Dispensary monitoring of patients with diabetes. Treatment of diabetes mellitus Dia diabetes type 2 type

In the Sverdlovsk region of patients with diabetes mellitus (according to the National Register of 2015)

Consequences of the late complications of diabetes diabetic retinopathy The leading cause of blindness in adults 1.2 Diabetic nephropathy The leading reason for terminal renal failure 3.4 Cardiovascular diseases prevalence them 2-4 times higher than in populations 5 Diabetic neuropathy The leading cause of non-removable amputation of the lower extremities 7.8 8/10 patients with diabetes dies from the SS complications 6 1. UKPDS GROUP. Diabetes Res 1990; 13 (1): 1- Fong DS et al. Diabetes Care 2003; 26 (Suppl 1): S99-S HDS. J Hypertens 1993; 11 (3): 309- MOLITCH ME ET AL. Diabetes Care 2003; 26 (Suppl 1): S94-S Kannel WB et al. Am Heart J 1990; 120: 672- Gray RP et al. In Textbook of Diabetes 2nd Edition, Kings Fund. London: British Diabetic Association, Mayfield Ja et al. Diabetes Care 2003; 26 (Suppl 1): S78-S79

Natural development history CD 2 type Ramlo-Halsted Ba, Edelman SV. Prim Care 1999; 26: Nathan DM. N ENGL J MED 2002; 347: Secrecy Insulin Hyperinsulinmia Insufficiency Years Promotional Insulino - Resistance Postprandial Glucose Glucose Automobile Lowering Glucose Recycling Peripheral Tissues Raising Glucose Products Microangiopathy Macroangiopathy CD 2 Type Secretion Incretions Obesity Hydodine Excessive Nutrition

SD 2 type risk groups All people aged 45 years old All people with excess body and obesity (BMI 25 kg / m 2) + presence 1 risk factor - family history of SD (parents or sibs with SD 2 type) - familiar low physical activity. - gestational diabetes or the birth of a large fetal in history - arterial hypertension (140/90 mm Hg. Art. Or drug antihypertensive therapy) - HDP cholesterol 0.9 mmol / l and / or triglyceride level 2.82 mmol / l - polycystic syndrome The ovaries - the presence of cardiovascular diseases - prediabet, revealed earlier algorithms for the provision of specialized assistance to patients with diabetes edited by I.I. Dedova, M.V.Stakova: 7th edition, Moscow, 2015

25 kg / m 2 + 1 from risk factors under normal result - 1 time in 3 "title \u003d" (! Lang: screening screening tests: plasma glucose empty stomach or PGTT with 75 g of glucose Age of the beginning of the screening of the group in which screening is conducted Any adults CMT\u003e 25 kg / m 2 + 1 from risk factors at normal result - 1 time in 3" class="link_thumb"> 6 !} Screening Screening Tests: Plasma Glucose Emptyco or PGTT with 75 g of glucose The age of the beginning of screening of the group, in which screening is conducted by the frequency of the survey any adults CMT\u003e 25 kg / m from risk factors at the normal result - 1 time in 3 years of persons with prediabet - 1 time per year\u003e 45 toss normal body weight in the absence of risk factors under normal result - 1 time in 3 years algorithms for the provision of specialized assistance to patients with diabetes edited by I.I. Dedova, M.V.Stakova: 7th edition, Moscow, 2015 25 kg / m 2 + 1 from risk factors at the normal result - 1 time in 3 "\u003e 25 kg / m 2 + 1 from risk factors under normal result - 1 time in 3 years of persons with prediabet - 1 time per year\u003e 45 Normal body weight in the absence of risk factors under the normal result - 1 time in 3 years algorithms for the provision of specialized care for patients with diabetes edited by I.I. Dedova, M.V.Stakova: 7th edition, Moscow, 2015 "\u003e 25 kg / m 2 + 1 from risk factors under normal result - 1 time in 3 "title \u003d" (! lang: screening screening tests: glucose plasma on empty stomach or PGTT with 75 g glucose the age of the beginning of screening of the group in which screensing the survey frequency any adults \u003e 25 kg / m 2 + 1 from risk factors under normal result - 1 time in 3"> title="Screening Screening Tests: Plasma Glucose Emptyco or PGTT with 75 g of glucose Age of the beginning of screening of the group, in which screening is conducted by the frequency of the survey any adults of CMT\u003e 25 kg / m 2 + 1 from risk factors at normal result - 1 time in 3"> !}

