1. America's Most Prevalent Disease. Currently,
it is estimated that 25.8 million children and adults in the United States -
8.3% of the population - have diabetes, and that number is increasing. In 2010,
1.9 million new cases of diabetes were diagnosed in people aged 20 years and older.
[source: American Diabetes Association]. To date, no cure has been
found, and due to the nature of this disease, a cure does not appear
likely. Management of diabetes is very challenging, and in most cases
complications eventually develop.
2. Diabetic Foot Ulcer. A common complication is the development
of peripheral vascular disease, otherwise known as "poor circulation".
These patients eventually develop diabetic neuropathies (diminished
sensation to their extremities). The combination of these problems
often leads to non-healing diabetic leg ulcers. Approximately 15% of diabetics
have foot ulcers.
3. Circulation Issues. Often, even if they are caught early,
diabetic foot ulcers are difficult to heal, due to decreased
circulation. Microvascular and macrovascular complications of diabetes
diminish the blood flow to the extremities, limiting the gradient of
oxygen pressure in the tissue. Wound healing involves a complex series
of events initiated by chemoattraction of macrophages, production of
growth factors, fibroblast hyperplasia, and production of collagen.
Oxygen is an essential controlling factor for bactericidal, fibroblast
growth, angiogenesis, collagen synthesis, epithelialization, and other
biochemical processes essential for wound healing.
4. Difficulty of Treating Foot Ulcers. Historically, these wounds
can be a nightmare for patients, as well as their families, physicians
and surgeons. Standard care of diabetic foot ulcers includes off-loading
(via bed rest, prosthetics, casts, etc.), debridement of devitalized
wound tissue, moist dressings, and management of infection with topical
or systemic antibiotics. Unfortunately, none of these therapies
effectively increases oxygen delivery to the affected tissue. Ultimately
it is this inadequate delivery of oxygen to the affected area that will
prevent healing. Without HBOT a majority of these wounds eventually
require surgery. The surgical options are typically skin grafting,
revascularization procedures or amputation. In most cases, these
patients are poor surgical candidates due to wound infection and their
underlying debilitating disease.