Diabetes is an increasing problem around the world. Vascular disease is one of the most common complications of diabetes. Because of this, wound healing in diabetics is a major health challenge. Short of curing and reversing diabetes, managing the complications would be much improved by the use of such technologies as pulsed electromagnetic fields (PEMFs). Because of the diabetic vascular disease and wound healing problems, 15% of diabetics eventually develop the disastrous and disabling problem of a foot ulcer, which, in 12% to 24% of cases, requires amputation.
Diabetes is the leading cause of non-injury-related lower leg and foot amputations in the United States. PEMF therapy initiated early in someone’s history of diabetes can be useful to prevent the development of vascular complications. Even if or when vascular problems become obvious, higher intensity local PEMF therapy should be strongly considered.
PEMF Promote White Blood Cells to Heal
Significant experimental scientific evidence has shown that PEMF therapy:
Encourages white blood cells to heal the endothelium (the linings of blood vessels)
Stimulates angiogenesis (the growth of new blood vessels) when there are blockages of blood vessels
Boosts the rapid growth of myofibroblasts and keratinocytes (cells necessary to build new blood vessels)
Improves the symptoms of diabetic peripheral neuropathy
Promotes diabetic wound healing
Human studies have shown that full body PEMFs stimulate mononuclear cells (tissue rebuilding cells) that promote angiogenesis and healing of chronic foot ulcers.
PEMF Study of Diabetic Foot Ulcer Healing
A study (Cañedo-Dorantes et al., 2015) was done to evaluate the use of specific PEMFs applied indirectly to different parts of the body to induce healing of diabetic foot ulcers. The study also evaluated whether exposing different volumes of circulating blood to electromagnetic fields would produce better results.
Procedure In the study, 26 diabetics whose diabetic foot ulcers had not been helped by conventional treatments were divided into two groups—a forearm group and a chest group—to receive treatment and record healing time. In both groups, 120 Hz sinusoidal wave PEMFs were applied twice a week for about 14 weeks or until complete healing was seen.
The forearm group received 8 gauss (0.8 milli-tesla) for 2 hours per treatment. The chest group received 6 gauss (0.6 milli-tesla) for 25 minutes per treatment. (Gauss and tesla are units that measure the strength of magnetic fields.)
Ulcer recurrences and adverse effects were investigated during short-term (less than 1 year) and long-term (3.4 years to 7.8 years) follow-up.
Results Healing time ranged from 28 days to 94 days (mean, 61 days) in the forearm group, and 34 days to 92 days (mean, 63 days) in the chest group. By the end of the 100-day treatment period, 88% of the diabetic foot ulcers in the forearm group were healed and 94% in the chest group.
There were no adverse effects or ulcer recurrences in the original ulcer site during treatment, during the short-term follow-up period, or during the long-term follow-up period in both groups. All participants with diabetic foot ulcers that healed during the study and were examined 3.4 to 7.8 years after treatment ended continued to show healed ulcer areas regardless of their electromagnetic stimulation regime or individual characteristics.
The size of the pool of circulating blood treated (chest versus forearm) did not appear to matter even though the treatment time for the chest was only 20% of the forearm time. Also, it’s quite possible that higher intensity PEMFs would have produced even better results.
Comparing the Healing Rates of PEMFs to Other Diabetic Ulcer Therapies
It would be helpful to have a sense of how well other therapies work versus PEMFs. Various studies have shown the following results:
Silver dressings: 22% to 31%
Graft materials: 30% to 56%
Platelet concentrates: 79%
Casting: 82% to 95%
PEMF therapy: 88% to 94%
Because each of these studies used different treatment periods, it’s easiest to speak about the percentage of healing during the time of the study. Most of these studies used 84 days for the study period; others used 56 days and 43 days. So, even the indirect approach to healing diabetic foot ulcers with these PEMFs produced a healing benefit comparable to—or better than—conventional therapies. This suggests common physiologic effects that result in the healing action.
Further Evidence Supporting PEMF Therapy
Recent evidence suggests that PEMFs stimulate certain cell receptors known as adenosine receptors that are on most types of white blood cells. White blood cells are needed to decrease inflammation and stimulate tissue healing. This research indicates that the optimal PEMF intensity to stimulate white blood cells is about 15 gauss (1.5 milli-tesla). So, stimulating white blood cells in the circulation can still impact ulcers away from the area of stimulation. It can also be expected that PEMF treatment of an ulcer directly, with or without whole body treatment, would get even better results and faster.
