Heyboer Iii M, Wojcik SM, Swaby J, Boes T, et al.
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc. Date of publication 2019 Jan 1;volume 46(4):437-445.
1. Undersea Hyperb Med. 2019 Jun-Jul-Aug - Third Quarter;46(4):437-445.
Blood glucose levels in diabetic patients undergoing hyperbaric oxygen therapy.
Heyboer Iii M(1), Wojcik SM(1), Swaby J(1), Boes T(1).
Author information:
(1)Department of Emergency Medicine, Division of Hyperbaric Medicine and Wound
Care, SUNY Upstate Medical University, Syracuse, New York U.S.
INTRODUCTION: To determine if hyperbaric oxygen (HBO2) therapy has an effect on
diabetic blood glucose levels (BGL) and, if so, the extent of this effect. Also,
to examine factors that exacerbate any observed effect.
METHODS: This was a retrospective review of prospectively collected quality data
on diabetics undergoing HBO2. Pre- and post-treatment BGL were recorded.
Pre-treatment BGL ⟨120 mg/dL received glucose supplementation. Hypoglycemia was
defined as BGL ⟨70 mg/dL. BGL ⟨90 mg/dL was included as an elevated hypoglycemia
threshold.
RESULTS: 77 patients representing 1,825 treatments were included for analysis.
No patient had deleterious side effects or required emergency care. BGL
decreased in 75.4% of treatments in this group, with a median decrease of 25
mg/dL (IQR=54 mg/dL; range of decreased 374 mg/dL to increased 240 mg/dL). A
statistically significant greater percentage of treatments of patients with type
2 diabetes resulted in a decrease in BGL (1598 or 77.5%) compared to treatments
of patients with type 1 diabetes (169 or 51.5%) (χ2(1, N=1767) =55.37, p⟨0.001).
1.1% of treatments had post-HBO2 serum glucose ⟨90 mg/dL, and 0.2% of treatments
had post-HBO2 serum glucose ⟨70 mg/dL. The majority (70%) of patients with
post-HBO2 BGL ⟨90 mg/dL were maintained on insulin alone (χ2(2, N=20) =12.4,
p=0.002). Well-controlled diabetics (i.e., those with all BGLs within 50 mg/dL
over all pre-HBO2 treatments) had no post-HBO2 BGL ⟨70 mg/dL or ⟨90 mg/dL.
CONCLUSION: Our results suggest that HBO2 does not cause a clinically
significant decrease in diabetic patient BGL. No patient in our study had
deleterious side effects or required emergency care. We found that glucose level
of ⟨90 mg/dL occurred more often in those who use insulin. Hyperbaric patients
who exhibit consistent BGL values may represent a group who could be managed
similarly to the non-diabetic population.
Copyright© Undersea and Hyperbaric Medical Society.
PMID: 31509900 [Indexed for MEDLINE]
Conflict of interest statement: The authors of this paper declare no conflicts
of interest exist with this submission.
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