The rules for conducting OGTT PGTT should be carried out in the morning against a background of at least 3-day unlimited nutrition (more than 150 g of carbohydrates per day) and ordinary physical activity. The test must precede the night starvation for 8-14 hours (you can drink water). The last evening meal must contain 30-50 g of carbohydrates. After the blood fence, an empty stomach, the subject should no more than 5 minutes drink 75 g of anhydrous glucose or 82.5 g of glucose monohydrate dissolved in 250-300 ml of water. During the test, smoking is not allowed. After 2 hours, a re-election of blood is carried out. To prevent glycolysis and erroneous results, the definition of glucose concentration is carried out immediately after taking blood, or blood must be centrifuged immediately after taking, or stored at a temperature of 0-4 ° C, or be taken into a test tube with a preservative (sodium fluoride). Algorithms for the provision of specialized care for patients with diabetes edited by I.I. Dedova, M.V.Stakova: 7th edition, Moscow, 2015

OGTT is not conducted against the background of an acute disease against the background of short-term reception of drugs that increase the level of glycemia (glucocorticoids, thyroid hormones, thiazids, beta-adrenoblays, etc.) algorithms for the provision of specialized assistance to patients with diabetes edited by I.I. Dedova, M.V.Stakova: 7th edition, Moscow, 2015

The diagnosis of glucose (venous plasma) is higher than 7.0 mmol / l on an empty stomach or glucose of solid capillary blood above 6.1 mmol / l of glycohemoglobin of blood above 6.5% blood glucose above 11.1 mmol / l at any time of the day. At least 2 indicators in the diabetic range. In the absence of symptoms of acute metabolic decompensation, the diagnosis must be made on the basis of two digits in the diabetic range, for example, twice a certain HBA1C or a single definition of HBA1C + one-time definition of glucose level algorithms for the provision of specialized assistance to patients with diabetes edited by I.I. Dedova, M.V.Stakova: 7th edition, Moscow, 2015

Galcohemoglobin as a diagnostic CD diagnostic criterion as a diagnostic CD criterion selected HBA1C level 6.5% level is considered normal. Of Clinical Chemists (IFCC) and standardized in accordance with the reference values \u200b\u200badopted in Diabetes Control and Complications Trial (DCCT)

Standardized Equipment for determining the level of the NVA1 C in 2014 installed MH of CO in 11 LPU: 1. GBUZ CO "Serovskaya GB 1" 2. GBUZ CO "Krasnoturian GB 1" 3. GBUZ CO "Irbit CGB" 4. GBUZ CO "Alapaevskaya TsGB ", 5. GBUZ CO" Urban Hospital 3 Kamensk-Uralsky ", 6. GBUZ SO" City Hospital 1 City Asbestos ", 7. GBUZ CO" City Hospital 1 G. Pervouralsk ", 8. GBUZ CO" Revdin City Hospital ", 9. GBUZ CO "KRASNOUFIM CRP", 10. GBUZ CO "Demidov City Hospital of Nizhny Tagil", 11. GBUZ CO "Sverdlovsk Regional Clinical Hospital 1".

