What it is
Hyperbaric oxygen therapy, often called HBOT, involves breathing oxygen inside a pressurized chamber. The pressure is higher than normal air pressure, which allows the body to take in more oxygen than it usually does. Chambers may be single-person or larger rooms for multiple people.
A diabetic ulcer, most often found on the foot, is an open sore that can develop when diabetes affects circulation, nerve sensation, or the skin's ability to repair itself. Because these wounds can be slow to heal and may become infected, they are usually managed by a care team rather than a single provider.
The FDA has cleared HBOT for a limited list of indications, and certain diabetic foot ulcers are among them. That does not mean it fits every diabetic ulcer. Whether a person is considered a candidate depends on an individual evaluation by a licensed clinician.
How it’s traditionally been approached
Diabetic ulcer care has traditionally centered on the basics: assessing the wound, checking blood flow, managing blood sugar with the person's medical team, keeping pressure off the area, and removing non-healing tissue. Dressings are chosen to suit the wound's needs.
HBOT has generally been considered as an add-on, not a first step. Clinicians often look at how long a wound has been present, how deep it is, whether standard care has already been in place, and whether other factors such as infection or poor circulation need attention first.
Clinics and payers often use specific criteria to decide who qualifies. These criteria can include a wound's classification and its history. Requirements differ from one provider and insurer to another, so they are worth asking about directly.
How the right wound care specialist may help
A wound care specialist may be able to evaluate the ulcer, look at what may be slowing healing, and explain whether HBOT is something to discuss. A visit often includes a review of health history, a wound examination, and questions about current care, footwear, and daily activities.
If HBOT is considered, the clinician may also review other health factors, such as heart, lung, or ear conditions, because the chamber environment is not right for everyone. The specialist may coordinate with your primary care provider, endocrinologist, or other team members.
Questions worth asking a licensed provider: What is the cause and stage of my wound? Am I a candidate for HBOT, and why or why not? What other options exist? What is the expected healing time? What would insurance coverage look like, and what approvals are needed? Results are never guaranteed, and a good provider will say so.
The whole-person view
Living with a slow-healing wound can be tiring and stressful. Worry, poor sleep, and low mood can affect daily routines, and the body's stress response can in turn affect how a person feels physically. Body, mind, and stress influence each other, so caring for the whole person matters alongside caring for the wound.
Some people find body-based support, such as the approaches offered by Somatic Experiences, helpful for easing tension and stress. Others value talking with a licensed counselor through a resource like Therapists.plus. These are complements to medical care, not replacements for it.
Somatic Experiences: trauma and emotional healing →Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- HBOT is FDA-cleared only for certain indications, and being a candidate depends on a licensed clinician's evaluation of your specific wound and health.
- Seek medical care promptly for signs of infection, such as spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever, or chills, or if a wound is rapidly worsening.
- For emergencies such as heavy bleeding, exposed bone or tendon, or signs of sepsis, call 911 or go to the nearest ER. If you are in emotional crisis, call or text 988.
- Licensed professionals should guide all wound and diabetes care; this page does not diagnose or recommend treatment.
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Frequently asked questions
Who are typical hbot candidates for a diabetic ulcer?
Typical hbot candidates for a diabetic ulcer are people whose wounds meet criteria a clinician uses, often involving a wound that has not improved with standard care. Only a licensed provider can decide after an evaluation. Criteria vary between clinics and insurers.
Is HBOT FDA-cleared for diabetic foot ulcers?
HBOT is FDA-cleared for certain diabetic foot ulcers, among a limited list of indications. It is not cleared for every wound or condition. Ask your provider how your wound fits.
Does HBOT replace standard diabetic ulcer care?
No, HBOT is generally considered an addition to standard wound care, not a replacement. Wound assessment, pressure relief, infection management, and blood sugar care with your medical team remain important.
Will HBOT heal my diabetic ulcer?
No one can promise that. HBOT may help some people as part of a broader plan, but outcomes vary with the wound and the person's overall health. A provider can explain what is realistic.
Is HBOT covered by insurance for a diabetic ulcer?
Coverage differs by payer, plan, and the wound's documented details. Many plans require approval in advance. Ask the clinic and your insurer what is needed before starting.
Who might not be a good candidate for HBOT?
Some health conditions, such as certain lung, heart, or ear problems, may make HBOT unsuitable. A licensed clinician reviews these during evaluation. Be sure to share your full health history.
Educational resource. WoundKare shares general information and connects people with independent wound care specialists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.