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Hyperbaric Oxygen Therapy for Diabetic Neuropathy
Hyperbaric Oxygen Therapy (HBOT) is an effective treatment for diabetic
neuropathy. By driving oxygen deep into
tissues, it reduces cell death and pain
symptoms. Hyperbaric oxygen also
stimulates the growth of new blood
vessels, enabling the body to increase
effective oxygen and nutrient delivery.
Hyperbaric oxygen therapy is a medical
treatment that uses pure oxygen to speed
and enhance the body’s natural ability
to heal. Hyperbaric oxygen therapy
is an American Medical Association, FDA
and Medicare approved modality.
While sometimes hyperbaric medicine
procedures are used as a primary
emergency treatment, it is more often
used as a cost effective adjunct or
enhancement therapy.
Of the estimated 20 million people in
the United States with diabetes, 3 million struggle with
DPN—and even patients with pre-diabetes and impaired
glucose (blood sugar) tolerance may have symptoms. The
older the person is, the longer he or she has had
diabetes, and the less-controlled the disease, the
greater chance of feeling pain because of damaged
nerves.
Fifty percent of patients with
long-standing diabetes have numbness, burning,
electrical sensations, stabbing, or shooting pain in
their feet or legs—and it’s usually worse at night.
While the pain is uncomfortable, the lack of sensation
can have even worse consequences. If a person’s shoes
fit improperly, are too tight, have rough spots inside,
or rub when the person walks, the blisters, abrasions or
cuts may not be felt. Because circulation is not as good
as it is for people without diabetes, these wounds can
become infected and very difficult to heal.
If there is tissue damage and a wound
that resists healing, many insurance companies will
cover Hyperbaric Oxygen Therapy. For more information go
to
Diabetic Neuropathy Therapy.
How does
hyperbaric oxygen therapy
work?
During hyperbaric
oxygen therapy (HBOT), the patient
breathes pure, 100% oxygen under
increased atmospheric pressure.
(The air we normally breathe contains
only 19-21% of this essential element.)
The concentration of oxygen normally
dissolved in the bloodstream is thus
raised many times above normal (up to
2000%). With HBOT therapy, in
addition to the blood, all body fluids
including the lymph and cerebrospinal
fluids are infused with the healing
benefits of this molecular oxygen.
It can reach bone and tissues which are
inaccessible to red blood cells, enhance
white blood cell function, and promote
the formation of new capillary and
peripheral blood vessels.
Hyperbaric treatment results in
increased infection control and faster
healing of a wide range of conditions.

HBOT is a
medical treatment.
You should locate a
HBOT facility near you and get a
consultation before beginning this
treatment. Once you're comfortable
with it, you can also purchase chambers
for home use if you have a severe case.
Currently we don't
have a reliable referral source yet, but
we're working on it. You may wish
to type in "hyperbaric
oxygen therapy" along with the name of
your city into a SEARCH ENGINE to find a
center near you.
HBOT works very well
when combined with other natural
protocols. Example: ReBuilder,
nutrition, other oxygen sources, control
diabetes. The more severe the
suffering, the more you should do to
combat the condition.
See
more about treatments
here.
A few studies on
HBOT for review.
Below are
just a few study summaries for your
perusal...
The
Efficacy of the Hyperbaric Oxygen Therapy for the
Treatment of Diabetic Neuropathy
Neuropathology
and Nerve Oxygen Saturation - Diabetic Neuropathy
Diabetic
Neuropathy - A Debate
HYPERBARIC OXYGEN IMPROVES PERIPHERAL
NERVE REGENERATION
Several studies have documented the
effectiveness of hyperbaric oxygen in models of acute
and delayed crush injury. Intermittent exposure to
hyperbaric hyperoxia serves to interrupt the injury
cycle of edema, ischemia and tissue necrosis,
as well as hemorrhagic hypotension, which
in turn leads to former edema and ischemia. Tissue
ischemia is countered by the ability of hyperbaric
oxygen to elevate tissue oxygen tensions.
Furthermore, edema is reduced, secondary to hyperoxia-induced
arteriolar vasoconstriction, leading to
improved tissue viability, thereby reducing necrosis. Hyperbaric oxygen has also been studied in
models of peripheral nerve injury. Researchers from the US Air
Force School Aerospace Medicine and
Louisiana
State
University
recently sought to determine what, if any,
morphologic changes are associated with hyperbaric
oxygen treated peripheral nerve injury.
Their model involved a crushed sciatic nerve in the
rabbit.
