Ozone therapy for diabetes

At a Glance:

1. Although diabetes is becoming increasingly common and there are many drugs available, about half of US and Canadian cases remain poorly controlled. This indicates the need for better integrative care that involves diet and exercise, and options such as ozone therapy.
2. Diabetic complications can be painful, debilitating, and costly. Aside from managing blood sugar and blood pressure, effective conventional treatments tend to be limited to symptom management. 
3. Ozone therapy can temporarily improve insulin sensitivity, stimulate beta cell regeneration, normalize blood lipids, and increase insulin production.
4. Ozone-oxygen therapy can address several aspects of diabetes not currently addressed by standard of care protocols. These aspects include boosting tissue oxygenation and circulation, resetting antioxidant defense, modulating inflammation, and improving mitochondrial functions. 
5. By resetting antioxidant defense, improving tissue oxygenation, and modulating immune response, ozone therapy might be more effective at treating hard-to-treat infections in diabetes, such as diabetic ulcers. 
6. Various clinical trials have shown benefits of ozone therapy for diabetic eye and ear complications, and neuropathy.
7. In conclusion, ozone therapy should be considered as part of a diabetic management toolbox, whether on its own or in combination with standard-of-care treatments. 

Diabetes is a chronic condition that is becoming more prevalent. It can be hard to manage, and have long-term painful and costly complications. While genetics and family history play a significant role in the development of diabetes, many modifiable factors influence this disease’s onset and progression [1]. 

There is already a cure for type 2 diabetes: diet and exercise. ~6% of American diabetics go into remission after weight loss through caloric deficits and lifestyle changes. They no longer need diabetes medications to manage their blood sugar [2]. Since 90% of blood sugar regulation involves muscle mass, muscle building and resistance training is beneficial and can put type 2 diabetes into remission [3].

Unlike pills, however, prescribing diet and exercise and getting people to follow through is tricky and never taught in medical school. Also, since diet and exercise do not generate pharmaceutical revenue, doctors tend to prescribe medications first. Even the American Diabetes Association has only recently (in 2020) started recommended low-carb diets as many patients put their diabetes into remission by eating less carbs [4].

Although there are numerous diabetes medications on the market, only about half of American and Canadian patients reach target blood sugar levels even when using them [5]. Also, one in 10 don’t reach minimal controls or remain with HbA1C > 9% even with specialist care. As a result, diabetes complications remain a common concern. It’s no wonder newer and more expensive drugs continue to enter the market. 

Ozone therapy remains secondary to diet and exercise, and even medications, for diabetes management. However, ozone therapy may be uniquely beneficial for managing diabetes and its complications beyond what conventional medicine can do. Unlike conventional diabetes treatments, ozone-oxygen therapy improves tissue oxygenation and helps with hard-to-treat infections. Therefore, ozone therapy should be considered as a tool in any diabetes care toolbox. In this article, we will explore how ozone therapy can be beneficial for diabetes and diabetic complications.

How Ozone Therapy Can Uniquely Help Diabetes

Most people know that those with type 2 diabetes (T2DM) have high blood sugar due to insulin resistance, whereas type 1 diabetes (T1DM) is typically an autoimmune disease that attacks and destroys insulin-producing beta cells in the pancreas. Therefore, treatments for type 2 diabetics are typically an insulin sensitizer drug, while type 1 diabetics need insulin. 

Now, that’s not the whole story for both types of diabetes. Research has discovered many other aspects of diabetes pathology that are not yet addressed in modern medicine. These unaddressed dysfunctions may explain why some cases struggle to get their blood sugar under control with standard medications.  

In this section, we’ll discuss both commonly and lesser known aspects of diabetes that ozone therapy might help with [6].

Improves insulin sensitivity and fasting glucose levels

Insulin resistance is a key feature of T2DM, where the body's cells become less responsive to insulin. 

Normally, insulin facilitates the uptake of glucose into cells for energy production or storage. In insulin resistance, there is reduced glucose uptake into the muscle, fat, and liver cells. 

This insulin resistance often results from a complex interplay of factors that interfere with insulin signals, including [7]:

• Excess fatty acids in the blood
• Inflammatory cytokines
• Adipokines, or hormone-like proteins from fat cells

Over time, the pancreas compensates by producing more insulin. However, this compensation can eventually fail as the overworked pancreas can no longer catch up, leading to persistent high blood sugar levels and the onset of T2DM [8].