Regulatory documents Order of the Ministry of Health of the Russian Federation G 899 N - on the approval of the procedure for the provision of medical care to the adult population on the Endocrinology profile - Primary health care is prescribed by the general for the endocrinologist, the therapist of the district and general practitioner (general functions) Order of the Ministry of Health of the Russian Federation G 1344 N - On approval of the procedure for conducting dispensary observation

In accordance with the order of the Ministry of Health of the Russian Federation from G 1344 N "On approval of the procedure for conducting dispensary observation". Sugar diabetes type 2 without insulin is subject to dispensary observation at the therapist or a general practitioner (family doctor) 1 time in 3 months

Regulation on the organization of medical care patients with diabetes in the territory of the Sverdlovsk region (project) Therapeutic-therapists, general practitioners (family doctors) perform the following functions: conduct diagnostics to identify diabetes and other carbohydrate disorders (establish the fact of having sugar Diabetes or Preiaibet), screensing in risk groups provide medical assistance in outpatient conditions based on medical care standards guide patients to provide specialized medical care to the endocrinologist's doctor in accordance with routing at least 1 time in 12 months (if necessary - more often).

The procedure for planned actions in suspected diabetes: 1. To clarify the degree of violation of carbohydrate metabolism - the therapist or doctor of the OVP 2. When for the first time detected by diabetes mellitus, it is necessary: \u200b\u200ba) to recommend a diet, physical activity and metformin (if I have anything more than 25 kg / m 2 and in the absence of contraindications), recommend the glycemia Self-controlling b) to send to the endocrinologist in accordance with the routing - clarification of the type of diabetes (if necessary) - the data of the data into the diabetes mellitus register - the definition of individual treatments (target values \u200b\u200bof the empty stomach and after meals, target NVA1 C) If insulin suspected, the need (clinic of pronounced decompensation) is to direct to the endocrinologist with the "Cito! - Insulin need? " - consultation on the day of circulation or within 3 working days

Dispensary reception (inspection) Therapeuts of precinct, general practitioners (family doctors) 1 time in 3 months - includes the collection of complaints and anamnesis, physical examination. Including, in each inspection, be sure to indicate: the data of the self-control of glycemia, the patient weight dynamics, body mass index, blood pressure presence or absence of ulcerative lesions on the lower limbs (visual inspection). At least 1 time a year at the reception, the palpator assessment of the pulsation of the arteries stop. Appointment and evaluation of laboratory and instrumental research: 1 time per month - Glicated hemoglobin at least once a year: General blood test, general urine analysis, blood biochemistry (AST, Alt, Bilirubin, Common cholesterol, general protein, creatinine, potassium, sodium , calculating the speed of glomerular filtration), albuminuria or daily proteinuria, ECG, inspection of the eye dna ophthalmologist (with the expansion of the pupil), fluorography or radiography of the chest organs

Indications for consulting an endocrinologist with type 2 diabetes (in the direction from the therapist doctor, a general practitioner) (project): for the first time identified diabetes mellitus at least once every 12 months in a planned manner - to control the condition and correction prior to expiration 12 Months - In the case of the absence of achieving target levels of carbohydrate exchange compensation (according to self-control and / or glycated hemoglobin) on the current sugar therapy for 6 months. The target levels of carbohydrate exchange compensation and the type of sugar therapy are determined by the endocrinologist. Doses of sugar-based drugs in dynamics can be adjusted by the therapist to achieve target levels of carbohydrate exchange compensation. Before the expiration of the period of 12 months - with a non-standard course of the disease, the emergence of new symptoms (signs of progression of complications of sugar diabetes or signs of other endocrine diseases)

Inpatient treatment Treatment in a 24-hour hospital according to testimony according to territorial attachment - is carried out on the basis of inter-municipal medical centers (MMC) in specialized endocrinological offices according to Annexes 4, 5, 6 to the order of the Ministry of Health of the Russian Federation from H, or in therapeutic offices with the presence of licensed endocrinological beds where the endocrinologist treatment is carried out in the presence of testimony patients with diabetes mellitus are sent to the GBUZ with the "Sverdlovsk Regional Clinical Hospital 1" (hereinafter referred to as the GBUZ CO "POB 1") - for residents of the region - or in Mau "City Clinical Hospital 40" (hereinafter Mau "GKB 40") - For the inhabitants of Yekaterinburg, hospitalization in the endocrinological department of GBUZ with "Sotb 1" is carried out in the direction of endocrinologists of the Consultative and Diagnostic Polyclinic "GBUZ from Sotb 1" (after full-time consultation or teleconsultation).

