What is diabetes?
Diabetes is a chronic health condition that affects how your body turns food into energy. Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is the main source of energy and comes from food. Insulin, a hormone made by the pancreas, helps your glucose from food get into your cells to be used for energy. Sometimes the body doesn’t make enough – or any – insulin or doesn’t use the insulin well. Glucose then stays in your blood and doesn’t reach your cells.
The most common types of diabetes are type 1, type 2 and gestational diabetes.
Type 1 diabetes is when the body does not make insulin and your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin everyday to stay alive.
Type 2 diabetes is when the body does not make or use insulin well. You can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs most often in middle-aged and older people.
Gestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born.
Hyperbaric Oxygen And Diabetes
Hyperbaric oxygen has been promoted as an effective treatment for diabetic foot wounds with the first controlled trial for this indication being reported in Diabetes Care over 20 years ago. Advocates have suggested that the experimentally demonstrated effects of hyperbaric oxygen on
improving wound tissue hypoxia
down-regulating inflammatory cytokines
promoting fibroblast proliferation
make it a useful adjunct in clinical practice for “problem wounds” such as diabetic foot ulcers.
Hyperbaric oxygen is also touted for eradicating difficult-to-treat soft tissue and bone infections by mechanisms that include killing microorganisms, improving leukocyte and macrophage function, and enhancing the effect of antimicrobials.
We can then speculate that these beneficial effects might powerfully reduce the risk of lower-extremity amputation in diabetic patients with foot wounds. For example, a Cochrane database systematic review published in 2004 concluded that “HBO significantly reduced the risk of major amputation and may improve the chance of healing at one year.” Goldman RJ more recently published a systematic review and meta-analysis that included 10 studies. Goldman concluded that hyperbaric oxygen reduces the risk of amputation and increases the likelihood of wound healing.
In a randomized trial carried out by Duzgun et al. published in 2008, the effect of hyperbaric oxygen with standard wound care alone on 100 patients with a diabetic foot wound ulcer that had not responded to a month of appropriate treatment was assessed. They found that hyperbaric oxygen was associated with statistically significantly higher rates of wound healing (66%), lower rates of operative interventions, and fewer lower extremity amputations.
In a double-blinded study by Löndahl et al., they demonstrated that hyperbaric oxygen significantly reduces the size of nonischemic chronic leg ulcer wounds during a 6-week observation. In addition, complete ulcer healing at the 1-year follow-up was noted in significantly noticed.
Around the world case studies from hyperbaric clinics are showing life-changing results, such as infections being cleared in the varicose ulcer patients and clear signs of healing with granulation apparent in both patients. One patient with Charcot’s foot said she felt her feet touch the floor when getting out of bed after the first treatment, which is remarkable. She then followed with 20 sessions which greatly enhanced her perception of peripheral stimuli.
We understand when adequate blood flow is compromised as in diabetes
oxygen cannot reach the underlying tissue to support the natural healing process. No wound can heal without appropriate oxygenation, which makes the diabetic wound more complex. There is no treatment, other than hyperbaric oxygen, that can provide the necessary oxygen to the tissue. Breathing 100% oxygen under pressure allows the dissolution of oxygen into all bodily fluids, including plasma and lymph to restore and enhance the natural healing process. Hyperbaric oxygen stimulates the development of new capillary growth and recent research has shown a significant increase in naturally produced stem cells following treatment. Neutrophils, fibroblasts, macrophages, and osteoclasts are all dependent upon oxygen to carry out their specific inflammatory or repair functions, hence hyperbaric oxygen is a pioneer in wound healing.
Falco et al exposed prediabetic NOD mice to hyperbaric oxygen vs two control groups which received 21% oxygen and oxygen-depleted air for 60 minutes every day. Type 1 diabetes risk was assessed, less than 50% of the hyperbaric oxygen group mice developed hyperglycemia, compared to more than 75% of the control groups. The severity of insulitis was also reduced in the hyperbaric oxygen group.
One key mechanism of action in how hyperbaric oxygen provides beneficial effects in diabetes is through the suppression of inflammation, in particular the modulation of integrin expression and adhesion molecules. Such a mechanism would interfere with the homing of inflammatory cells to islets, thereby reducing insulitis.
It is suggested that hyperbaric oxygen could modulate inflammation through hypoxia-inducible factor (HIF)-1. Hypoxia increases HIF-1 expression, whereas hyperoxia represses HIF. HIF-1 can induce interleukin (IL)-7 and inhibit Foxp3+ regulatory T-cell (Treg) development. Therefore, by reducing the expression of HIF-1, hyperbaric oxygen could inhibit the Th17 pathway and promote Treg development, thereby protecting from type one diabetes. Repression of HIF by hyperbaric oxygen may promote β-cell survival and play a beneficial role in diabetes.
View the Studies
Hyperbaric oxygen therapy for wound healing and limb salvage: a systematic review
Prevention of Autoimmune Diabetes and Induction of β-Cell Proliferation in NOD Mice by Hyperbaric Oxygen Therapy
Influence of hyperbaric oxygen on leukocyte functions and hemostasis in normal volunteer divers
Hyperbaric Oxygen Therapy for Diabetic Foot Wounds
A Breath for Life
Is HBOT a Cool Treatment for Type 1 Diabetes?
Hyperbaric Oxygen Therapy Improves Glucose Homeostasis in Type 2 Diabetes Patients: A Likely Involvement of the Carotid Bodies
Use of hyperbaric oxygen therapy in T2 diabetics with pelvic lesions. Clinical experience
Efficacy of Hyperbaric Oxygen Therapy (HBOT) in New-onset Type-1 Diabetes Mellitus