Diabetes does not prevent you from working on the railway
Diabetes mellitus in medical circles is called a non-infectious epidemic XXI century. A quarter of a billion people in the world already suffer from this disease, and by 2025, according to World Health Organization forecasts, their number will increase by more than one and a half times. How to deal with this disease and can diabetics work? railway transport, “Gudk” was told by the chief freelance endocrinologist of the health department of JSC Russian Railways.
– Emma Anatolyevna, what kind of misfortune is this – diabetes mellitus?
– This disease may be associated, firstly, with insufficient secretion of insulin in the body and, secondly, with a decrease in the body’s response to its action. Accordingly, there is type 1 diabetes mellitus and type 2 diabetes mellitus.
In type 1 diabetes, pancreatic cells that produce insulin, a hormone that helps nutrients, and especially glucose, penetrate the tissues of our organs and saturate them with energy, die and are never restored. This disease can develop at any age, but it mainly affects children, adolescents and young adults.
Diabetes of the second type is characterized mainly by a decrease in the susceptibility of tissues - liver, muscle, fat - to the action of its own insulin. As a result, even with a high level of glucose in the blood, the body suffers from a lack of energy stored in it. Diabetes of the second type usually affects older people, but in recent years it has “rejuvenated” and now occurs even in children.
The insidiousness of diabetes is that it can go unnoticed for 5–12 years from the onset of the disease, and when the diagnosis is made, serious complications associated with elevated blood glucose levels are discovered in every second patient. Ultimately, this disease can cause blindness, kidney failure, nerve and vascular damage, lower limb amputations, strokes and heart attacks.
– Who is at risk for this disease?
– Diabetes mellitus is a disease with a genetic predisposition. It is necessary, first of all, for people whose families have relatives with diabetes to monitor the appearance of its signs.
Moreover, the inheritance of type 1 diabetes is approximately 5%, and the risk of developing type 2 diabetes is much higher – 25% or more. The disease can manifest itself in each generation, or it can “skip” through a generation.
The second category of risk group is people with overweight and obesity. The number of such people in the world has exceeded two billion, and today obesity is classified as an independent disease.
It is now known that belly fat is active tissue. It produces hormones and other substances that lead to serious illnesses, including diabetes. The risk increases even more if such people simultaneously suffer from arterial hypertension, gout, liver or gallbladder diseases.
Women who have given birth to children weighing more than four kilograms should also monitor their blood sugar levels. Large children are most often born to mothers who subsequently develop type 2 diabetes. But people over 65 years of age are at the highest risk of developing type 2 diabetes.
– According to official data from the Ministry of Health and Social Development, there are about 6 million people with diabetes in our country, but experts agree that there are twice as many of them.
The number of people with diabetes at JSC Russian Railways in 2007 exceeded 65 thousand. It is known that every year medical institutions The company identifies more than 6 thousand patients with this diagnosis. And we cannot close our eyes to this fact.
Many railway workers with type 2 diabetes, including workers who directly ensure train safety, continue to work in their professions only because, having learned about their disease, they unquestioningly follow the recommendations of doctors monitoring their health.
All international experience shows: the earlier diabetes mellitus is detected and treatment is started, the lower the risk of complications and the higher the quality of life of the sick person.
– So, the railway worker was found to have elevated blood sugar levels. What's next?
“Such patients need to be sent to a hospital, where they are fully examined, prescribed medications and taught what parameters need to be monitored in order to reduce the risk of complications and remain working in railway transport. Such people are subsequently almost no different from their healthy colleagues, except that they take specific medications and measure their blood sugar levels 3–4 times a day.
Schools are opening all over the world for people suffering from this disease. The Diabetes School has been operating in the endocrinology department of Central Clinical Hospital No. 1 of JSC Russian Railways for almost 20 years. We teach patients how to check their blood sugar levels. With the help of modern glucometers, this can be done within 5 seconds - at home or in the office, in the cabin of a locomotive or train compartment. We tell you how, using complexes of the most effective and at the same time safe drugs, you can maintain your sugar level within the required limits for a long time.
– Do people with diabetes need to follow any special diet?
– Our school’s recommendations use international system meal planning, which has been practiced for 40 years and works well. It is useful not only for diabetics, but also for all people trying to lose excess weight, and healthy people too.
At diabetes mellitus You are allowed to eat almost all foods, but in smaller quantities and evenly distributing them throughout the day. Usually these are three main meals - breakfast, lunch and dinner - and mandatory snacks between them. We teach you how to compose for yourself individual plan nutrition, distribute all nutrients under the influence of hypoglycemic drugs.