How ozone-oxygen therapy helps with insulin resistance and glycemic control

Ozone-oxygen IV therapy works by infusing blood with a mix of >95% oxygen combined with ozone. This enhances tissue oxygenation, similar to hyperbaric oxygen (HBO) therapy. Since there is limited published evidence on how ozone therapy reduces blood sugar, we’ll extrapolate from hyperbaric and animal studies. 

Hyperbaric oxygen therapy, now a widely-used treatment for diabetic ulcers, tends to reduce blood sugar, according to a systematic review of 10 clinical studies. In fact, most hyperbaric treatment protocols now involve steps to prevent hypoglycemia during the treatment. The systematic review suggests that this drop in blood sugar could be due to both increased insulin secretion and insulin sensitivity [9].

In diabetic mice, HBO therapy (100% oxygen at 2.0 ATA for one hour daily for a week) significantly reduced fasting blood glucose levels and improved insulin sensitivity (p<0.01). HBO increased the production of GLUT4, a protein primarily responsible for bringing glucose into the cells in response to insulin. HBO stimulated AMPK phosphorylation and UCP1 expression in brown adipose tissue – both markers of glucose breakdown and usage. 

HBO therapy also doubled pancreatic beta cell mass, the area responsible for secreting insulin. These findings suggest that HBO enhances insulin sensitivity by modulating glucose transport and metabolism in diabetic mice [10].

In another rat study, ozone-oxygen gas injected into the abdominal cavity of diabetic rats significantly enhanced the effects of insulin at reducing fasting blood sugar and HbA1c  [11].

In another rat study, ozone rectal insufflation aimed to treat diabetic foot ulcers also improved blood sugar control [12].

In conclusion, ozone therapy may temporarily enhance insulin sensitivity and lower fasting glucose levels in diabetic patients. 

Boosts mitochondrial function

Mitochondria are vital organelles (little organs) within cells responsible for producing most of your cellular energy as adenosine triphosphate (ATP). In addition, your mitochondria detect dangers or oxidative damage, and dials down your cellular energy or kills the damaged cells accordingly. 

Mitochondrial dysfunction is when the mitochondria cannot produce enough energy either due to excess oxidative stress, cellular damage, or other detected dangers. 

High blood sugar typically increases oxidative stress. However, mitochondrial dysfunction as part of cellular aging can contribute to type 2 diabetes.

In type 2 diabetics, mitochondrial dysfunction contributes to:

• Lower beta cell capacity, thus reducing insulin production
• Lower insulin response in muscles, fat, and heart cells [13] 
• Poor healing in end tissues that tend to develop diabetic complications, such as nerve endings [14] 
• More oxidative stress that perpetuates more insulin resistance and tissue damage
• Fatigue, brain fog, and cognitive decline

How ozone-oxygen therapy helps with mitochondrial dysfunction

By providing oxygen and resetting the cellular antioxidant defense, ozone therapy can enhance mitochondrial function. This is crucial for managing diabetes and its complications. 

A clinical trial investigated the impact of ozone-high-dose therapy (OHT) on mitochondrial function in six healthy patients. Over one week, the patients received OHT twice. The Bioenergetic Health Index (BHI) in peripheral blood mononuclear cells (PBMC) was assessed, showing significant improvement after treatment. 

The increase was primarily due to enhanced mitochondrial reserve capacity and maximum respiration. An increase in non-mitochondrial oxygen consumption indicated activation of antioxidant and detoxifying enzymes via the Nrf-2 pathway. These findings suggest that OHT could be a safe and effective therapy for diseases involving mitochondrial dysfunction, including diabetes [15].

Improves tissue oxygenation and circulation

When diabetes is poorly controlled, resulting in persistently high blood sugar, both types of diabetes can have complications related to lack of blood flow and insufficient oxygen.

High blood sugar can affect both small (microvascular) and large (macrovascular) blood vessels [16]. The elevated glucose and oxidative stress damages the inner lining of blood vessels, leading to reduced nitric oxide availability. This impairs the blood vessels’ flexibility and ability to relax to allow more blood flow. 