Algorithm of individualized choice of targets for NBA1 therapy with Age of a young medium elderly or up

HBA1C,% GPN, mmol / l GP 2 hours after meals, mmol / l

The beginning of the treatment of SD 2 type Metformin - therapy of the first line - to be prescribed, making sure the absence of contraindications (history, oac, b / x) to send to the endocrinologist with the first type 2 type identified: data in the register Customized targets (glycemia on an empty stomach and after meals, NVA1 with ) Recommendations for treatment (correction) Control 1 p at 3 months (NVA1 C and diaries of self-control), in the absence of the target level - to send to the endocrinologist, is repeated no later than 6 months later. When the targets are reached - to direct 1 p to the endocrinologist at 12 months.

Over the past decades, Metformin has fundamentally changed the treatment of type 2 diabetes around the world. Despite the presence in the market of about 10 classes of drugs for the treatment of SD 2 type 2, Metformin remains the widest drug in the 1st line of the CD 2 type 2 type of CHACRA AR. Am j Ther 2014; 2: 198-210. Metformin - the most studied and widely used drug in the 1st line of the treatment of CD 2 type

Effects of metformin Metformin reduces the relative risk of cardiovascular events in patients with type 2 (UKPDS) ¹ Metformin demonstrated long-term advantages for the SCC (metabolic memory effect) ² Metform therapy ensures a significant reduction in glycemia¹ in comparison with existing PSPs, Metformin neutrally affects the mass Body or leads to an insignificant reduction of ³ 1. UKPDS 34 LANCET 1998; 352: Holman RR et al. NEJM 2008; 359 (15): Nathan Dm et al. Diab Care 2009; 32 (1):

Algorithms of specialized medical care patients with SD RAE Changing lifestyle in the "debut" of SD2 HBA1C from 6.5 to 7.5% 1 Stage Start of monotherapy therapy: MET IDPP-4 AGPP-1 alternative: cm *; Hinides, TBE, Akarboz * See Besides Glyibenklamide 2 Stage Intensification of therapy Continue the initial therapy Combination 2 x preparations except for non-rat combination decrease in HBA1C

1 Stage Start Therapy Insulin ± Other Alternative Preparations: Combination 2 x - 3 x Preparations (Basis - CM) 2 Stage Intensification Intensification Therapy I insulin-therapy Combination 2 x or 3 x Preparations In addition to irrational combinations Reduced HBA1C 1.5% reduction in HBA1C 9.0% Algorithms Specialized medical care SD RAE patients in any combination of 2 or 3 drugs recommended the use of metformin in the absence of contraindications 9.0% Algorithms of specialized medical care SD RAE patients in any combination of 2 or 3 drugs recommended the use of metformin in the absence of contraindications "\u003e

Restrictions of therapy of the Metformist immediate release of the drug segment several times a day, which reduces the commitment of patients to therapy 1 unwanted phenomena by the gastrointestinal tract, which are noted in 20-30% of patients 2.3 about 60% of patients with type 2, do not reach the targets of therapy 4 1 . PAES AHP et al. Diabetes Care 1997; 20 (10): Garber AJ et al. Am J Med 1997; 103: Krentz AJ et al. Drug SAF 1994; 11: Saaddine JB et al. ANN INTERN MED 2006; 144: 465-74

Polyprigmasia - the main problem of therapy of SD 2 type Morning Day for Night Metformin Glyibenklamide Atorvastatin Bisoprolol Ramipril Felodipin Aspirin Mononitrate Amitriptin Sildenafil An example of a patient's daily therapy with CD 2 type 60% -75% of patients with type 2 type 2 in research ACCORD, ADVANCE, ProACTIVE and Record 5 preparations per day Accord Study Group. N ENGL J MED 2008; 358: Advance Collaborative Group. N ENGL J MED 2008; 358: Dormandy Ja et al. Lancet 2005; 366: Home Pd et al. N ENGL J MED 2007; 357: 28-38 ITC-CMC-GXR-SKO-29.DEC.2014