Drinking alcohol is also not prohibited. However, before raising a glass in pleasant company, it is recommended to drink a glass of sweet juice or eat something sweet, and after drinking alcohol, be sure to have a snack, but not lard or cucumber, but potatoes, rice or bread.
An acute complication of diabetes mellitus is the so-called hypoglycemic state, in which the patient’s blood sugar level suddenly drops sharply. The reason may be excessive physical activity - gardening, sports competition, that is, loss of energy without additional food intake. With this syndrome, a person suddenly experiences one or more unpleasant symptoms: dizziness, changes in vision, hunger, headache, hand tremors. In such cases, we recommend not to be scared, but to urgently take three pieces of sugar as a medicine and sit for ten minutes - all unpleasant syndromes, as a rule, go away. Otherwise, you can repeat the sugar intake - we recommend that you always have a few pieces, sweets, and sweet juice with you. Trained patients always know the symptoms of hypoglycemia and try to prevent its development.
– What is “diabetic foot”?
– This is still a common and very serious complication of diabetes. As the disease is treated uncontrolled, the nerve fibers of the foot are affected and its sensitivity decreases. At the same time, arterial damage develops, the feet do not receive the nutrition they require, and this can lead to the appearance of trophic ulcers, gangrene and leg amputation.
Tragedy can be avoided if, when unpleasant sensations appear in the legs, you turn not to a surgeon, but first of all to an endocrinologist. Vascular surgeons, who do not always know the characteristics of vascular damage to the foot in patients with diabetes, advise such patients to walk more. And for us the main thing is that the sore foot is at rest.
In recent years, a new specialty has appeared in endocrinology - podiatrist. These doctors have the full range of diagnostic and therapeutic skills to provide care to such patients. At the Diabetic Foot clinics, they teach patients how to care for their feet. There is nothing complicated in their recommendations - wash your feet more often, examine them every day, put on clean socks, pick up comfortable shoes so that she does not squeeze the foot in any way. If such recommendations are strictly followed, the risk of foot amputation in diabetics is reduced by 50–70%.
It is also important to know that vascular surgery has made great progress in recent years, and the use of latest technologies, for example, stenting narrowed arteries in the lower leg, can lead to complete restoration of blood circulation in the affected lower limb.
Diabetes is a specific disease: it cannot be cured, but you can live a completely happy and happy life with it. long life. It does not interfere with studying, starting a family, traveling, playing many sports, building a career and simply enjoying every day. However, a diagnosis of diabetes means a risk of pathological conditions and poor health, which goes against the grain of some professions. Who you can and can’t work with diabetes - that’s what we’ll talk about today.
If you have type 1 diabetes, it is important to choose a profession that would correspond to the correct daily and nutritional regimen, would not give heavy loads, and would also allow you to regularly take sugar measurements and insulin injections. Type I diabetes mainly affects young people who can still choose a job. With this disease, quiet professions with standardized working hours are recommended: in doctors, pharmacists, economists, teachers, agricultural workers, librarians, bankers, IT specialists, full-time media journalists and so on.
But type II diabetes, as a rule, occurs in adulthood, when choosing a profession is no longer relevant. In general, a person can continue to do their usual work, provided that they can maintain the recommended daily routine, eat on time and take medications. The exception is for specialties associated with responsibility for life: aviation and any other transport, working with complex mechanisms, and so on.
- work with temperatures unfavorable for the body (hot workshops);
- work with poisons and toxins;
- work with significant visual strain;
- stay at the workplace in the same position for a long time;
- work at night;
- stay on business trips for a long time.
In addition, there are a number of professions that are strictly prohibited for people with diabetes. These are professions associated with risk to life both for people and for the patient himself. Diabetics are not allowed to work in the armed forces, police, fire services, in aviation (both flight and ground personnel), in the underground, ground and railway transport industry. All this, one way or another, requires serious mental and physical stress, so any deviations from normal well-being are unacceptable here.
This way, diabetes does not block the path to your dream career. You just need to take into account the risks, the severity of the disease - and confidently move towards your goal. Adequate therapy, diet and moderate physical activity provide excellent health, which in turn allows you to achieve heights in any chosen profession.
And the great influence exerted on its course by the conditions and regime of the patient’s professional work creates certain difficulties and limitations. Therefore, among social problems related to diabetes, one of the most pressing is the choice of profession and employment of people suffering from this disease.