The membrane around small blood vessels thickens, reducing oxygen and nutrient delivery to tissues. These can lead to common diabetic complications, such as:

• Eye problems such as diabetic retinopathy, cataracts, and glaucoma
• Ear problems such as hearing loss
• Kidney disease
• Nerve damage, either in the limbs or nerves that control vital organs
• Limb infections and diabetic ulcers

Whereas, in large blood vessels, the damage from high blood sugar along with elevated lipids and cholesterol can significantly increase cardiovascular risk [17, 18].

How ozone therapy helps with oxygenation and circulation in diabetes

Ozone therapy can enhance circulation and oxygenation in diabetic patients by:

• Dilating blood vessels
• Improving red blood cell flexibility
• Boosting nitric oxide production

These three changes enhance tissue oxygenation and promote overall vascular health. This can significantly improve the quality of life for diabetics and mitigate complications associated with poor circulation.

Clinically, this can lead to improved wound healing and lower risk of foot ulcers and limb amputations. Symptomatically, patients might experience less pain and swelling in extremities, along with improved mobility. 

A randomized controlled trial investigated the efficacy of ozone therapy in treating diabetic foot ulcers (DFUs) in 200 patients aged 18-85. Patients were divided into two groups: one received standard DFU care plus ozone therapy, while the other received only routine care. 

Wound size, wound grade, healing time, blood sugar levels, and inflammatory biomarkers were tracked throughout the course of the study.

The ozone group showed complete wound closure, with significantly shorter healing times compared to the control group (p < 0.05). The average healing time in the ozone group was 69.44 days. These results suggest that ozone therapy is effective in promoting DFU healing and reducing infection and amputation risks [19].

Mitigates oxidative stress

In type 2 diabetes and poorly-controlled type 1 diabetes, oxidative stress is elevated due to high blood sugar and mitochondrial dysfunction  [20], contributing to:

• More mitochondrial dysfunction and more oxidative stress
• Damage to tissues, blood vessels, and cellular components
• Impaired insulin signaling, and thus worse insulin resistance
• A less effective immune system
• Diabetic complications

How ozone therapy helps with oxidative stress in diabetes

Ozone therapy provides a small dose of oxidative stress that activates the body's antioxidant defense mechanisms, such as the Nrf2 pathway, enhancing the expression of genes related to:

• Antioxidant defense, such as the enzymes superoxide dismutase, catalase, and heme oxygenase-1  [21]. 
• Phase II detoxification enzymes (e.g., glutathione S-transferase, sulfotransferase, glycine N-acyltransferase)
• Stress response proteins (e.g., heat shock proteins, RNA chaperone proteins)
• Glutathione production – the most important cellular antioxidant

Clinically, this can translate to improved management of blood glucose levels and a reduction in the oxidative damage associated with diabetes. This can reduce oxidative damage-related complications such as neuropathy, retinopathy, and cardiovascular issues. 

An animal study investigated the effects of ozone therapy on oxidative stress and diabetic complications in rats. Five groups were used, including a control group, a diabetes-induced group with streptozotocin (STZ), and groups treated with ozone, oxygen, and a control ozone group without STZ. 

The ozone-treated group showed improved glycemic control and reduced oxidative stress markers, such as aldose reductase, fructosyl-lysine, and advanced oxidation protein products. Nitrite and nitrate levels remained stable. These findings suggest that repeated ozone therapy works by enhancing antioxidant defense [12].

Reduces inflammation and rebalances immune function

Low-grade chronic inflammation is a significant contributor to the development and progression of type 2 diabetes (T2DM). In T2DM, fat cells and other cells release pro-inflammatory cytokines such as TNF-α, IL-6, and CRP [22]. On an unhealthy diet, especially high-fat meals, components of bacterial cell walls (lipopolysaccharides) from the gut bacteria can cross the gut wall into the bloodstream, causing an inflammatory response [23].

Interleukin 6 (IL-6) is a multifunctional cytokine implicated in the development of T2DM. Elevated IL-6 levels predict T2DM and contribute to [24]:

• Inflammation
• Insulin resistance
• β-cell dysfunction

Tumor necrosis factor-alpha (TNF-α) plays a significant role in diabetes by promoting inflammation and insulin resistance. Anti-TNF-α treatment may [25]: 

• Reduce beta cell destruction
• Improved insulin signaling
• Restoring proper blood sugar levels
• Improve immune tolerance

The lifestyle-related inflammation and cytokines interfere with insulin signaling pathways, leading to insulin resistance. The persistent inflammation can also damage pancreatic beta cells, impairing their ability to produce insulin. 