Metformin prolonged release. Innovative patented production technology The unique diffusion system through the gel barrier GELSHIELD provides a gradual and uniform release of metformin from the Tablet Glucophage Long - T Cmax Tablets of the prolonged action - 7 hours. - T Cmax tablets with ordinary release - 2.5 hours. Before receiving inside after receiving inside Timmins P. Clin Pharmacokinet 2005; 44: 721-9

Any nm from the head of the gastrointestinal dyspepsic phenomena swelling the abdomen The meteorism of reckoning in the stomach of the method of prolonged release in comparison with the Metform NV in patients with the first BLONDE type cd 2 type patients. CURR MED RES OPIN 2004; 20: 565-% - 75% 1 year of therapy% of patients p

Dosing mode: Patients who were first appointed glucophage Long: 1. Instructions for medical use glucophage Long 500 mg of LSR / Instructions for medical use Glucophage Long 750 mg LP Titration dose is carried out based on glycemic control indicators. If the target level of glycemia is not achieved, the dose of the drug should be increased.

Translation of patients with NV metrophum on the Methodsign of a prolonged release The principle of translation "dose at a dose" or a dose appointment as close as possible to applicable 1. Instructions for medical use glucophage Long 500 mg of LSR / Instructions for medical use Glucophage Long 750 mg LP

MET CMS TTE IDPP-4 Basal insulin Bazal insulin AGPP-1 rational combinations of sugar-based drugs Algorithms of specialized medical care patients with diabetes 6th production of diabetes mellitus. 2013; (1S): DOI: / DM20131S1-121
Teleconsultations in GBUZ with "Pokb 1" - Since 2013 orders of the Ministry of Health with 370-P from and 1013-P from to order a connection for the first time, write a letter to our Center for Teleconsultations: RU or call:

THANKS FOR ATTENTION! RU RU (343), RU (343)

Considerable amount of diseases involve the dispensary method of observation, and diabetes mellitus is no exception. Drainage dispensarization allows you to identify possible deviations during the disease, monitor the improvement and deterioration of patients, to provide the necessary assistance and carry out proper treatment. In the dispensary mode, the patient is under constant supervision, at the prescribed time takes the necessary medicines, is in caring hands.

Sugar diabetes is one of the most common chronic ailments. Therapeutic treatment allows you to return a person to normal life, to maintain life indicators normal. Dispensary observation has another action - helps to keep human ability to the highest possible time.

Important: Preventive work carried out in climanization mode allows you to identify possible complications at an early stage, which contributes to the rapid elimination.

Advantages of dispensary

Diabetes patients with diabetes are a set of preventive and therapeutic measures aimed at identifying the disease at its early stage, warning or suspension of the progressive stage. Dispensary observation involves regular conducting therapeutic measures against the patient, maintaining its physical condition, as well as spiritual and psychological. Among other things, such an observation allows you to maintain a high-level disability of diabetics, as well as prevent possible complications.

Properly organized dispensarization of diabetics allows you to:

Eliminate symptoms of the disease;
Avoid consequences (ketoacidosis, hypoglycemia);
Normalize the body weight of the patient;
Observed in several doctors of different directions.

Who needs a closerization?

One of the most important moments of dispensary observation is to observe relatives of people suffering from diabetes. Mothers who gave birth to children weighing from 4 kg, also fall under such observation. In addition, continuous observation is underway for pregnant women and mothers who have recently born.

It is worth noting that when detected in pregnant diabetes, she ahead of time is placed in the maternity hospital for constant control by the medical personnel. Born babies from mothers-diabetics from the first days is assigned to the dispensing of children with diabetes mellitus to identify the disease at the initial stage and suspend its development.