Practical recommendations on these issues are ambiguous and differentiated depending on the patient’s age, severity, nature of the course and method of treatment of the disease, presence of complications, length of service and professional qualifications. Such recommendations are based on an assessment of the possibility of combining a specific type professional activity with the need to comply with the treatment and prophylactic regimen.
Diabetes in a mild (and in some cases even severe) form in most cases allows middle-aged people to continue their normal professional activities without any significant restrictions (of course, subject to compliance with the appropriate regime).
This problem becomes of primary importance for teenagers and young people when choosing a profession. This requires competent consultation, timely psychological preparation and professional guidance. The usually severe, labile course of diabetes in such patients, their dependence on daily, sometimes several times a day, insulin injections, and their tendency to acidotic and hypoglycemic states exclude the possibility labor activity in professions associated with significant physical and psycho-emotional stress, the inability to strictly adhere to the daily routine.
Professions that are certainly contraindicated for insulin-dependent diabetic patients include those of drivers of all types of passenger and freight transport (pilots, drivers, machinists, etc.); workers of services with an unregulated work schedule, significant stress and the possibility of extreme situations (military personnel of private and non-commissioned officers, combat service, police officers, high-rise builders, assemblers, mountain rescuers, climbers); athletes and artists with high physical stress professional risk; workers servicing machines and devices in isolated rooms if frequent business trips are necessary, or work at night.
Relatively contraindicated are professions in which labor activity makes it difficult to adhere to the regime, nutrition and rest: cooks, bartenders, artists and musicians (especially during evening performances, frequent tours), as well as work with a changing rhythm of work, strong visual strain, unfavorable production conditions environment (presence in the air production premises toxic impurities, high or low temperature, high levels of noise and vibration, forced posture, working with moving mechanisms).
Work associated with prolonged psycho-emotional stress, as well as the risk of contracting an infectious disease or injury, is undesirable.
Patients with diabetes mellitus can be oriented toward study and subsequent work in the following professions: library workers, lawyers, economists, teachers, higher school teachers, craftsmen and installers of television and radio equipment, repairmen in workshops, instrument and machine adjusters, seamstresses, motorists, salesmen shops, cashiers, office workers, medical workers(except for operating surgeons and operating nurses), construction workers, finishers, painters, parquet floor workers, joiners, carpenters, drillers, turners, scientists (not exposed to constant contact with harmful chemicals), editorial and publishing workers, administrative and economic personnel, field farmers and etc.
The list is indicative in nature and in each specific case the choice of profession should be decided individually, taking into account the totality of the factors indicated above (age, work experience, severity and nature of the disease).
In case of diabetes in middle and old age, even in severe form, the patient can continue his previous work (with the exception of drivers). However, this is only possible if there are conditions for timely, strictly prescribed food intake, sugar-lowering medications, exclusion of night work and frequent business trips.
During the course of the disease, complications may arise that require a medical occupational examination (VTE).
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.
Diabetes mellitus type 1
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.
- 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 volume and timing of meals depends on what insulin is used for type 1 diabetes.
- It is also important to focus on the insulin administration regimen. The bulk of carbohydrates should be eaten in the morning and lunchtime.
- Since insulin levels and requirements can change each time, the dosage of insulin for type 1 diabetes mellitus must be calculated at each meal.
- If you are planning a workout or an active walk, you need to increase the amount of carbohydrates in your diet, since during intense physical activity people need more carbohydrates.
- If you have type 1 diabetes, you should not skip meals or, conversely, overeat. A single serving may contain no more than 600 calories.
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.
Diabetes mellitus type 2
The therapeutic diet for type 2 diabetes is aimed at reducing excess load on the pancreas and reducing weight in the diabetic.
- When compiling a diet, it is important to maintain a balanced content of proteins, fats and carbohydrates - 16, 24 and 60 percent, respectively.
- The caloric 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.
- You need to eat at least five times a day at the same time, and the diet must be based on physical activity and taking glucose-lowering medications.
For type 2 diabetes, it is necessary to completely exclude dishes that contain an increased amount of fast carbohydrates. These dishes include:
- ice cream,
- cakes,
- chocolate,
- cakes,
- sweet flour products,
- candies,
- bananas,
- grape,
- raisin.
There are also contraindications for eating fried, smoked, salty, hot and spicy foods. These include:
- Fatty meat broths
- Sausage, frankfurters, wieners,
- Salted or smoked fish,
- Fatty types of poultry, meat or fish,
- Margarine, butter, cooking and meat fat,
- Vegetables, salted or pickled,
- High-fat sour cream, cheese, curd cheese.
