Abstract
Diabetes leads to widespread complications including pancreatic β-cell damage, nephropathy and impaired wound healing. Hyperbaric oxygen therapy (HBOT) has been shown to improve wound healing through induction of stem cell recruitment and the potential to inhibit progression of diabetic complications. We aimed to determine the efficacy of HBOT in wound healing and organ preservation in a diabetic rat model. Diabetes was induced in male Wistar rats (n = 10/group) using streptozotocin (20 mg/kg sc) daily for 3 days. A wound was inflicted on the skin over the back and the rats were given HBOT (2.3 ATA for 1 h/day) for 1, 3, 5, 7 or 10 days or were not treated. Blood glucose, pancreatic β-cell damage, diabetic nephropathy and wound healing progression were assessed. Diabetic rats not treated with HBOT had significantly higher blood glucose levels compared to controls (26.7 ± 3.3 mmol/L vs. 5.8 ± 0.4 mmol/L; P ≤ 0.05). This was associated with significant increase in the percentage of β-cell damage (72% ± 9% vs. 10% ± 2%; P ≤ 0.05) and diabetic nephropathy. HBOT for 3 days and longer in diabetic rats reduced hyperglycemia to control levels. Pancreatic β-cell damage was negligible in rats treated with HBOT for 5 days and longer while diabetic nephropathy was diminished in animals treated for 10 days. Similarly HBOT induced wound healing and accelerated epithelial closure from 5 days of HBOT. In summary, our findings show the efficacy of HBOT in this diabetic rat model. There was significant reduction of hyperglycemia and inhibition of diabetic complications in the form of preservation of pancreatic and kidney structure and accelerated wound healing.
Highlights
Diabetes affects people worldwide and is currently viewed as the major epidemic of this century
We investigated the capacity of Hyperbaric oxygen therapy (HBOT) to inhibit the progression of diabetic complications including organ preservation and wound healing
No significant difference in the blood glucose level was found in HBOT diabetic rats from Day 3 onwards compared to control nontreated non-diabetic rats (Figure 2)
Summary
Diabetes affects people worldwide and is currently viewed as the major epidemic of this century. By 2030, it is predicted that the number of diabetes sufferers will increase by 20% in developed countries and by 70% in developing countries [4] [5] It is a major independent risk factor for cardiovascular disease with up to 10 fold increased risk of cardiovascular events compared to age-matched non-diabetic patients. The condition affects stem cell function contributing to poor wound healing and low grade chronic inflammation This is manifested in multiple diabetic complications including pancreatic β-cell damage, retinopathy, neuropathy, nephropathy, atherosclerosis and myocardial infarction [12]. Diabetic foot ulcers are estimated to occur in 15% of all patients with diabetes and are the leading cause of hospital admissions for people with diabetes in developed countries [14]. Foot ulcers are a major diabetic associated morbidity often leading to a poor quality of life and precede most diabetes related lower leg amputations [4]
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