Strategic approaches to spa treatment and medical rehabilitation for patients with diabetes mellitus and its complications: a literature review

INTRODUCTION. Diabetes mellitus (DM) is associated with a high risk of developing micro- and macrovascular complications, leading to significant functional limitations, reduced quality of life, and increased economic burden on the healthcare system. Medical rehabilitation and spa treatment play a key role in the comprehensive management of such patients, contributing to improved functional outcomes and the prevention of disability. AIM. To analyze modern approaches to the organization and methods of medical rehabilitation and spa treatment for patients with DM and its complications based on a systematic literature review. MAIN CONTENT OF THE REVIEW. The present article provides a detailed analysis of the goals and methods of rehabilitation for specific complications of DM: diabetic neuropathy, nephropathy, retinopathy, lower extremity vascular disease, osteoarthropathy, acute vascular events, as well as for cognitive and psychological impairments. Particular attention is paid to the role of spa treatments using natural physical factors (balneotherapy, pelotherapy, and climatotherapy). The article highlights the potential for implementing innovative technologies, such as mechanotherapy with biofeedback and virtual reality, to enhance the effectiveness and personalization of the rehabilitation process. CONCLUSION. The rehabilitation of patients with DM requires a comprehensive, individualized approach and coordinated work of a multidisciplinary team. Accumulated data confirm the effectiveness of a wide range of rehabilitation methods for improving physical and psychosocial functioning. However, the absence of unified and structured programs, in conjunction with the necessity for further research to evaluate the comparative effectiveness of individual methods, underscores the relevance of this issue and identifies potential avenues for future research.