Study shows successful treatment for diabetic foot ulcers
This multi-center scientific study was conducted with 22 adults with severe diabetic ulcers on their legs and their wounds improved significantly with hyperbaric oxygen treatment, even without a glycemic control prior treatment.
By Joe Cardozo
“Investigations suggest that treating patients with diabetic ulcers (open and infected wounds tend to get worse) with hyperbaric oxygen should be implemented immediately even in patients with poor blood glucose control at the time when the therapy is prescribed,” stated Dr. Owaise Mansuri from Southern Illinois University of Springfield, US.
Hyperbaric oxygen is being increasingly used in conjunction with antibiotics, debridement and revascularization therapies, for treating chronic wounds that won’t heal and become infected, and which are associated with poorly controlled Diabetes. This treatment significantly improved ulcers, as well as phagocytes function, collagen synthesis and angiogenesis.
Debridement is the process of removing dead, damaged or infected tissue, which is done surgically or with the larval method to improve the remaining tissue of a diabetic ulcer.
How was this study done?
12 participants had Hemoglobin A1c levels of less than 7.5% and formed part of the “controlled” group while the other 10 participants had Hemoglobin A1c values of 7.5% or higher, and belonged to the “uncontrolled” group.
Participants received 20 hyperbaric oxygen sessions and routine care of their diabetic ulcers for a month. All of the participants had deep diabetic ulcers, with serious corresponding to degrees 2 through 4 of the Wagner classification.
Wagner Ulcer Classification System
Grade 1 – Superficial diabetic ulcer.
Grade 2 – Diabetic ulcer that involves ligaments, tendons, joint capsule and the membrane that covers the muscles and keeps them in place, but without the presence of abscess or Osteomyelitis (bone infection).
Grade 3 – Deep diabetic ulcer with abscess or osteomyelitis or bone infection.
Grade 4 – Gangrene presence in the forefoot.
Grade 5- Gangrene presence extended across the foot.
The injuries’ volume was reduced by 71% in the controlled A1c levels group (<7.5%) while the volume of those in the “uncontrolled” Hemoglobin A1c levels group (greater than 7.5%) decreased by 65%, which doesn’t represent a significant difference in healing or improvement of ulcers between both groups.
Ulcers improvement due to the treatment was altered whether by the presence of peripheral artery disease, hypertension, smoking, body weight or duration of Diabetes diagnosis or the onset of the ulcer, said Dr. Mansuri.
The research results were mixed, but the study showed an increase in healing or improvement of diabetic ulcers and a significant decrease in the need for amputation, with the application of hyperbaric oxygen treatment, without there being a significant difference between the two groups despite the difference in Hemoglobin A1c (6.5% vs 8.8%). “The impact of glycemic control when applying the treatment wasn’t analyzed in this study,” said Dr. Mansuri.
“We believe that the effect of hyperbaric oxygen treatment is powerful enough to counteract the negative effects of hyperglycemia” was Dr. Mansuri’s answer when asked how he’d reconcile this study’s results with those of other studies that show that hyperglycemia hinders and delays healing or improvement of diabetic ulcers.
At Diabetes Up to Date we celebrate the success of this and other scientific studies which seek to improve the quality of life of people with Diabetes or decrease the risk factors for developing it.
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