Health & Fitness

New therapy could reduce diabetes-related amputations

Hyperbaric oxygen therapy (HBOT), best known as an antidote for underwater diving disorders, involves inhaling pure oxygen while reclining in a pressurized chamber.

The intense flood of oxygen to the blood can stimulate cell growth, promote the formation of new blood vessels and fight certain infections, said Alan Davis, who directs the Center for Wound Care and HBOT at Northwest Hospital outside Baltimore.

Swedish researchers have shown HBOT can help foot ulcers heal in certain patients with diabetes, according to a 2010 study published in the journal Diabetes Care. A review of other trials also found that HBOT seemed to reduce the number of amputations in people with diabetes who have chronic foot ulcers, according to a Cochrane Review of the literature.

But while the data on chronic wound healing is promising, research is also sparse and many physicians are still skeptical.

The Swedish study appeared to be “well done,” but “it still doesn’t tell us which patients will benefit from this very expensive treatment,” said Tony Berendt, an infectious disease physician at Oxford and co-author of several clinical guidelines on diabetic foot infection.

Diabetes develops when a person’s body can’t make a normal amount of insulin, or uses it incorrectly. “Insulin controls blood sugar; if the levels are too high, blood vessel and/or nerves can be harmed,” said Davis.

Damage to the blood vessels or nerves can result in a loss of circulation or reduced sensation to the feet. This can make it difficult to detect a sore or injury.

“Those with diabetes lose the gift of pain,” said David Armstrong, director of the Southern Arizona Limb Salvage Alliance at the University of Arizona department of surgery.

Armstrong’s research has shown that up to 25 percent of those with diabetes will develop a foot ulcer. More than half of foot ulcers become infected; one in five infections require amputation.

HBOT may improve the oxygen concentration in the peripheral tissues, and that increased oxygen concentration may improve healing, Armstrong said. But, he said, if blood isn’t able to flow, due to peripheral vascular disease, the super oxygenated blood won’t be able to get to the extremities and HBOT will be nearly useless.

Chicago Tribune

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