In most cases, type 1 diabetes mellitus is an autoimmune disease characterized by the destruction of insulin-producing beta cells, which is the result of absolute insulin deficiency and, therefore, treatment is associated with the administration of insulin. The therapeutic treatment of type 1 diabetes includes the use of insulin for glycemic control, balanced nutrition and regular physical activity. Daily insulin requirements vary depending on age, diet, self-monitoring of blood glucose and daily routine. Obesity affects some patients with type 1 diabetes, which increases their insulin requirements and negatively affects their metabolic control. The type 1 diabetes diet is an essential part of the treatment program and helps to achieve glycemia targets and avoid insulin dose difficulties. Traditionally, for sick children and their parents, there are diet classes in the School of diabetes, but the equivalence in terms of diet and the actual nutrition of children is not sufficiently studied. Therefore, a combination of insulin therapy and an individual nutrition plan is necessary, which is the key to proper metabolic control. The usual nutritional guidelines for patients with type 1 diabetes should be the same as those for the general population.

The article presents the possibilities of implementing the priority project “New model of medical organization providing primary health care” aimed at increasing the accessibility and satisfaction of patients with the quality of medical care. An example of an outpatient dietary consultation shows the resources for detecting medical losses and ways of optimizing the activities of medical personnel using the tools of lean technologies. The article reflects the experience of the Training Centre for lean technologies in health care of the Saint Petersburg State pediatric medical university, created in 2018 with the aim of training medical workers of different specialties to use tools of economical production in conditions of simulated clinic. The conduct of business games and “The Factories of Processes” makes it possible to reconstruct the work of the individual office or the entire polyclinic. The possibility of standardization of medical processes, use of check-lists in the work and organization of each cabinet, introduction of the system “5S” and identification of medical losses with subsequent optimization of the initial reception is presented. In this work “The Process Factory” “The optimization of the appointment of a doctor-specialist” is presented, allowing to make a detailed analysis of the duration and structure of the reception, to perform the mapping of medical processes and to use visual management, considering the efficiency, Safety and quality of the doctor’s work. The acquired skills in simulated conditions help to implement this methodology and effectively use the tools of lean technologies in practice.