Is Hyperbaric Oxygen Therapy Safe for Diabetics?
HBOT is one of the most studied treatments for diabetic foot wounds. But blood glucose monitoring is important during treatment. Here's what diabetic patients need to know.
Is Hyperbaric Oxygen Therapy Safe for Diabetics?
Yes. HBOT is used specifically for diabetic patients. One of its primary FDA-approved indications is diabetic lower-extremity wounds. Diabetic wound care is one of the most common reasons people get HBOT.
But diabetes changes how the body responds to treatment. A few things need monitoring.
Blood Glucose: HBOT Can Lower It
HBOT has a glucose-lowering effect. For insulin-dependent diabetics, this means hypoglycemia is a real risk during or after sessions, especially if you came to the appointment fasting or with borderline glucose levels.
Check your blood glucose before each session. Don’t come in hypoglycemic. A light meal an hour or two before your appointment is recommended.
Talk to your care team about timing of insulin doses on treatment days. Some adjustments may be needed.
Your clinic will likely monitor your glucose as well, but check it yourself before leaving home.
Medicare Threshold: Wagner Grade III
Medicare covers HBOT for diabetic lower-extremity wounds that meet the Wagner Grade III or higher classification. This means the wound has reached bone, tendon, or joint capsule involvement with osteomyelitis or abscess — not just a surface ulcer.
Your wound care physician grades the wound. Grade III requires 30 days of standard wound care that hasn’t resulted in adequate healing before HBOT is approved.
See the Wagner grade classification guide for the full breakdown of the 0-5 scale.
Vision Changes: A Known Side Effect in Diabetics
HBOT can cause temporary nearsightedness (myopia), particularly in longer protocols of 40+ sessions. This effect is more common in older adults and diabetic patients.
Your vision may shift during a treatment course and return to baseline after treatment ends. This is documented and expected. Don’t update your glasses prescription during an active HBOT course. Tell your eye doctor you’re in treatment before any vision appointments.
Neuropathy and Ear Equalization
Patients with significant diabetic peripheral neuropathy may not feel pressure changes in their ears the way other patients do. The discomfort that normally signals a need to equalize may be reduced.
Tell the staff about significant neuropathy. They’ll monitor pressurization carefully and check in with you more frequently during pressurization.
Daily Foot Inspection Still Matters
This sounds obvious, but diabetic wound patients in HBOT sometimes focus entirely on the chamber and forget that standard wound care continues alongside it. Inspect your feet daily. Keep up with your wound care dressings and protocols. HBOT improves oxygen delivery to tissue — it doesn’t replace the rest of your wound care plan.
FAQ
Q: Is HBOT safe for diabetic patients? Yes. It’s FDA-approved for diabetic lower-extremity wounds. Blood glucose monitoring before sessions is important.
Q: Can HBOT lower blood sugar? Yes. Monitor glucose before each session. Don’t arrive fasting. Discuss insulin timing with your care team.
Q: Does Medicare cover HBOT for diabetic wounds? Medicare may cover it for Wagner Grade III or higher wounds after 30 days of failed standard wound care. Verify rates with your facility’s billing team — they change annually.
Q: Can HBOT affect vision in diabetics? Yes. Temporary nearsightedness can occur, more commonly in diabetics. It reverses after treatment ends.
Related: Diabetic Wounds and HBOT | Side Effects of HBOT | Insurance Coverage for HBOT
Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Hyperbaric oxygen therapy must be prescribed and supervised by a licensed physician. Always consult your care team about your specific situation. This site does not establish a doctor-patient relationship.