Unfortunately, diabetes mellitus is considered an incurable pathology, which dramatically reduces the quality of life of patients. Therapy of the disease is to support optimal blood sugar levels with the help of nutritional correction, exercise and medical support.
The disease has several forms, which differ from each other in the causes and mechanism of development. Each of the forms leads to a series of acute and chronic complications that prevent patients from working normally, living, in some cases, even serving themselves. In connection with similar problems, every second diabetic has a question about whether they give a disability in diabetes. What kind of help you can get from the state and what the law says about it will be discussed further in the article.
Little about the disease itself
Diabetes is a disease in which the body is unable to fully participate in the metabolism, especially carbohydrates. The main manifestation of the pathological condition is hyperglycemia (elevated glucose in the bloodstream).
There are several forms of the disease:
- The insulin-dependent form (type 1) - most often occurs on the background of a hereditary predisposition, affects people of different ages, even children. The pancreas is not able to produce enough insulin, which is necessary for the distribution of sugar throughout the body (into cells and tissues).
- Insulin-independent form (type 2) - is typical for older people. It develops on the background of malnutrition, obesity, characterized by the fact that the gland synthesizes a sufficient amount of insulin, but the cells lose their sensitivity to it (insulin resistance).
- Gestational form - develops in women during the childbearing period. The mechanism of development is similar to type 2 pathology. As a rule, after the baby is born, the disease disappears on its own.
A large amount of glucose in the blood - the main symptom of diabetes
Other forms of "sweet disease":
- genetic abnormalities of insulin-secreting cells;
- violation of the action of insulin at the genetic level;
- pathologies of the exocrine gland;
- disease caused by drugs and toxic substances;
- disease as a result of infection;
- other forms.
The disease manifests itself a pathological desire to drink, eat, the patient often urinates. There is dry skin, itching. Periodically, a rash of a different nature appears on the surface of the skin, which heals for a long period, but after a time appears again.
The progression of the disease leads to the development of complications. Acute complications require immediate medical intervention, and chronic ones develop gradually, but practically are not eliminated, even with the help of medical treatment.
What determines the disability in diabetes?
Patients should understand that if you want to get a disability in diabetes, you will need to try hard. Confirm the presence of pathology will have regularly. As a rule, with 1 group it is necessary to do this once every 2 years, with 2 and 3 - annually. If the group is given to children, re-examination takes place upon reaching the age of majority.
For patients with serious complications of endocrine pathology, going to the hospital itself is considered a test, not to mention collecting the necessary documents for passing a medical and social expert commission.
The process of collecting documents is a long and tedious procedure for patients.
Getting a disability depends on the following factors:
- type of "sweet disease";
- the severity of the disease - there are several degrees, which are characterized by the presence or absence of compensation of blood sugar levels, while taking into account the presence of complications;
- comorbidities - the presence of serious comorbidities increases the chance of getting a disability in diabetes;
- restriction of movement, communication, self-service, work capacity - each of these criteria is evaluated by members of the commission.
Assessment of the severity of the disease
Experts specify the severity of the patient who wants to get a disability, according to the following criteria.
The mild degree of the disease is characterized by a compensated condition in which the glycemia indicators are maintained by means of nutritional correction. There are no acetone bodies in the blood and urine, sugar on an empty stomach does not exceed 7.6 mmol / l, there is no glucose in the urine. As a rule, this degree rarely allows the patient to receive a disability group.
Moderate severity is accompanied by the presence of acetone bodies in the blood. Sugar on an empty stomach can reach up to 15 mmol / l, glucose appears in the urine. This degree is characterized by the development of complications in the form of a lesion of the visual analyzer (retinopathy), kidney (nephropathy), pathology of the nervous system (neuropathy) without the presence of trophic ulcerations.
Patients have the following complaints:
- blurred vision;
- decrease in working capacity;
- impaired ability to move.