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.
Diet planning 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 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.
Although, it must be admitted, the awareness of the entire population about “sugar disease” is quite high here. There is also a special public organization dealing with the problems of children and adolescents, patients diabetes, in terms of their studies and work. It is noteworthy that the majority of patients with diabetes, both young and adults, thanks largely to the active popularization of knowledge about diabetes and propaganda healthy image life - do not hide their illness. And, of course, they are not shy about carrying out their daily “tasks” in full view of others.
So, I have repeatedly seen young people, most likely students, doing a blood test on a glucometer or injecting insulin by using syringe pen in cafes, metro stations and other public places. What will they become tomorrow? Wouldn't it hurt them? diabetes achieve your goals?
After all, he did not prevent many world-famous athletes, scientists, artists, writers, and politicians from writing their glorious page in history. Among them are hockey player Bobby Clarke and football player Harry Mabbutt, artists Fyodor Chaliapin and Lyudmila Zykina, Elizabeth Taylor and Elvis Presley, artist Paul Cézanne, scientist Thomas Edison, writers H.G. Wells and Mikhail Sholokhov, Marshal Fyodor Tolbukhin, politicians Nasser and Sadat, Tito and Gorbachev and many other representatives different countries and nationalities. It is curious that in the list of American record holders with SD 33 athletes are listed; The list of artists and singers is even more impressive. The example of these people is clear evidence that the disease diabetes- is by no means the collapse of all hopes of doing what you love.
Are all professions available?
However everyday life sick diabetes must be subject to a certain treatment, preventive and hygienic regime. Only its careful observance can allow people suffering from this disease to be socially active, lead a lifestyle as close to normal as possible, and engage in interesting and useful work. It is also important that activities that are exciting and compatible with the requirements of an individual regime are undoubtedly a powerful factor in maintaining the patient’s vital activity and social satisfaction.
However, how diabetologist With many years of experience I can confirm: specific features individual species work 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 work activity with restrictions due to the nature of the disease is not removed from the agenda when choosing a profession, during study, work, and even at retirement age.
In our time of scientific progress and high technology Many new professions have emerged, expanding the types of work activities. Thus, in the “Classifier of Professions” operating in Russia we find several thousand names of a wide variety of professions (there are more than a thousand of them starting with the letter “A” alone!). But, unfortunately, not everything is acceptable for diabetes. Some specialties are clearly contraindicated; admission to many others has strict restrictions. And, of course, the statements that sometimes appear in the media that “with good SD compensation and without complications, you can master any profession.” (By the way, does the much-desired compensation always remain stable?)
Of course, in resolving the issue of vocational guidance and work activity of the patient diabetes What is needed is not a formal (presence of disease), but an individual approach. He must take into account not only and not so much the fact of the presence of the disease, but also its important personal characteristics: the form, severity and nature of the course, means and treatment regimen, the presence and severity of complications, “ diabetological» patient literacy, possession of self-control and emergency self-help, level of self-discipline and responsibility for oneself and others.
Step by step…
According to many diabetologists in Australia, it is optimal if, in the process of raising a sick person, diabetes the child will unobtrusively instill in him an interest in such activities, which he himself, out of his own aspirations, and not forcedly, will subsequently consider as a priority, most desirable for him in terms of professional activity.
Tactfully, competently, from childhood, a child can be introduced to such areas of life as musical art, engineering (the range of possibilities here is huge!), professional work with a computer, study foreign languages(translation studies), theoretical physics, mathematics, pedagogy, financial and economic management and so on.
As the child grows up, while searching for his professional guidance, parents and teachers can gradually explain to him the personal and social expediency of preferentially choosing one or another “suitable” profession, and provide arguments for its attractiveness and prospects. Similar arguments can be used in communication with young people who are sick diabetes during their studies at the institute or who still have a short work experience in their specialty - those who still have many years of a full “life with diabetes” ahead, and for the sake of such a life they can consciously change their future profession from the right angle.
By the way, young people themselves—sick people—can often act as bearers and promoters of such reasonable decisions diabetes. A recent Internet post from the International Diabetes Federation (IDF) featured a "Support Group" appeal for sick students. Among its authors are Anna Ostergre (23 years old, student at the University of Copenhagen, type 1 diabetes since 1999), Dana Lewis (student at the University of Alabama, 19 years old, sick since age 14), Quitlin Mac Enery (student at Georgetown University, 22 years old, has been sick since he was 3 years old)…
When a person becomes ill with diabetes at a more mature age and has a solid professional record and experience (most often the disease then proceeds in the second type), the question of further professional activity is decided purely individually, taking into account many factors, including psychological ones.
