Effect of Carbon Dioxide Therapy on Diabetic Foot Ulcer
Affiliation(s)
Faculty of Pharmacy and Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan.
Faculty of Pharmacy and Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan.
ABSTRACT
Ulceration of diabetic foot represents one of the most concerning complications associated with uncontrolled blood sugar in diabetes mellitus. The aim of this study is to evaluate the condition of twenty-two diabetic patients with different degrees of ulceration in their feet after daily secessions of carbon dioxide therapy. Blood flow to the affected foot was measured by Doppler; also the size, color, degree of ulceration and sensation of the ulcerative area were all evaluated. Results showed improvement of blood flow to the affected foot as well as improvement in the sensation and color of the ulcerative area. It was concluded that carbon dioxide therapy of diabetic foot was promising and needed thorough investigation to be brought widely into application.
Ulceration of diabetic foot represents one of the most concerning complications associated with uncontrolled blood sugar in diabetes mellitus. The aim of this study is to evaluate the condition of twenty-two diabetic patients with different degrees of ulceration in their feet after daily secessions of carbon dioxide therapy. Blood flow to the affected foot was measured by Doppler; also the size, color, degree of ulceration and sensation of the ulcerative area were all evaluated. Results showed improvement of blood flow to the affected foot as well as improvement in the sensation and color of the ulcerative area. It was concluded that carbon dioxide therapy of diabetic foot was promising and needed thorough investigation to be brought widely into application.
Cite this paper
Shalan, N. , Al-Bazzaz, A. , Al-Ani, I. , Najem, F. and Al-Masri, M. (2015) Effect of Carbon Dioxide Therapy on Diabetic Foot Ulcer. Journal of Diabetes Mellitus, 5, 284-289. doi: 10.4236/jdm.2015.54035.
Shalan, N. , Al-Bazzaz, A. , Al-Ani, I. , Najem, F. and Al-Masri, M. (2015) Effect of Carbon Dioxide Therapy on Diabetic Foot Ulcer. Journal of Diabetes Mellitus, 5, 284-289. doi: 10.4236/jdm.2015.54035.
References
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http://dx.doi.org/10.1007/s00125-003-1274-6 [13] Wallace, C., Reiber, G.E., LeMaster, J., et al. (2002) Incidence of Falls, Risk Factors for Falls, and Fall-Related Factures in Individuals with Diabetes and a Prior Foot Ulcer. Diabetes Care, 25, 1983-1986.
http://dx.doi.org/10.2337/diacare.25.11.1983 [14] Lipsky, B.A. (2004) A Report from the International Consensus on Diagnosing and Treating the Infected Diabetic Foot. Diabetes/Metabolism Research and Reviews, 20, 68-77.
http://dx.doi.org/10.1002/dmrr.453 [15] Lipsky, B.A., Picoreto, R.E. and Wheat, L.J. (1990) The Diabetic Foot: Soft Tissue and Bone Infection. Infectious Disease Clinics of North America, 4, 409-432. [16] Gerding, D.N. (1995) Foot Infections in Diabetic Patients: The Role of Anaerobes. Clinical Infectious Diseases, 20, 83-88.
http://dx.doi.org/10.1093/clinids/20.Supplement_2.S283 [17] Sapico, F.I., Witte, J.L., Canawati, H.N., Montogomerie, J.Z. and Bessman, A.N. (1984) The Infected Foot of the Diabetic Patient: Quantitative Microbiology and Analysis of Clinical Features. Reviews of Infectious Diseases, 6, 171-176.
http://dx.doi.org/10.1093/clinids/6.Supplement_1.S171 [18] Caputo, G.M., Gavanagh, P.R., Ulbrech, J.S., Gibbones, G.W. and Karchmer, A.W. (1994) Assessment and Management of Foot Diseases in Patients with Diabetes. The New England Journal of Medicine, 331, 853-860.
http://dx.doi.org/10.1056/NEJM199409293311307 [19] Joshi, N., Caputo, G., Weitekamp, M. and Karchmer, A. (1999) Infections in Patients with Diabetes Mellitus. The New England Journal of Medicine, 341, 1906-1912.
http://dx.doi.org/10.1056/NEJM199912163412507 [20] Alavil, S.M., Khosravi, A.D., Sarami, A., Dashtebozorg, D. and Montazeri, E.A. (2007) Bacteriologic Study of Diabetic Foot Ulcers. Pakistan Journal of Medical Sciences, 23, 681-684. [21] Alnaeb, M.E., Crabtree, V.P., Boutin, A., Mikhailidis, D.P., Seifalian, A.M. and Hamilton, G. (2007) Prospective Assessment of Lower-Extremity Peripheral Arterial Disease in Diabetic Patients Using a Novel Automated Optical Device. Angiology, 58, 579-585.
