become a permanent topic for our magazine. In some countries, education and work opportunities for people with diabetes are protected by law. Public groups of diabetics, which are being created all over the world, are standing up to defend their rights and guarantees, uniting patients on the scale of cities, towns - and on a national scale. Among other problems, they manage to solve issues related to career guidance, vocational training for young people, and retraining for 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.
Magazine "Diabetic" No. 1 for 1993.
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