Exposure to hyperbaric oxygen across the
range of current clinical dose schedules was compared to
untreated, and pressure (hyperbaric air) controls. A
pathologist blinded as to group documented the extent of
nerve regeneration via morphologic analysis of electron
micrographs. All of the animals exposed to
hyperbaric oxygen were reported to demonstrate advanced
stages of a healed nerve, in contrast to both control
groups. As this research was limited to a
determination of regeneration of morphology, the exact
effects of hyperbaric oxygen were not known. The authors
speculate, however, that there may be several suggesting
increased myelination, decreased edema, reduced internal
collagen and improvements in neurofilamentous material
density. They conclude that this study provides
additional evidence of a link between tissue oxygen
levels from hyperbaric oxygen treatment and the health
of peripheral nerves.
... all
animals exposed to hyperbaric oxygen
"demonstrated characteristics expected
of in the advanced stages of a healed
nerve"
Effect of hyperbaric oxygen therapy on nerve regeneration in early diabetes.
Aydin A, Ozden BC, Karamursel S, Solakoglu S, Aktas S, Erer M.
Department of Plastic and Reconstructive Surgery, Instanbul Medical Faculty, Istanbul, Turkey. atakanaydin@yahoo.com
Nerve regeneration in diabetes is essential for reversal of neuropathy as well as the recovery of nerves from injury due to acute nerve compression and entrapment. Endoneural hypoxia due to hyperglycemia-induced blood flow reductions is observed early in the course of diabetes, and the resultant ischemia plays a role in the diminished neural regeneration. Hyperbaric oxygen therapy is capable of producing tissue hyperoxia by raising oxygen tensions in ischemic tissues, and was shown to be beneficial in the reversal of experimental ischemic neuropathy. In this study, an experimental diabetes model was used to evaluate the functional and histomorphological effects of hyperbaric oxygen therapy on early diabetic nerve regeneration. Our results indicate that there is significant histomorphological impairment of nerve regeneration, even in very early stages of diabetes. However, no beneficial effects of hyperbaric oxygen therapy could be demonstrated at this stage. Copyright 2004 Wiley-Liss, Inc.
PMID: 15160386 [PubMed - indexed for MEDLINE]
Hyperbaric Oxygen Therapy and Neuropathy
[A study of peripheral neural conduction, motor and sensory, in diabetic patients treated with hyperbaric oxygenation]
Viera C, Galvez C, Carrasco B, Santos C, Castellanos R.
Departamento de Neurofisiologia Clinica, Hospital Clinico Quirurgico Hermanos Ameijeiras, La Habana, Cuba.
INTRODUCTION: There are some occlusive disorders in the vasa nervorum and metabolic changes disminishing oxygen liberation by erytrocites at the capillary blood vessels, and these disturbances lead to endoneural microhypoxia. Hyperbaric oxygen reverts hypoxia in the diabetic neuropathy. OBJECTIVE: We studied motor and sensitive peripheric neuroconduction in nine diabetic patients, with distal symmetrical polyneuropathy, during normoglycemia. Four of them were insulin dependent and five were non insulin dependent. PATIENTS AND METHODS: The electrophysiological studies were done before treatment with hyperbaric oxygen, in a week, three and six months later. The abnormal electrophysiological parameters detected in diabetics were terminal latencies (enlarged), velocities of conduction (slowed) and distal amplitudes of compound action potentials (reduced). RESULTS: Neither distal latencies nor distal amplitudes and conduction velocities in peroneal nerve showed significative changes in the statistical analysis. We observed slower conduction velocities in the motor fibers of the median nerve in the examination performed six months after treatment. There was an increase of distal latency and retardation of the velocity of conduction six months later after treatment in the sensitive fibers of median nerve, whereas the amplitudes of sensitive action potentials decreased progressively. These changes suggest large diameter peripheral fibers didn't receive benefit with hyperbaric oxygen treatment.
CONCLUSIONS: In all patients disappeared all symptoms of dysesthesias, paresthesias, distal pains and cramps in the legs and arms, suggesting functional changes in small unmyelinated fibers which we can't test with conventional techniques to prove it.
PMID: 10390749 [PubMed - indexed for MEDLINE]
Experimental ischemic neuropathy: salvage with hyperbaric oxygenation.
Kihara M, McManis PG, Schmelzer JD, Kihara Y, Low PA.
Department of Neurology, Mayo Foundation, Rochester, MN 55905.
Ann Neurol. 1995 Jan;37(1):89-94.
