Hyperbaric Oxygen Therapy and Vascular Complications in Diabetes Mellitus

Abstract

<jats:p> Vascular complications in patients with diabetes mellitus (DM) are common. Since impaired oxygen balance in plasma plays an important role in the pathogenesis of chronic DM-associated complications, the administration of hyperbaric oxygen therapy (HBOT) has been recommended to influence development of vascular complications. Hyperbaric oxygen therapy involves inhalation of 100% oxygen under elevated pressure from 1.6 to 2.8 absolute atmospheres in hyperbaric chambers. Hyperbaric oxygen therapy increases plasma oxygen solubility, contributing to better oxygen diffusion to distant tissues and preservation of the viability of tissues reversibly damaged by atherosclerosis-induced ischemia, along with microcirculation restoration. Hyperbaric oxygen therapy exerts antiatherogenic, antioxidant, and cardioprotective effects by altering the level and composition of plasma fatty acids and also by promoting signal transduction through membranes, which are impaired by hyperglycemia and hypoxia. In addition, HBOT affects molecules involved in the regulation of nitric oxide synthesis and in that way exerts anti-inflammatory and angiogenic effects in patients with DM. In this review, we explore the recent literature related to the effects of HBOT on DM-related vascular complications. </jats:p>

Changes in clinical and biochemical characteristics in combination treatment for diabetic macular edema

“…It has been reported that the use of HBO in type 2 DM reduced hypoxia in tissues, reduced blood glucose, increased insulin secretion, increased target cell insulin sensitivity, and normalized an imbalance of the antioxidant system [15,16]. Until recently, there have been limited reports on the use of HBO in DR.…”

“…Activation of oxidative processes causes the formation of a branched system protecting tissues from damage by aggressive oxygen radicals [superoxide anion radical (O2-), hydroxyl radical (HO-) and hydrogen peroxide Н2О2]. SOD family enzymes catalyze the dismutation of superoxide radicals into oxygen and hydrogen peroxide peroxide, and CAT catalyzes the conversion of hydrogen peroxide to water and molecular oxygen [11][12][13][14][15][16]. GSR provides restoration of the reduced form of glutathione [17], which significantly decreases the risk of oxidative stress.…”

“…A combined anti-VEGF and hyperbaric oxygen (HBO) therapy is a possible approach for improved efficacy of treating DME in non-proliferative DR (NPDR) in the presence of type 2 DM. It has been reported that the use of HBO in type 2 DM reduced hypoxia in tissues, reduced blood glucose, increased insulin secretion, increased target cell insulin sensitivity, and normalized an imbalance of the antioxidant system [15,16]. [19].…”

Integrated pancreatic microcirculatory profiles of streptozotocin‐induced and insulin‐administrated type 1 diabetes mellitus

“…It has been already known that heterogeneity in microcirculatory blood perfusion and inadequate transport of oxygen to the microcirculation are closely related to the pathogenesis, and the development of diabetes and its complications 7 . However, the role of oxidative stress and hypoxia in T1DM is still a controversy, especially in the onset of T1DM.…”

“…It has been already known that heterogeneity in microcirculatory blood perfusion and inadequate transport of oxygen to the microcirculation are closely related to the pathogenesis, and the development of diabetes and its complications. 7 However, the role of oxidative stress and hypoxia in T1DM is still a controversy, especially in the onset of T1DM. It is evident that hyperglycemia in T1DM individuals induces pathological alterations in endothelial cells, which may increase oxidative stress and contribute to endothelial dysfunction.…”