If the nature of this activity allows it to be combined with the implementation of the necessary therapeutic and preventive measures, then the patient can continue to work in his specialty, limiting himself only to unburdensome correction of its schedule and duration, diet and physical activity. Most often this is possible with type 2 diabetes. Much less often, but not at all excluded, and when type 1 diabetes. Sometimes a sick person definitely has to stop working in his usual position and field.
If, due to existing attachments, accumulated knowledge and experience, it is difficult for a person to move into another area professional work or stop it altogether, then similar situations It is advisable to change a specialty to one that is similar in profile to the previous one. For example, a sick bus or taxi driver can be retrained as a repairman or dispatcher in the same fleet; an active professional athlete can become a youth team coach or a sports school administrator; a policeman transfers to non-operational work in his own department; military officer - to work at the military registration and enlistment office, military educational institution...
Medical angles
Of course, such retraining or initial choice of profession should be based on basic medical requirements. They are:
exclusion of work with shift schedule, in the late evening and at night;
refusal of work (or limitation thereof) associated with increased physical activity and harmful working conditions (unfavorable microclimate of working premises, hazardous physical, chemical and biological influences, prolonged visual and strong psycho-emotional stress);
exclusion of work in extreme conditions (underwater, underground, in emergency circumstances, in isolated rooms, etc.);
exclusion (limitation) of work on managing ground, air, underground and other public transport, construction and other dangerous and complex mechanisms;
exclusion (limitation) of work in conditions that do not allow or make it difficult to seek help from others or provide emergency medical care.
Taking into account these initial requirements and from the point of view of acceptability for the patient diabetes All types of professions can be divided into three main groups.
Contraindicated.
Drivers of public transport (buses, trams, trolleybuses, taxis), pilots, cosmonauts, submariners, divers, miners working in caissons, builders and high-altitude installers, drivers and operators of moving construction and other machinery, repairmen of external electrical networks, mine rescuers; work with high level physical, chemical or biological (infectious) hazards, work in difficult (extreme) temperature and humidity conditions, work in places remote from the possibility of providing emergency medical care; other high-risk professions associated with the occurrence of extreme situations, requiring special attention and responsibility, excluding the possibility of complying with the treatment and prophylactic regimen necessary for the patient.
Relatively contraindicated.
Works and professions associated with frequent business trips and associated with exposure to industrial pollution environment requiring prolonged visual strain; professional sports; working in isolated rooms without partners, with irregular working hours, high psycho-emotional stress.
Teachers of secondary and higher schools, researchers and laboratory assistants (with the exception of exposure to harmful environmental factors), doctors (except for specialties surgical profile, infectious disease specialists, emergency medical services), pharmacists, financial workers, economists, programmers, builders and interior repairmen, librarians, different kinds administrative and economic managerial work and a number of other professions that do not interfere with compliance with the regime required for a given patient.
Driving your car
Somewhat beyond the scope of our topic is the question of using personal by car. Naturally, for those patients who do not have medical contraindications associated with advanced age, severity and nature of the disease, there is no reason to restrict the right to drive a personal car. In most cases, they can drive a car without restrictions. patients with type 2 diabetes. As for patients with Type 1 diabetes, then they are also allowed to drive their car - provided that the disease is well compensated, they are not prone to frequent hypoglycemic reactions and caused by “hypo” fog and loss of consciousness. But preferably on “quiet” highways, where there is no heavy traffic and pedestrian traffic.
In any case, the driver must:
not to violate the prescribed diet and medications (injections) insulin);
drive after the prescribed meal and no later than an hour before the next meal;
have with you glucometer, hypoglycemic agents And syringe pen, a drug glucagon, a sandwich, some sweets, glucose tablets, plain and sweet (sugar) water;
at the slightest sign of beginning hypoglycemia stop the car immediately and check blood sugar level, if necessary, take glucose tablets, drink sweet water, etc.;
It is advisable to have with you a medallion (bracelet) indicating that he has a diabetes mellitus or other similar identification with the addresses and telephone numbers of persons who need to be notified in case of need (calling for an ambulance) medical care, accident);
during a long trip, make rest stops at least every one and a half to two hours.
Professor Ilya Nikberg, Sydney
The original article can be found on the official website of the newspaper DiaNews
