General principles for rehabilitation of patients with type 1 diabetes and diabetic nephropathy

All over the world, an increase in type 1 diabetes mellitus is noted annually, along with its late complications. In recent years, more and more information has appeared aimed at the prevention and rehabilitation of children with diabetes. Type 1 diabetes mellitus is a genetically determined disease, in the development of which the main component is an autoimmune process that triggers the destruction of β-cells, which leads to a decrease in insulin production, and subsequently to its absolute insufficiency, the main method of treatment is insulin replacement therapy. To select an adequate dose of insulin, it is necessary to take into account HbA1c, glycemic and glucosuric profiles. Children are advised to use semi-synthetic or genetically engineered insulins. In children, intensified insulin therapy is more often used in the form of a combination of short and medium-acting insulins or ultra-short with prolonged ones. This article presents an analysis of insulin therapy and self-control in children and adolescents with type 1 diabetes mellitus and diabetic nephropathy. It was found that children with diabetic nephropathy approached their illness less responsibly, did not always count bread units and kept records in self-control diaries. Also, this group of children were more likely to receive human insulin with the use of syringe pens. The nutrition of children with diabetes should not be inferior in calories to that of healthy adolescents, while the energy value of the daily diet should be calculated taking into account age, gender, body weight, and energy expenditures. Taking into account the possibility of regression of the initial diabetic complications when the compensation of carbohydrate metabolism is achieved, therapy for type 1 diabetes is a means of preventing the development of severe diabetic complications.