HBOT and diabetic foot ulcers: what the evidence says
Diabetic foot ulcers are one of the best-known medical uses of hyperbaric oxygen therapy, and one of the most misunderstood. Here's a balanced look.
The problem
People with diabetes can develop slow-healing wounds on their feet. Nerve damage means small injuries go unnoticed, and poor circulation means the tissue doesn't get enough oxygen to heal. Some wounds become infected and, in severe cases, lead to amputation.
Where HBOT fits
HBOT is used as an add-on to standard wound care, not a replacement for it. Standard care includes cleaning and removing dead tissue, controlling infection, taking pressure off the foot (offloading), managing blood sugar and restoring blood flow where possible.
The idea is that extra oxygen dissolved in the blood can reach poorly supplied tissue, supporting the body's own healing processes and its ability to fight infection.
What the research shows
The evidence is mixed. Some studies have found HBOT improves healing in certain diabetic foot ulcers, while others found less benefit. In general:
- HBOT is considered for deeper, more severe wounds (for example, those reaching tendon or bone) that haven't improved with good standard care.
- It is not recommended for minor or shallow wounds that are healing normally.
- Results depend heavily on the quality of the overall wound care.
What a course involves
Medical treatment for wounds usually means daily sessions at about 2.0 to 2.5 ATA, often 20 to 40 or more sessions, at a hospital or wound-care center, under a physician.
Insurance
Medicare and many insurers cover HBOT for diabetic foot ulcers that meet specific criteria. Medicare, for example, covers certain deeper wounds that haven't responded to at least 30 days of standard wound care. See Does insurance cover HBOT?.
The bottom line
If you have diabetes and a foot wound, see your doctor or a wound-care specialist promptly. Don't try to self-treat with wellness HBOT sessions; diabetic foot wounds need medical care.
Our wellness sessions are not a treatment for wounds or diabetes.