Severe manifested severe condition of the diabetic. High rates of ketone bodies in urine and blood, blood sugar above 15 mmol / l, a significant level of glycosuria. The defeat of the visual analyzer stage 2-3, kidney - 4-5 stage. The lower limbs are covered with trophic ulcers, gangrene develops. Patients often show reconstructive surgery on the vessels, amputations of the legs.
Extremely severe disease is manifested by complications that do not have the ability to regress. Frequent manifestations - a severe form of brain damage, paralysis, coma. A person completely loses the ability to move, see, maintain himself, communicate with other people, orient himself in space and time.
Impaired ability to move - one of the criteria for confirmation of disability
Each group of disability meets certain criteria according to which it is assigned to sick people. Further, it is considered when members of the MSEC can give a group of diabetics.
The establishment of this group is possible if the patient is on the border of mild and moderate severity of the disease. At the same time, violations of the work of the internal organs of a minimal degree occur, but they no longer allow a person to fully work and live.
The conditions for obtaining status are the need to use special devices for self-service, as well as the fact that the patient cannot work in his profession, but is able to perform other work that is less labor-intensive.
Conditions for the establishment of disability diabetics:
- damage to visual functions of 2-3 severity;
- end-stage renal pathology, chronic renal failure under conditions of hardware dialysis, peritoneal dialysis, or kidney transplantation;
- persistent lesions of the peripheral nervous system;
- mental problems.
Hemodialysis - indications for the establishment of 2 degrees of disability to the patient
This group of disability in diabetes is laid in the following cases:
- affection of one or both eyes, manifested by partial or complete loss of vision;
- severe pathology of the peripheral nervous system;
- bright mental disorders;
- Charcot's foot and other severe lesions of the limb arteries;
- end-stage nephropathy;
- frequent critical decrease in blood sugar, requiring emergency medical care.
Patients are serviced, moved only with the help of strangers. Their communication with others and orientation in space, time are broken.
It is better to clarify which disability group is given to a child with an insulin-dependent form of the disease from the attending physician or specialist of the medical-social expert commission. As a rule, the state of disability is established for such children without clarifying their status. Re-examination is carried out in 18 years. Each specific clinical case is considered individually, other outcomes are possible.
On the procedure for obtaining disability with type 2 diabetes can be found in this article.
Children - contingent, receiving disability for a long time
Inspections for paperwork in MSEK
The procedure of preparing patients for the establishment of disability is rather laborious and time consuming. The endocrinologist suggests that patients receive disability status in the following cases:
- serious condition of the patient, lack of compensation for the disease;
- disruption of the normal functioning of internal organs and systems;
- frequent bouts of hypo-and hyperglycemic states, com;
- mild or moderate disease that requires the transfer of the patient to less labor-intensive work.
The patient must collect a list of documents and pass the necessary research:
- clinical analyzes;
- blood sugar;
- sugar load test;
- glycated hemoglobin analysis;
- urine analysis according to Zimnitsky;
- consultation of the ophthalmologist, neuropathologist, nephrologist, surgeon.
From the documents it is necessary to prepare a copy and original of the passport, a referral from the attending physician to MSEC, a statement from the patient himself, an extract stating that the patient was undergoing treatment in a hospital or outpatient clinic.
It is necessary to prepare a copy and the original workbook, a certificate of disability, if there is a process of re-examination.
It is important to remember that at the time of the re-examination possible removal of the group. This may be due to the achievement of compensation, improvement of the general condition and laboratory parameters of the patient.
For disability, you need to prepare a large package of documents.
Rehabilitation and working conditions
Patients who are assigned a 3rd group, can perform work, but with easier conditions than before. The average severity of the disease allows minor physical exertion. So patients should abandon night duty, long trips, irregular work schedules.
If diabetics have vision problems, it is better to reduce the voltage of the visual analyzer, for diabetic foot - to abandon standing work. The 1st group of disability says that patients can not work at all.
Rehabilitation of patients includes nutrition correction, adequate workloads (if possible), regular examination of an endocrinologist and other narrow specialists. You need a spa treatment, visiting diabetes school. MSEC specialists make up individual rehabilitation programs for patients with diabetes.