In type 1 diabetes, autoimmunity plays a central role in the disease process. The immune system, specifically T-cells, targets and destroys pancreatic beta cells, leading to a decrease in insulin production. This autoimmune attack is often triggered by genetic and environmental factors, although the exact cause remains unclear. The inflammatory response in the pancreas, characterized by the infiltration of immune cells and the release of cytokines, exacerbates beta-cell destruction. 

This inflammation reduces the number of functional beta cells and impairs their ability to produce and secrete insulin, contributing to the hyperglycemia characteristic of T1DM [26].This inflammatory state not only exacerbates insulin resistance and beta cell damage, but also contributes to the development of diabetic complications. 

How ozone therapy helps with inflammation in type 1 and type 2 diabetes

A meta-analysis focused on the role of ozone therapy in reducing inflammation across various clinical conditions. An evidence gap map reviewed 26 systematic studies, highlighting the use of different ozone administration routes. Of the 11 reviews focused on inflammation, five reported positive effects, two potentially positive, three inconclusive, and one no effect. Ozone therapy reduces inflammatory markers like IL-6 and TNF-alpha, along with oxidative stress and inflammatory symptoms. The study suggests that ozone therapy can help with both types of diabetes partly by modulating inflammation [27].

Normalizes blood lipids

A clinical study investigated the effects of endovenous ozone therapy on serum lipid patterns and the antioxidant defense system in 22 patients with previous myocardial infarction (heart attack). These patients underwent 15 sessions of ozone autohemotherapy. 

The results showed a statistically significant decrease in plasma total cholesterol and low-density lipoprotein levels (p < 0.05). Additionally, there were substantial increases in erythrocyte glutathione peroxidase and glucose-6-phosphate dehydrogenase activities, two antioxidants and free radical scavengers, with no change in plasma lipid peroxidation levels. 

The study concluded that ozone therapy improves blood lipid metabolism and enhances the antioxidant protection system, leading to reduced cardiovascular risk [28]. 

Other Ways that Ozone Therapy Helps with Diabetic Complications

Improves immune responses against infections

Elevated blood sugar can weaken immune functions. Also, the persistent low-grade inflammation and poor circulation can make it even harder for the body to fight infections.

The reactive oxygen species (ROS) and lipid oxidation products (LOPs) like 4-hydroxynonenal (HNE) from ozone therapy have antimicrobial and immunomodulatory effects. As a result, it can jumpstart stagnant immune functions, including in diabetes.

A controlled clinical trial on diabetic foot ulcers (DFUs) evaluated the effectiveness of combining standard wound care with ozone therapy to reduce bacterial colonization and improve healing. The control group (n=12) received standard care with antimicrobial dressings, while the intervention group (n=15) also received ozone bagging therapy.

Combination therapy significantly decreased bacterial colonies (p=0.001) but did not significantly affect wound healing scores (p>0.05). The study suggests that ozone therapy can reduce bacterial presence in DFUs, with further research needed to optimize dosage and exposure time for improved healing [29].

Stimulates tissue repair/regenerative pathways

Ozone therapy modifies the body’s regenerative pathways by jump-starting immune functions, providing oxygen, and stimulating mitochondrial functions. So, systemic ozone therapy such as IV therapy and rectal insufflation can often help restore nerve functions and repair common damages in diabetic complications [30]. 

Clinical Trials and Published Ozone Therapy Protocols for Diabetic Complications

Diabetics with eye complications

Study Overview

A single-center, randomized, controlled, parallel-group study was conducted at the Ozone Complementary Research Center in Tehran, Iran, from May 2019 to February 2020. The study enrolled 60 patients with type 2 diabetes to evaluate the effects of systemic oxygen-ozone therapy on eye complications [31].

Protocol

• Oxygen-Ozone Therapy:
  • Major Autohemotherapy: Blood (1.2 mL/kg) was drawn, mixed with an ozone-oxygen mixture (25-30 µg/mL), and reinfused.
  • Minor Autohemotherapy: Blood (10 mL) was mixed with 10 mL of ozone-oxygen and injected intramuscularly.
• Frequency: Twice a week for 20 sessions over 10 weeks.

Evaluation

• Primary Endpoint: Visual Evoked Potentials (VEP) measured at baseline, and after one, two, and three months.
• Secondary Outcome: HbA1c levels measured at baseline and after three months.
• Ophthalmologic Examination: Classification of retinopathy status (e.g., NPDR, PDR).

