Diabetes mellitus (DM) is defined as a group of metabolic diseases characterized by chronic hyperglycaemia caused by disturbances in the secretion or effects of the insulin, or their combination. DM is a chronic disease which over years causes irreversible changes leading to damage to body tissues.
HBOT is a valuable complementary method of the treatment of diabetic changes on the skin, especially of the lower extremities, which develop due to the deterioration of blood supply in the damaged small blood vessels and capillaries.
- Accelerates healing
- Reduces the rate of amputations
- Increases the amount of diabetic wounds healed completely in the long run
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There is medical, peer-reviewed evidence that for patients with diabetic foot syndrome, HBOT significantly reduces the risk of amputation by 50% and can shorten the duration of the treatment.
In a study that enrolled 28 patients with chronic neuropathic ischemic defects of I-III degree on Wagner’s scale, the size of the defect was clearly reduced by 41%. After four weeks, the two subjects healed completely after undergoing HBO treatment.
Out of the 68 patients with diabetic foot syndrome II – IV on Wagner’s scale, 35 patients received exposure in the hyperbaric chamber. 33 patients were randomized to the control group without the application of hyperbaric oxygen therapy. HBOT group demonstrated a significantly lower risk of amputation. A detailed analysis showed the HBOT had greatest positive impact on reducing amputations in the most severe defects of Wagner’s stage IV (2/22 HBOT vs. 11/20 control group).
During their lifetimes, an estimated 25% of diabetic patients develop a foot ulcer and of those, 15% to 20% undergo an amputation within 5 years of ulcer onset.
The adequate supply of oxygen is an essential factor for infection control and wound healing. Breathing 100% pure medical oxygen under increased pressure higher than the atmospheric has a beneficial effect on the healing of diabetic wounds (ulcers).
What do Experts Say?
There are a number of medical studies that have shown therapeutic and economic effect of the HBOT application for the diabetic foot syndrome.
This prospective study investigated 18 patients with ischemic defects on Wagner II scale.
HBOT was applied once a day for 90 minutes at pressure of 2.5 atmospheres, totalling 30 sessions. After six weeks, 5 of 8 patients healed in the HBOT group versus the control group, where only 1 out of 8 patients healed.
Abidia A, Laden G, Kuthan G. et al:
The role of hyperbaric oxygen therapy in ischaemic diabetic lower extremity ulcers:
a double-blind randomised control trial.
Eur J Vasc Endovasc Surg, 25, 2003: 513 – 518
The study included 28 patients with neuropathic defects on Wagner scale I-III.
HBOT group (14 patients) was treated 2 times a day for 90 minutes at pressure of 2.5 atmospheres for 2 weeks, 5 exposures per week. The control group (13 patients) was treated with standard therapy. Result: In the second week of the study, the reduction in defect size was substantially larger (41%) in the HBOT group, in comparison with the control group. After 4 weeks, 2 patients from the HBOT group healed completely. In the control group, no one healed.
Kessler L, Bilbault P, Ortega F et al:
Hyperbaric oxygenation accelerates the healing rate of nonischemic chronic diabetic foot ulcers.
Diab Care, 26, 2003: 2378 – 2382
Treatment with hyperbaric chamber is not only effective, but economically viable as well
The 4th and the 8th European Consensus Conferences held in London in 1998 and in Ravel in 2006, respectively, were dedicated to the topic of assessing the effectiveness of HBOT in the treatment of diabetic foot. The importance of the use of HBOT for diabetic foot syndrome is also included in the meta-analysis within the world-renowned framework of the Cochrane Review. The conclusion was that for the patients with ulceration, the HBOT significantly reduces the high risk of amputation with a significant chance of complete healing within one year. Numerous studies have evaluated the cost of the treatment and after-care of patients with diabetic foot. A recent study published in the International Journal of Technology Assessment in Health Care presented results from Canada, assessing the cost of treatment in the twelve-year period for patients with and without the application of hyperbaric oxygen therapy. Cost savings for patients with HBOT was 10,000 Canadian dollars (circa 7,500 EUR).