Hyperbaric oxygenation is effective in augmenting the delivery of oxygen to tissue, but also causes oxidative stress. As part of our focus on improving peripheral nerve salvage from ischemic fiber degeneration, we evaluated whether hyperbaric oxygenation rescues peripheral nerve, rendered ischemic by microembolization, from ischemic fiber degeneration. The supplying arteries of rat sciatic nerve were embolized with microspheres of 14 microns diameter at moderate (2 x 10(6)) and high (5.6 x 10(6)) doses. Rats were randomized to receive hyperbaric oxygenation treatment (2.5 atm 100% oxygen for 2 hours/day for 7 days beginning within 30 minutes of ischemia), or room air. End points for the embolized limb were (1) behavioral scores (0-11 in increasing levels of limb function), (2) nerve action potential of sciatic-tibial nerve, (3) nerve blood flow, and (4) histological grade as percentage of fibers undergoing ischemic fiber degeneration (0 = < 5%; 1 = 5-25%; 2 = 26-50%; 3 = 51-75%; 4 = > 76%). Nerve blood flow and nerve action potential were uniformly absent and more than 90% of fibers had degenerated in both control and treatment groups receiving high doses. Control and treatment groups receiving moderate doses were well matched by level of ischemia (8.5 +/- 0.3 [N = 18] vs 7.7 +/- 0.4 ml/100 gm/min [N = 18], p > 0.05) but were significantly different by behavior score (5.6 +/- 0.7 vs 9.2 +/- 0.5 [N = 19], p < 0.001), nerve action potential (1.4 +/- 1.0 vs 3.9 +/- 0.5 [N = 6], p < 0.05), and histology (2.4 +/- 0.4 [N = 5] vs 0.8 +/- 0.5 [N = 4], p < 0.05). On single teased fiber evaluation, the predominant abnormality was E (axonal degeneration). We conclude that hyperbaric oxygenation will effectively rescue fibers from ischemic fiber degeneration, providing the ischemia is not extreme.
PMID: 7818263 [PubMed - indexed for MEDLINE]
Effect of hyperbaric oxygenation on normal and chronic streptozotocin diabetic peripheral nerves.
Low PA, Schmelzer JD, Ward KK, Curran GL, Poduslo JF.
Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905.
Hyperbaric oxygenation is known to affect energy metabolism and endothelial cell structure and function, but its effects on peripheral nerve have not been reported. We investigated whether it would (i) reverse established streptozotocin-induced diabetic neuropathy, a condition in which endoneurial hypoxia exists; (ii) affect energy metabolism in nerve; and (iii) alter the blood-nerve barrier. Sprague-Dawley rats that had been diabetic for 3 months and age-matched controls were used in these studies. One diabetic group and one control group were treated with hyperbaric oxygenation (2 atm for 2 h, 5 days/week) for 4 weeks. Identical groups remained in room air. Sciatic nerve adenosine triphosphate (ATP), creatine phosphate, lactate, and glucose concentrations showed similar changes at rest in both room air and after hyperbaric oxygenation. Nerves of control and diabetic groups exhibited increased lactate production and increased utilization of glucose, ATP, and creatine phosphate after 15 min of anoxia. The albumin blood-nerve barrier index was increased in control and diabetic nerves after hyperbaric treatment. Nerve conduction velocity was reduced in the diabetic-room air group and not improved by hyperbaric oxygenation. Caudal nerve action potential, which was significantly reduced in this group, was normalized after hyperbaric treatment. Resistance to ischemic conduction failure was increased in untreated diabetic nerve but not significantly different from controls after hyperbaric exposure. These findings indicate that treatment with hyperbaric oxygenation will partially reverse the neuropathy encountered in chronic diabetes. The biochemical changes are suggestive of enhanced nerve energy metabolism induced by hyperbaric oxygenation. The altered albumin blood-nerve barrier index presumably results from the action of free radicals on endothelial cells.
PMID: 3335240 [PubMed - indexed for MEDLINE]
The effectiveness of intermittent hyperbaric oxygen in relieving drug-induced HIV-associated neuropathy.
Jordan WC.
Department of Internal Medicine, Charles R. Drew University of Medicine and Science, King-Drew Medical Center, Los Angeles, California 90059, USA.
This 3-month study evaluated the effects of hyperbaric oxygen on drug-induced neuropathies in 22 patients with human immunodeficiency virus. All patients included in the study had been taking an antiretroviral medication for at least 12 months and had subjective symptoms of numbness or tingling, lethargy, and a decrease in deep tendon reflex. Patients with an active substance abuse history or Kaposi's sarcoma were excluded. Of the 20 patients who completed the series, 17 had significant improvement, 2 had a demyelinating disorder that may have affected the outcome, and 1 had no change.
