[abstract] HBO AND HYPOGLYCEMIA IN DIABETIC SURGICAL PATIENTS WITH CHRONIC WOUNDS

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[abstract] HBO AND HYPOGLYCEMIA IN DIABETIC SURGICAL PATIENTS WITH CHRONIC WOUNDS

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Title: [abstract] HBO AND HYPOGLYCEMIA IN DIABETIC SURGICAL PATIENTS WITH CHRONIC WOUNDS
Author: Capelli-Schellpfeffer, M; Pilipson, LH; Bier, M; Howe, L; Boddie, A
Abstract: INTRODUCTION: Hyperbaric oxygen therapy (HBO) in diabetic surgical patients with chronic wounds can enhance wound healing. However, the reported complication of hypoglycemic events in diabetics is 1.3 per 100 treatments (Tx), as compared to the rate of oxygen toxicity seizures of 0.01 per 100 Tx. METHODS: We prospectively monitored fingerstick whole blood glucose before and after HBO treatments in a convenience sample of surgical patients sequentially referred to HBO in a monoplace chamber at 2.5 ATA for 90' with 100percent O2. RESULTS: No hypoglycemic events were noted. In 18 monitored Tx of patients with no nutritional intake within 2 hours of HBO, average pre-Tx glucose was 122.1 mg/dl, SD +/- 44.8 and average post-Tx glucose was 102.2 mg/dl, SD +/- 23.8 (t = 3.45, df = 17, p = 0.003). For 7 diabetics who underwent 70 Tx, an average decrease in glucose of 21 mg/dl, CL (95percent) = 8.47 was observed. For 11 non-diabetics with 63 Tx, the average change in glucose was 0.57 mg/dl, CL (95percent) = 6.11. CONCLUSION: Our data analysis suggests a hypoglycemic response to hyperbaric oxygen therapy, particularly in diabetic patients. Since the 1870s, a relationship between CNS toxicity, HBO and blood glucose has been suggested (Bert, 1878). We postulate there is a change in glucose metabolism with HBO that leads to hypoglycemia because HBO supersaturates plasma with oxygen, one of the substrates for metabolic energy generation, driving glucose consumption. In addition, increased aerobic metabolism in the pancreatic islets of Langerhans during HBO may stimulate insulin secretion. The HBO effect on beta cell mitochondria and the implications for islet cell secretion is of interest as oxidative phosphorylation in the beta cell mitochondria may be significant in insulin secretion in response to glucose intake and other nutrients (Kadowaki et al., 1994). The critical step in glucose-induced secretion has been shown to be the production of ATP by the mitochondrion, utilizing glycolytically generated NADH (Dukes et al, 1994). Further laboratory and clinical studies are warranted, as the observation of HBO's hypoglycemic effects has implications for the study of insulin secretion, wound healing, and the prevention of seizures in patients undergoing HBO treatment. diabetes hypoglycemia
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/569
Date: 1996

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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