When I wrote that HBOT may not help
foot ulcers on April 12, 2013, I was disappointed because I felt that
the researchers had missed something or used the wrong pressures. I
have now seen three people being treated by hyperbaric-oxygen therapy
and all three have foot ulcers that healed with HBOT.
Results of the study were presented at
the European Association for the Study of Diabetes (EASD) 2015
Meeting, by lead investigator Magnus Löndahl, MD, of Lund
University, Sweden.
A total of 38 patients completed
hyperbaric-oxygen treatment, 37 completed placebo treatment, and 19
did not complete treatment (both groups combined). At baseline,
hyperbaric oxygen and air patients had had type 2 diabetes for 23 and
21 years, respectively, had a median age of 67 and 71 years, and had
foot-ulcer duration of 11.4 and 10.3 months.
What surprises me is the length of foot
ulcer duration. I know one of the three had a foot ulcer for 5
months and two others for less than 4 months. In addition, three of
our support group have had foot ulcers for less that 4 months and
were able to have their foot ulcers healed with medications. This is
one reason to see a podiatrist on a quarterly basis, as they examine
your feet for foot ulcers, ingrown toe nails and other foot problems.
They will also examine your lower legs for problems and refer you to
another doctor if necessary.
“Now at 6 years, 63.2% of patients
who received at least 37 treatments (of 40 total) of hyperbaric
oxygen survived compared with 40.5% of those who got placebo.”
“Dr Giel Nijpels, from the Free
University of Amsterdam, the Netherlands, the session moderator,
commented on the potential clinical use of hyperbaric oxygen.”
"It seems to work, but we can
speculate about the disadvantages, including the high cost. Also, I
have some doubts about the way the data were analyzed — I'm unsure
if this is fully accurate. The problem is that they attempted to
blind the patients, and there was a huge dropout rate.
"Also, let's remember you find
this type of treatment only in large academic centers — it isn't
that easy to administer this form of therapy," he added.
“Turning his attention to the
possible reasons for the positive effect on chronic diabetic foot
ulcer, Dr Löndahl said: "I have no definite explanation today.
It might be a coincidence or associated with ulcer healing. It is
unlikely to be due to improved macrovascular function, but we do have
data that improved microvascular function might be associated with
survival, not least due to improved autonomic neuropathy."
Despite the positive results, Dr
Löndahl concluded that "we need more information and to further
explore and verify findings before [this therapy is]…applied in
clinical management of diabetic foot ulcer."
I feel that this type of treatment
needs to be explored further, as the expense needs to be considered.
HBOT does have its place in medicine, especially in diabetes and
traumatic brain injury, and possibly other areas besides deep sea
diving.