In addition, under thorough observation, persons suffering from overweight and obesity are falling. Violation of fat exchange leads to a violation of carbohydrate, which is one of the reasons for the development of diabetes. The risk group also includes people with such diseases as:

Pancreatitis;
Purulent diseases (furunculosis, barley, abscesses, carbuncules);
Dermatitis
Eczema;
Polyneurite;
Cataract;
Retinopathy;
Supporting endarterite.

Observation and prevention

Observation of diabetic patients is the prerogative of endocrinologists. However, the primary visit to the doctor will accompany the inspections and other specialists - therapist, neuropathologist, oculist, gynecologist. Before the dispensarization of patients with diabetes is prescribed, a person will need to pass several analyzes:

Blood;
Urine;
X-ray;
Blood to identify the level of glucose;
On cholesterol maintenance;
On the content of bilirubin;
Acetone;
Measure body weight;
Measure growth;
Arterial pressure;
Electrocardiographic study.

Subsequent inspections from the endocrinologist should be held at least 1 time in 3 months, it is desirable to attend the doctor much more often. Proper treatment can freeze diabetes on the latent stage, after which the patient will be removed from the dispensary observation.

When detecting a severe form of the disease on a primary examination of the patient, they will be sent to the hospital, where the above doctors will need to be examined by a surgeon, a otolaryngologist, as well as to pass tests to the number of ketone bodies in Croy and nitrogen.

Important: With a severe form of diabetes, the patient can be appointed regular passage of inspection every month or more often.

Elderly people

Not so long ago, a health upgrade program was conducted, including the dispensing of the elderly population with diabetes mellitus. Often 2 Type of this disease is manifested only over the age of 40, when other diseases are diagnosed - complications of diabetes. 2 Type, as you know, to identify quite difficult, so long years it progresses what causes serious consequences.

Today, every elderly patient has the right to:

Development of an individual diet;
Development of individual exercises;
Calculation of a suitable dose of insulin and other drugs;
Regular analysis of tests.

It is very important that the patients responsibly belonged to their problem were interested in the current state of the disease, asked their questions, regularly visited the doctor and donated the necessary analyzes. Diabetes are encouraged to purchase personal glucose meters and periodically independently do the level of sugar levels. Do not refuse physical exertion, on the contrary, it is recommended to charge a daily charge, but not overwork.

It is unacceptable to hide diabetics from relatives about the presence of the disease and closes. Diabetes is not the end of life. Only relatives, medical workers and the patient himself can return themselves to normal life. Following the instructions of the doctor, compliance with the installed diet, regular dispensarization will help a person overcome this crisis and return to normal life.

Important: The older generation needs to defend its rights in medical institutions, in no case cannot be irresponsible to the problem of diabetes.

Sugar diabetes is a lifelong disease. Many patients have a diagnosis of diabetes mellitus causes depression, loss of interest in the world around. The endocrinologist must constantly carry out psychotherapeutic conversations with sick and members of his family, emphasizing that, with the right mode and treatment, the patient can lead a normal lifestyle, to fulfill its professional duties and not feel its inferiority.

The patient must also master the tactics of autotraining, muscle relaxation. In the case of pronounced depression and fear of the disease, consultation and dispensary observation of the psychotherapist and in some cases of a psychiatrist are appropriate.

It is very important to create a favorable psycho-emotional situation at work and in the family, to surround the attention, care. This will help him feel a full-fledged member of society.

12. Training of the patient, self-control

The system of learning and self-control is of great importance, as it allows to maintain the state of compensation and prevent the development of heavy angiopathies and neuropathies.

Training and self-control patients with diabetes mellitus include:

familiarization with the essence of the disease, the mechanisms of its development, the forecast, the principles of treatment;
compliance with the right regime of labor and recreation;
physical education classes;
organization of proper medical nutrition;
self-control of blood and urine indicators (using indicator strips, glucometers);
constant monitoring of their body;
study of the clinic of comatose states and measures to prevent them, as well as the provision of emergency care;
studying Injection Injection Methods.