Conclusion
Routine whole body PEMF treatment is advisable for every diabetic to prevent or reduce vascular complications using a sufficient electromagnetic field intensity to adequately and routinely stimulate circulating white blood cells.
Reference
Cañedo-Dorantes L, Soenksen LR, García-Sánchez C, et al. Efficacy and safety evaluation of systemic extremely low frequency magnetic fields used in the healing of diabetic foot ulcers—phase II data. Arch Med Res. 2015 Aug;46(6):470-8.
Clinical trial on Vigo by St Mary's University in London reported multiple health benefits
糖尿病在全球範圍內成為一個不斷增加的問題。血管疾病是糖尿病最常見的併發症之一。因此，糖尿病患者的傷口癒合是一個重大的健康挑戰。在治愈和逆轉糖尿病之前，利用脈衝電磁場（PEMFs）等技術來管理併發症將會大大改善情況。特別是在糖尿病血管疾病和傷口癒合問題明顯的情況下，強烈建議考慮使用更高強度的局部PEMF治療。
PEMF 促進白血球癒合
重要的實驗科學證據顯示，PEMF治療可以：
促使白血球癒合血管內皮（血管內壁）
在血管阻塞時刺激血管新生（血管的生長）
促進肌纖維母細胞和角質細胞的快速生長（這些細胞對於建立新血管至關重要）
改善糖尿病周邊神經病變的症狀
促進糖尿病傷口癒合
人體研究表明，全身PEMF可以刺激單核細胞（組織重建細胞），促進慢性足部潰瘍的血管新生和癒合。
糖尿病足部潰瘍癒合的PEMF研究
一項研究（Cañedo-Dorantes et al., 2015）評估了使用特定PEMF間接應用於身體不同部位來促使糖尿病足部潰瘍癒合的效果。該研究還評估了將不同容積的循環血液暴露於電磁場中是否會產生更好的結果。
程序
在該研究中，將26名糖尿病患者，其足部潰瘍未經常規治療改善，分為前臂組和胸部組，接受治療並記錄治療時間。在兩個組中，每週兩次應用120 Hz正弦波PEMF，治療持續約14週或直到完全癒合為止。
前臂組每次治療接受8高斯（0.8毫特斯拉）治療2小時。胸部組每次治療接受6高斯（0.6毫特斯拉）治療25分鐘。 （高斯和特斯拉是測量磁場強度的單位。）
在短期（不到1年）和長期（3.4年至7.8年）的隨訪期間，對潰瘍復發和不良反應進行了調查。
結果
前臂組的癒合時間為28天至94天（平均61天），胸部組的癒合時間為34天至92天（平均63天）。在100天的治療期結束時，前臂組的88%糖尿病足部潰瘍癒合，胸部組的94%癒合。
在治療期間、短期隨訪期和長期隨訪期中，兩個組的原潰瘍部位都沒有出現不良反應或潰瘍復發。在研究期間癒合的糖尿病足部潰瘍參與者，在治療結束後經過3.4到7.8年的檢查，仍然顯示出癒合的潰瘍區域，不論其電磁刺激方案或個體特徵如何。
無論治療的循環血液池大小（胸部相比前臂）是否重要，即使胸部治療時間僅為前臂治療時間的20％。此外，更高強度的PEMF可能會產生更好的結果。
將PEMF的癒合速度與其他糖尿病潰瘍治療方法進行比較會有所幫助
各種研究顯示以下結果：
銀敷料：22％至31％
移植材料：30％至56％
血小板濃縮物：79％
石膏固定：82％至95％
PEMF治療：88％至94％
由於每個研究使用不同的治療期間，最容易談論研究期間內的癒合百分比。大多數研究使用84天的研究期；其他研究使用56天和43天。因此，即使是使用間接方法治療糖尿病足部潰瘍的PEMF，其癒合效果與或優於常規治療相當。這表明存在共同的生理作用，促使癒合。
進一步的證據支持PEMF治療
最近的證據表明，PEMF可以刺激一種稱為腺苷受體的特定細胞受體，該受體存在於大多數類型的白血球上。白血球對於減少發炎和刺激組織癒合是必需的。這項研究表明，刺激循環中的白血球可以對遠離刺激區域的潰瘍產生影響。可以預期，直接對潰瘍進行PEMF治療，無論是否結合全身治療，都可以獲得更好的結果並更快地癒合。
結論
建議每位糖尿病患者定期接受全身PEMF治療，以預防或減少血管併發症，使用足夠的電磁場強度充分且定期刺激循環中的白血球。