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Related article: required. In the second step of the inquiry, however, if the schedular evaluation does not contemplate the claimant's level of Purchase V-Gel disability and symptomatology and is found inadequate, the RO or Board must determine whether the claimant's exceptional disability picture exhibits other related factors such as those provided by the regulation as "governing norms." 38 C.F.R. 3.321(b)(1) (related factors include "marked interference with employment" and "frequent periods of hospitalization"). Initial Rating for Diabetes Mellitus The Veteran's diabetes mellitus was initially rated 20 percent disabling under Diagnostic Code 7913 from September 2003. The 20 percent initial disability rating for diabetes mellitus was based on evidence showing oral hypoglycemic agents and a restricted diet were required. The Veteran's diabetic complications have been separately rated. These include a 0 percent rating for erectile dysfunction assigned under Diagnostic Code 7522 (from September 2003). During the appeal of the initial rating for diabetes mellitus, 0 percent ratings were assigned under Diagnostic Code 8520 for peripheral neuropathy of the right and left lower extremities prior to May 2, 2008, Buy V-Gel Online and as 10 percent disabling for the period since May 2, 2008. A 0 percent rating under Diagnostic Code 6099-6006 Buy V-Gel was also assigned for nonproliferative diabetic retinopathy of the left eye and bilateral cataracts (from February 2004). Diagnostic Code 7913 provides for a 20 percent rating where the diabetes mellitus requires insulin and a restricted diet, or an oral hypoglycemic agent and a restricted diet. A 40 percent rating is warranted for diabetes mellitus requiring insulin, restricted diet, and regulation of activities. A 60 percent rating is warranted for diabetes mellitus requiring insulin, restricted diet, and regulation of activities with episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice a month visits to a diabetic care provider, plus complications that would not be compensable if separately evaluated. A 100 percent rating is warranted for diabetes mellitus requiring more than one daily injection of insulin, restricted diet, and regulation of activities (avoidance of strenuous occupational and recreational activities) with episodes of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations per year or weekly visits to a diabetic care provider, plus either progressive loss of weight and strength or complications that would be compensable if separately Order V-Gel Online evaluated. 38 Purchase V-Gel Online C.F.R.