A Systematic Review to Assess the Impact of Hyperbaric Oxygen Therapy on Glycaemia in People with Diabetes Mellitus

Abstract

Background and Objectives: Hyperbaric oxygen is a recognised treatment for a range of medical conditions, including treatment of diabetic foot disease. A number of studies have reported an impact of hyperbaric oxygen treatment on glycaemic control in patients undergoing treatment for diabetic foot disease. There has been no systematic review considering the impact of hyperbaric oxygen on glycaemia in people with diabetes. Materials and Methods: A prospectively PROSPERO-registered (PROSPERO registration: CRD42021255528) systematic review of eligible studies published in English in the PUBMED, MEDLINE, and EMBASE databases, based on the following search terms: hyperbaric oxygen therapy, HBO2, hyperbaric oxygenation, glycaemic control, diabetes, diabetes Mellitus, diabetic, HbA1c. Data extraction to pre-determined piloted data collection form, with individual assessment of bias. Results: In total, 10 eligible publications were identified after screening. Of these, six articles reported a statistically significant reduction in blood glucose from hyperbaric oxygen treatment, while two articles reported a statistically significant increase in peripheral insulin sensitivity. Two articles also identified a statistically significant reduction in HbA1c following hyperbaric oxygen treatment. Conclusions: There is emerging evidence suggesting a reduction in glycaemia following hyperbaric oxygen treatment in patients with diabetes mellitus, but the existing studies are in relatively small cohorts and potentially underpowered. Additional large prospective clinical trials are required to understand the precise impact of hyperbaric oxygen treatment on glycaemia for people with diabetes mellitus.

Hyperbaric oxygen therapy for healthy aging: From mechanisms to therapeutics

“…In addition to the possible positive effects on glucose metabolism during normal aging, HBOT has shown clinical efficacy in lowering blood glucose and improving insulin sensitivity in type 2 diabetes mellitus [ [164] , [165] , [166] , [167] ], the most common age-related metabolic disorder. Notably, the majority of participants in these studies received HBOT for treatment of diverse conditions including non-healing ulcers and diabetic foot ulcers, leading to an older age range [ 165 ]. It suggests that these conclusions may be more applicable to the elderly diabetic population.…”

Efficacy and safety of hyperbaric oxygen therapy for acute central retinal artery occlusion in Hong Kong: results of the first 3 years

“…There is evidence suggesting a reduction in glycemia following HBOT in patients with diabetes mellitus, but the sample size is small and potentially underpowered. 29 There are a few limitations to the study. Only subjects with symptoms onset of ≤6 hours were included, and thus many patients were unable to benefit from HBOT, although the Undersea and Hyperbaric Medical Society recommends HBOT within 24 hours of symptoms onset.…”

Changes in clinical and biochemical characteristics in combination treatment for diabetic macular edema

“…It has been reported that the use of HBO in type 2 DM reduced hypoxia in tissues, reduced blood glucose, increased insulin secretion, increased target cell insulin sensitivity, and normalized an imbalance of the antioxidant system [15,16]. Until recently, there have been limited reports on the use of HBO in DR.…”

“…Activation of oxidative processes causes the formation of a branched system protecting tissues from damage by aggressive oxygen radicals [superoxide anion radical (O2-), hydroxyl radical (HO-) and hydrogen peroxide Н2О2]. SOD family enzymes catalyze the dismutation of superoxide radicals into oxygen and hydrogen peroxide peroxide, and CAT catalyzes the conversion of hydrogen peroxide to water and molecular oxygen [11][12][13][14][15][16]. GSR provides restoration of the reduced form of glutathione [17], which significantly decreases the risk of oxidative stress.…”

“…A combined anti-VEGF and hyperbaric oxygen (HBO) therapy is a possible approach for improved efficacy of treating DME in non-proliferative DR (NPDR) in the presence of type 2 DM. It has been reported that the use of HBO in type 2 DM reduced hypoxia in tissues, reduced blood glucose, increased insulin secretion, increased target cell insulin sensitivity, and normalized an imbalance of the antioxidant system [15,16]. [19].…”