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By Sarah Crane
Those of you who read last month’s hyperbaric oxygen therapy (HBOT) column on healing skin grafts are aware of the medical definition of hyperbaric oxygen therapy: oxygen administered to a patient in a pressurized environment. The treatment is painless and only involves one medical drug: Oxygen. This article hopes to help educate people about how HBOT can help alleviate some of the medical problems that can occur in the legs and feet that are associated with diabetes.
Roughly a quarter of the people in the United States who have diabetes are unaware of it and have not received a diagnosis from a certified medical professional. Recent statistics indicate that there are close to 30 million people in the United States who have diabetes. Diabetes can result in numerous conditions, including (but not limited to) impoverished circulation to the lower limbs and swollen feet.
The FDA has approved hyperbaric oxygen therapy as a means of medically treating lower-limb non-healing wounds. That is to say: if you have a wound below your knee, you are diabetic, you are undergoing traditional wound care, and your wound does not heal within 30 days, you are eligible for hyperbaric oxygen therapy. Not only would you be eligible for HBOT, but also most insurance companies would likely cover your hyperbaric oxygen therapy treatments.
There are several things patients can do to ensure an optimal response from hyperbaric oxygen therapy treatments. The patient often has a great amount of control over necessary lifestyle changes that should be made at home (i.e., altering diet to maintain a relatively normal and stable blood glucose level) or in their medical care (i.e., arranging for and continuing standard wound care treatment, even during or after undergoing hyperbaric oxygen therapy). Now, let’s explore a little more how HBOT can help those suffering from diabetes.
A relatively prevalent consequence of diabetes is decreased circulation to the feet. Diabetes can cause blood vessels to narrow and harden (and smoking can accelerate that process). This restricted circulation reduces the body’s ability to heal itself because nutrients in the blood (i.e., oxygen-rich plasma) cannot reach problem areas. Hyperbaric oxygen therapy encourages the body to develop new capillaries (i.e., small blood vessels). As these new blood vessels form (a process known as “angiogenesis”), circulation is improved. Additionally, because hyperbaric oxygen therapy decreases swelling, it is also able to decrease the amount of pressure on capillaries (which causes them to narrow in the first place!). As more blood is able to healthily circulate through the lower extremities, the body is able to heal itself and wounds have a better chance of healing by natural processes.
Hyperbaric oxygen therapy is also able to decrease swelling that can occur in the lower limbs (feet and legs). The nature of HBOT is to decrease inflammation by providing copious amounts of oxygen to areas of the body that were previously starved of blood. By both increasing the body’s circulation and presence of oxygen, hyperbaric oxygen therapy can decrease inflammation as well as the amount of inflammatory cytokines (i.e., proteins responsible for determining the severity of the body’s response to inflammation), while increasing collagen production. This collagen is how the body builds new skin cells and also contributes to the formation of new blood vessels.
While hyperbaric oxygen therapy can help improve the condition of lower limbs for those who are suffering from diabetes, it can help reduce swelling or inflammation caused by numerous conditions. It is important to note that hyperbaric oxygen therapy can help improve diabetic lower-limb wounds that are not responding (quickly or at all) to regular treatment. In some cases (in conjunction with adhering to a traditional wound care treatment regiment), hyperbaric oxygen therapy has even been able to eliminate the necessity of amputation. Therefore, HBOT has the ability to be life altering for some people. Please help us continue to educate ourselves and others about the medical uses of hyperbaric oxygen therapy.
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