PMID: 9640906 [PubMed - indexed for MEDLINE]
Effect of hyperbaric oxygen therapy on nerve regeneration in early diabetes.
Aydin A, Ozden BC, Karamursel S, Solakoglu S, Aktas S, Erer M.
Department of Plastic and Reconstructive Surgery, Instanbul Medical Faculty, Istanbul, Turkey. atakanaydin@yahoo.com
Nerve regeneration in diabetes is essential for reversal of neuropathy as well as the recovery of nerves from injury due to acute nerve compression and entrapment. Endoneural hypoxia due to hyperglycemia-induced blood flow reductions is observed early in the course of diabetes, and the resultant ischemia plays a role in the diminished neural regeneration. Hyperbaric oxygen therapy is capable of producing tissue hyperoxia by raising oxygen tensions in ischemic tissues, and was shown to be beneficial in the reversal of experimental ischemic neuropathy. In this study, an experimental diabetes model was used to evaluate the functional and histomorphological effects of hyperbaric oxygen therapy on early diabetic nerve regeneration. Our results indicate that there is significant histomorphological impairment of nerve regeneration, even in very early stages of diabetes. However, no beneficial effects of hyperbaric oxygen therapy could be demonstrated at this stage. Copyright 2004 Wiley-Liss, Inc.
PMID: 15160386 [PubMed - indexed for MEDLINE]
Effect of hyperbaric oxygen on ophthalmic artery blood velocity in patients with diabetic neuropathy.
Okamoto N, Nishimura Y, Goami K, Harino S.
Department of Ophthalmology, Osaka Teishin Hospital, Japan.
Jpn J Ophthalmol. 1998 Sep-Oct;42(5):406-10.
Exp Neurol. 1998 Feb;149(2):433-8.
To assess the relationship between blood flow and the complications of diabetes mellitus, we investigated the changes in the velocity of blood flow in the ophthalmic artery before and after hyperbaric oxygen therapy (HBO), one of the treatments for diabetic neuropathy. Color Doppler imaging was used before and after HBO. Seven diabetic neuropathy patients, 3 diabetics without neuropathy, and 7 normal, control subjects were enrolled. The patients were subjected to breathing 100% oxygen at 2.0 atmosphere absolute (ATA) for 1 hour. Hyperbaric oxygen therapy resulted in an average decrease in blood velocity by 15.0 +/- 9.0% (mean +/- SD) in normal subjects and 10.7 +/- 8.6% in diabetics without neuropathy. Blood velocity returned to the baseline level 4 hours after discontinuation of HBO. In contrast, blood velocity increased by 20.6 +/- 9.5% in diabetic patients with neuropathy irregardless of the severity of the diabetic retinopathy. The resistance index of the ophthalmic artery was not changed during HBO in the group with diabetic neuropathy, indicating that other mechanisms may be implicated, leading to the compensatory changes of blood flow. These results suggest that the increase in the blood velocity in the ophthalmic artery after HBO in diabetic neuropathy patients could be attributed to an imbalance in autonomic nervous function.
PMID: 9822973 [PubMed - indexed for MEDLINE]
Further References
- Strauss MB et al.: Delayed use of hyperbaric
oxygen for treatment of a model anterior
compartment syndrome. Journal of Orthopedic
Research 1986; 4:108-111.
- Skyhar MJ et al.: Hyperbaric oxygen reduces
edema and necrosis of skeletal muscle in
compartment syndromes associated with
hemorrhagic hypotension. Journal of Bone and
Joint Surgery 1986;68A:1218-1224
- Nylander G: Tissue ischemia and hyperbaric
oxygen treatment. Scand 1986; suppl. 533.
- Nylander G et al.: Reduction of postischemic
edema with hyperbaric oxygen. Plastic and
Reconstructive Surgery 1985;76:595-603
- Zamboni WA et al.: Functional evaluation of
peripheral-nerve repair and the effect of
hyperbaric oxygen. Journal of Reconstructive
Microsurgery 1995; 11:27-29.
- Bradshaw PO, et al.: Effect of hyperbaric
oxygenation on peripheral nerve regeneration in
adult male rabbits. Undersea and Hyperbaric
Medicine 1996; 23(2): 107-113.
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S tatements
about neuropathy and
hyperbaric
oxygen therapy are for information
only.
These
statements about neuropathy have not been reviewed by
the FDA. |
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