Ozone Therapy in Diabetes

(Complete Version)

According to the latest views, diabetes is characterized by dysmetabolism and a state of chronic oxidative stress. Of all diabetic patients, around 90% have type 2 diabetes, which tends to be progressive if an effective course of treatment is not taken. Type 2 diabetes is therefore a syndrome (characterized by the presence of multiple comorbidities), complicated by the continuous (and cumulative) presence of oxidative stress.

It is true that a careful diet, combined with moderate physical exercise and, of course, insulin/antidiabetic drugs, play an essential role in halting the progression of the disease. The problem arises when drug treatment, which is certainly effective, fails to normalize faulty metabolisms and accompany biochemical dysfunction, with progression to a chronic state of oxidative stress and the presence of complex anatomopathological lesions in various organs.

On the other hand, it is known that the concomitant use of oral antioxidants is safe, but not as effective as intended, and in the long term becomes practically incapable of normalizing the system redoxit is also known that if the Nrf2/Keap1 signaling pathways can be reactivated correctly, the balance can be re-established redox cellular at the physiological level and effectively protect the body against damage from the stress oxidative.

This is where the therapeutic potential of ozone has attracted a lot of attention, given its strong ability to induce controlled and moderate states of oxidative stress.
Scientific evidence has shown that it is capable of inducing the activation of the alpha subunit of hypoxia-inducible factor 1 (HIF1a), nuclear factor of activated T-cells (NFAT), nuclear factor erythroid 2-related factor 2 (Nrf2) and activator protein-1 (AP-1) metabolisms, and that these are the main mechanisms behind the effects of ozone therapy[i].
The activation of these molecular processes leads to up-regulation of endogenous antioxidant systems and the activation of immune functions, as well as the suppression of inflammatory processes, which is very important in correcting the oxidative stress present in diabetes.
In the treatment of diabetic foot (in topical application of ozone oils), there is a lot of evidence that it promotes healing, reduces the size of the ulcer and the risk of infection, as well as its antibacterial effect[ii].

Indications from 2018 are that, in addition to the significant improvement in healing observed, ozone therapy has a significant positive impact on patients’ quality of life and can be a valuable therapeutic option for patients with chronic wounds[iii]. Ozone therapy improves quality of life for diabetic patients[iv]shows efficacy in healing diabetic ulcers [v] and has the potential to be integrated into systemic treatments for diabetes with surprising and promising results[vi].

---

[i] Therapeutic relevance of ozone therapy in degenerative diseases: Focus on diabetes and spinal pain. J Cell Physiol. 2018 Apr;233(4):2705-2714. doi: 10.1002/jcp.26044.

[ii] The dual action of ozone on the skin. Br J Dermatol. 2005 Dec;153(6):1096-100.

[iii] Ozone therapy for the treatment of chronic wounds: A systematic review. Int Wound J. 2018 Aug;15(4):633-644. doi: 10.1111/iwj.12907.

[iv] Health-related quality of life in patients with chronic wounds before and after treatment with medical ozone. Medicine (Baltimore). 2018 Nov;97(48):e12505. doi: 10.1097/MD.0000000000012505.

[v] Efficacy of comprehensive ozone therapy in diabetic foot ulcer healing. Diabetes Metab Syndr. 2019 Jan – Feb;13(1):822-825. doi: 10.1016/j.dsx.2018.11.060.

[vi] An integrated medical treatment for type-2 diabetes. Diabetes Metab Syndr. 2014 Jan-Mar;8(1):57-61.