http://dx.doi.org/10.1177/0003319707305685 [22] Zenker, B. (2012) Carboxytherapy: Carbon Dioxide Injections in Aesthetic Medicine.
http://www.plastikoperationer.net/wp-content/uploads/2013/02/Carboxy-therapy-report.pdf [23] Hayashi, M.S., Yamada, S., Kumada, Y., Matsuo, H., Toriyama, T. and Kawahara, H. (2008) Immersing Feet in Carbon Dioxide-Enriched Water Prevents Expansion and Formation of Ischemic Ulcers after Surgical Revascularization in Diabetic Patients with Critical Limb Ischemia. Annals of Vascular Diseases, 1, 111-117.
http://dx.doi.org/10.3400/avd.AVDoa08001 [24] Pamela, C. and Richard, A. (2005) Lippincott’s Illustrated Review: Biochemistry. 3rd Edition, Lippincott Williams & Wilkins, New York. [25] Ziche, M., Morbidelli, L., Masini, E., Amerini, S., Granger, H.J., Maggi, C.A., Geppetti, P. and Ledda, F. (1994) Nitric oxide Mediates Angiogenesis in Vivo and Endothelial Cell Growth and Migration in Vitro Promoted by Substance P. Journal of Clinical Investigation, 94, 2036-2044.
http://dx.doi.org/10.1172/JCI117557 [26] Penhavel, M.V., Nascimento, V.H., Duraes, E.F., Carneiro, F.P. and Sousa, J.B. (2013) Effects of Carbon Dioxide Therapy on the Healing of Acute Skin Wounds Induced on the Back of Rats. Acta Cirurgica Brasileira, 28, 334-339.
[1] Kumar, P.J. and Clark, M. (2002) Textbook of Clinical Medicine. 8th Edition, Saunders, London. [2] American Diabetes Association (2009) Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 32, 62-67.
http://dx.doi.org/10.2337/dc09-S062 [3] Beverley, B. and Eschwège, E. (2003) The Diagnosis and Classification of Diabetes and Impaired Glucose Tolerance. In: Pickup, J.C. and Williams, G., Eds., Textbook of Diabetes, 3rd Edition, Blackwell Publishing, UK, 2.1-2.11. [4] Lindberg, G., Lindblad, U. and Melander, A. (2004) Sulfonylureas for Treating Type 2 Diabetes Mellitus. Cochrane Database of Systematic Reviews, 3, 151-155. [5] Bearse, M.A., Han, T., Schneck, M.E., et al. (2004) Local Multifocal Oscillatory Potential Abnormalities in Diabetes and Early Diabetic Retinopathy. Investigative Ophthalmology & Visual Science, 45, 3259-3265.
http://dx.doi.org/10.1167/iovs.04-0308 [6] Hove, M.N., Kristensen, J.K., Lauritzen, T. and Bek, T. (2004) The Prevalence of Retinopathy in an Unselected Population of Type 2 Diabetes Patients from Arhus County, Denmark. Acta Ophthalmologica Scandinavica, 82, 443-448.
http://dx.doi.org/10.1111/j.1600-0420.2004.00270.x [7] Seki, M., Tanaka, T., Nawa, H., et al. (2004) Involvement of Brain-derived Neurotrophic Factor in Early Retinal Neuropathy of Streptozotocin-Induced Diabetes in Rats: Therapeutic Potential of Brain-Derived Neurotrophic Factors for Dopaminergic Amacrine Cells. Diabetes, 53, 2412-2419.
http://dx.doi.org/10.2337/diabetes.53.9.2412 [8] Moran, A., Palmas, W., Field, L., et al. (2004) Cardiovascular Autonomic Neuropathy Is Associated with Microalbuminuria in Older Patients with Type 2 Diabetes. Diabetes Care, 27, 972-977.
http://dx.doi.org/10.2337/diacare.27.4.972 [9] Huang, C., Kim, Y., Caramori, M.L., et al. (2002) Cellular Basis of Diabetic Nephropathy: II. The Transforming Growth Factor-Beta System and Diabetic Nephropathy Lesions in Type 1 diabetes. Diabetes, 51, 3577-3581.
http://dx.doi.org/10.2337/diabetes.51.12.3577 [10] Shukla, N., Angelini, G.D., Jeremy, J.Y., et al. (2003) Homocysteine as a Risk Factor for Nephropathy and Retinopathy in Type II Diabetes. Diabetologia, 46, 766-772.
http://dx.doi.org/10.1007/s00125-003-1104-x [11] Svensson, M., Eriksson, J.W. and Dahlquist, G. (2004) Early Glycemic Control, Age at Onset, and Development of Microvascular Complications in Childhood-Onset Type 1 Diabetes: A Population-Based Study in Northern Sweden. Diabetes Care, 27, 955-962.