Patients are trained in clinics, hospitals, "schools for patients with diabetes". Training is carried out experimental endocrinology doctors in the form of individual conversations or group classes. Patients are also recommended to read popular publications dedicated to the problems of diabetes. Classes should be involved in the nearest relatives of patients with diabetes.

13. DISCISERIZATION

The dispensary observation of patients with diabetes mellitus is carried out for life.

The tasks of the dispensary observation are:

systematic monitoring of patients with diabetes and systematic inspection system;
timely conducting therapeutic and preventive measures aimed at restoring and preserving good well-being and disability of patients;
warning and timely detection of angiopathy, neuropathy, other complications of diabetes mellitus and their treatment.

The dispensarization is carried out by an endocrinologist. Approximate deadlines for dynamic monitoring of diabetes mellitus are given in Table. 35

Table. 35 Approximate deadlines for dynamic observation of patients with diabetes (M. I. Balabolkin, L. I. Gavre Ilyuk, 1983)

Research	Sugar diabetes severity
Research	easy	average	heavy
Diuresis	1 time per week	1 time per week	Daily
Glycosuria	1-2 times a week	1 time in 3 days	In one day
Acetionuria	1 time per month	1 time per week	In one day
Glycemia	1 time per month	1 time in 2 weeks	1 time per week
General analysis of blood and urine	1 time in 6 months	1 time in 6 months	1 time in 3 months
Full clinical examination *	1 time in 6 months	1 time in 3 months	1 time per month
X-ray study of the lungs, hearts, large vessels	1 time per year	1 time per year	1 time per year
Study of kidney functions	1 time per year	1 time and 6 months	1 time in 3 months
Oscillogram, reovazogram peripheral

With diabetes of any type, patients endocrinologists need expensive medicines and various therapeutic procedures. Given the sharp increase in morbidity, the state takes various measures to support patients. Benefits for diabetics allow you to get the necessary medicines, as well as undergo free treatment in the pretentia. Not every patient is informed about the possibility of obtaining compliance.

Does all diabetics have the right to benefits? Does it be necessary to make disabilities? Let's talk about this further.

What benefits are laid sick diabetes

Benefits for disabled

Diabetes patients with disability have the right to general benefits designed for all disabled people, regardless of the reasons for their status.

What support measures provide the state:

Health Restoration Activities.
Help qualified specialists.
Information support.
Creating conditions for social adaptation, ensuring education and work.
Discounts for housing and communal services.
Additional cash payments.

Benefits for children with diabetes

In a particular category of patients, children are distinguished with diagnosis of diabetes. The disease affects a small organism especially strongly, and with an insulin-dependent type of diabetes, a disability is established. Parents are important to be informed about the benefits from the state, allowing to reduce the cost of treatment and rehabilitation of a patient child.

For disabled children are provided by the following privileges:

Free triumph in a sanatorium is a wellness camp with the payment of fare to the place and the child, and his accompanying.
Disability pension.
Special conditions for the passage of the USE, assistance in admission to an educational institution.
The right to pass diagnostics and treatment in a foreign clinic.
Exemption from military duty.
Cancellation of taxes.

Parents of a sick child under the age of 14 receive cash payments in the amount of average earnings.

Parents or guardians of the child have the right to reduce working hours and receiving additional weekends. Old-age pension for these persons is provided early.

How to get benefits

The benefits of diabetics are provided by the executive bodies upon presentation of a sick special document. A document that allows you to receive support from the state is issued to the patient of the endocrinologist or its representative in the center of diabetology at the place of actual residence.

How to get medicines

Refusal of benefits

It is assumed that in the event of a refusal of full social security, diabetes patients receive the right to financial support from the state. In particular, we are talking about material compensation of unused vouchers in the sanatorium.

In practice, the amount of payments does not compare with the cost of rest, therefore, it is worth refusing to benefit only in exceptional cases. For example, when the trip is not possible.