Glucose Fluctuations in Diabetic Versus Non-Diabetic Patients with Chronic Wounds Undergoing Hyperbaric Oxygen Therapy

Introduction: Hyperbaric oxygen therapy (HBOT) heals chronic wounds through many mechanisms of action, such as neovascularization, enhanced oxidative killing of neutrophils, fibroblast proliferation, and bone remodeling. Patients undergoing HBOT have a potential drop of up to 20% in blood glucose levels during their treatments as reported in the literature. Diabetic patients can, therefore, potentially be at a higher risk for developing clinically significant hypoglycemia during HBOT for their wound treatment with devastating outcomes. The objective of this study is to determine whether diabetic patients have a greater decrease in blood glucose levels compared to the non-diabetic patients during HBOT.  

Method: Glucose levels were measured using the “One Touch Ultra 2” glucometer before and after each HBOT in consecutive diabetic and non-diabetic patients with chronic wounds. HBOT were done at 2 atmospheres absolute (ATA) for 90 minutes daily. The average numbers of HBOT ranged from 20-60 treatments. Patients were treated for the following wound conditions: Diabetic foot ulcer, refractory osteomyelitis and compromised graft/flap. Standard wound care practices were provided by a wound/HBOT specialist throughout the study period. 

Results: Nine patients, 8 males and 1 female, with an average age of 62 were enrolled. Five were diabetic and 4 were non-diabetic patients. Results were statistically analyzed using a Student’s T-test for independent samples. A total of 120 data points were analyzed. There was an overall blood glucose decrease of approximately 12 % in diabetic patients versus 15% in non-diabetic patients during HBOT (p=0.916).

Conclusion: This preliminary report indicates that there is no statistical significant change in blood glucose levels of diabetic versus non-diabetic patients with chronic wounds undergoing hyperbaric oxygen therapy.