http://dx.doi.org/10.2337/diacare.27.4.955 [12] Saely, C.H., Aczel, S., Marte, T., et al. (2004) Cardiovascular Complications in Type 2 Diabetes Mellitus Depend on the Coronary Angiographic State Rather than on the Diabetes State. Diabetologia, 47, 145-146.
http://dx.doi.org/10.1007/s00125-003-1274-6 [13] Wallace, C., Reiber, G.E., LeMaster, J., et al. (2002) Incidence of Falls, Risk Factors for Falls, and Fall-Related Factures in Individuals with Diabetes and a Prior Foot Ulcer. Diabetes Care, 25, 1983-1986.
http://dx.doi.org/10.2337/diacare.25.11.1983 [14] Lipsky, B.A. (2004) A Report from the International Consensus on Diagnosing and Treating the Infected Diabetic Foot. Diabetes/Metabolism Research and Reviews, 20, 68-77.
http://dx.doi.org/10.1002/dmrr.453 [15] Lipsky, B.A., Picoreto, R.E. and Wheat, L.J. (1990) The Diabetic Foot: Soft Tissue and Bone Infection. Infectious Disease Clinics of North America, 4, 409-432. [16] Gerding, D.N. (1995) Foot Infections in Diabetic Patients: The Role of Anaerobes. Clinical Infectious Diseases, 20, 83-88.
http://dx.doi.org/10.1093/clinids/20.Supplement_2.S283 [17] Sapico, F.I., Witte, J.L., Canawati, H.N., Montogomerie, J.Z. and Bessman, A.N. (1984) The Infected Foot of the Diabetic Patient: Quantitative Microbiology and Analysis of Clinical Features. Reviews of Infectious Diseases, 6, 171-176.
http://dx.doi.org/10.1093/clinids/6.Supplement_1.S171 [18] Caputo, G.M., Gavanagh, P.R., Ulbrech, J.S., Gibbones, G.W. and Karchmer, A.W. (1994) Assessment and Management of Foot Diseases in Patients with Diabetes. The New England Journal of Medicine, 331, 853-860.
http://dx.doi.org/10.1056/NEJM199409293311307 [19] Joshi, N., Caputo, G., Weitekamp, M. and Karchmer, A. (1999) Infections in Patients with Diabetes Mellitus. The New England Journal of Medicine, 341, 1906-1912.
http://dx.doi.org/10.1056/NEJM199912163412507 [20] Alavil, S.M., Khosravi, A.D., Sarami, A., Dashtebozorg, D. and Montazeri, E.A. (2007) Bacteriologic Study of Diabetic Foot Ulcers. Pakistan Journal of Medical Sciences, 23, 681-684. [21] Alnaeb, M.E., Crabtree, V.P., Boutin, A., Mikhailidis, D.P., Seifalian, A.M. and Hamilton, G. (2007) Prospective Assessment of Lower-Extremity Peripheral Arterial Disease in Diabetic Patients Using a Novel Automated Optical Device. Angiology, 58, 579-585.
http://dx.doi.org/10.1177/0003319707305685 [22] Zenker, B. (2012) Carboxytherapy: Carbon Dioxide Injections in Aesthetic Medicine.
http://www.plastikoperationer.net/wp-content/uploads/2013/02/Carboxy-therapy-report.pdf [23] Hayashi, M.S., Yamada, S., Kumada, Y., Matsuo, H., Toriyama, T. and Kawahara, H. (2008) Immersing Feet in Carbon Dioxide-Enriched Water Prevents Expansion and Formation of Ischemic Ulcers after Surgical Revascularization in Diabetic Patients with Critical Limb Ischemia. Annals of Vascular Diseases, 1, 111-117.
http://dx.doi.org/10.3400/avd.AVDoa08001 [24] Pamela, C. and Richard, A. (2005) Lippincott’s Illustrated Review: Biochemistry. 3rd Edition, Lippincott Williams & Wilkins, New York. [25] Ziche, M., Morbidelli, L., Masini, E., Amerini, S., Granger, H.J., Maggi, C.A., Geppetti, P. and Ledda, F. (1994) Nitric oxide Mediates Angiogenesis in Vivo and Endothelial Cell Growth and Migration in Vitro Promoted by Substance P. Journal of Clinical Investigation, 94, 2036-2044.
http://dx.doi.org/10.1172/JCI117557 [26] Penhavel, M.V., Nascimento, V.H., Duraes, E.F., Carneiro, F.P. and Sousa, J.B. (2013) Effects of Carbon Dioxide Therapy on the Healing of Acute Skin Wounds Induced on the Back of Rats. Acta Cirurgica Brasileira, 28, 334-339.