After a brief account on the principles of spa treatment of diabetes, focused on treatment of vascular complications, the authors discuss the pathophysiology of the peripheral vascular syndrome. The objective of its conservative treatment in spas is improvement of the functional disorder i.e. the reduced vascularization of the extremities influencing regulatory and adaptational mechanisms by application of balneological and physiatric methods. The authors evaluate the effectiveness of remedial exercise, reflex vasodilatation, providing evidence of the effect of Hauffe-Schweninger baths of the upper extremities, a pulsatile magnetic field and other physiatric procedures applied in the lumbar region. They discuss also carbon dioxide therapy (water and gaseous baths, subcuta- neous insufflation of the sprudel gas) radon, sulphur and iodine baths). Some supplementary electrotherapeutic methods are mentioned.

        Key words: peripheral vascular syndrome, diabetes mellitus, balneotherapy, remedial exercise, Hauffe-Schweninger’s baths of the extremities, reflex vasodilatation, carbon dioxide therapy, natural mineral water baths, pulsatile magnetic field, electrotherapy.