Exclusion criteria included participants with:

• G6PD deficiency
• Pregnant or nursing
• Abnormal coagulation or thyroid tests
• Hypersensitivity to ozone
• Reduced visual acuity not correctable by eye glasses

Outcome

Over three months, the ozone therapy group showed a significant reduction in P100 wave latency, indicating improved optic nerve function, though this improvement was not correlated with HbA1c levels. 

No significant changes in P100 amplitude were observed, and no adverse effects were recorded. The study suggests ozone therapy benefits optic pathway conduction in diabetics through repair mechanisms beyond just glycemic control [31].

Diabetic foot ulcers

Autohemotherapy

https://www.mdpi.com/2075-4426/13/10/1439

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178637/

A meta-analysis investigated the effectiveness of ozone therapy in treating wounds in patients with diabetic foot ulcers. They reviewed 17 studies and concluded that ozone therapy is promising for wound treatment in diabetic foot patients. The evidence determined that ozone therapy is effective, safe, and beneficial, with few adverse effects, making it an adequate treatment for diabetic foot ulcers [32].

A meta-analysis investigated the effectiveness of ozone therapy for treating diabetic foot ulcers (DFUs). They reviewed six clinical studies with a total of 428 subjects and concluded that ozone therapy is promising for DFU treatment. The results showed that ozone therapy can enhance wound healing through mechanisms such as improved vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), and platelet-derived growth factor (PDGF) levels, alongside its antibacterial properties. This evidence supports the potential of ozone therapy as a significant complementary treatment for DFUs [33].

‍

‍

Combined treatment

Study 1 Overview

A single-blind, randomized clinical trial was conducted from April 2016 to November 2017 across three centers in Iran, involving 200 diabetic patients with foot ulcers [19].

Protocol

• Local Ozone Therapy: Included bagging for 30 minutes, ozone oil gel every 12 hours, and subcutaneous ozone-oxygen injections
• Systemic Ozone Therapy: Administered via rectal or intravenous routes, combined with vitamin C tablets post-procedure
• Frequency: Twice a week until wound closure and epithelialization

Evaluation

• Baseline demographic data, wound grade, and size were recorded
• Laboratory tests (CBC, ESR, CRP, FBS, PT, PTT, creatinine) were conducted
• Outcomes: Healing time, sessions required, and need for amputation

Exclusion criteria included participants with:

• Abnormal thyroid or coagulation tests
• Pregnant or nursing women
• G6PD deficiency
• Ozone hypersensitivity

Outcomes

The average healing time was 69.44 ± 36.055 days in the ozone group, with total time to heal up to 180 days, whereas 25% of the control group were not healed by 180 days. In the control group, fasting blood sugar increased, whereas in the ozone group, fasting blood sugar decreased. 57% of patients in the control group required amputations, compared to 19.1% in the ozone group.

Study 2 Overview

A 65-year-old man with a grade IV neuropathic diabetic ulcer and osteomyelitis in his lower limb was treated at Ahwaz Wound Clinic [34].  

Protocol

• Initial treatment involved infection control, physiotherapy, and antibiotics.
• Additionally, topical ozone therapy (60 μg ozone limb bagging for 20 minutes daily) and autohemotherapy (ozonated blood twice a week) were administered. 
• Zinc supplementation was also provided. 

Outcomes:

• Ulcer wound had diminished inflammation and complete wound closing
• C-reactive protein levels decreased, indicating reduced inflammation and infection.

Topical ozone oil

Study Design

An unblinded, randomized controlled trial (RCT) involved 101 adults with a neuro-infectious diabetic foot [35].

Protocol

• Ozone Group (n = 51):
  • Ozone Therapy: 20 sessions via rectal insufflation (10 mg dose, 50 mg/L concentration) and local application using a vacuum-sealed plastic bag filled with ozone (60 mg/L) for one hour, followed by ozonized sunflower oil (Oleozon®)
• Control Group (n = 49):
  • Antibiotic Therapy: Systemic antibiotics and topical application for 20 days
• Additional Treatments: Debridement and gauze dressings for all wounds

Exclusion criteria included participants with:

• Severe septic conditions
• Hypersensitivity
• Hepatic dysfunction
• Renal failure
• Pregnancy
• Cancer
• Recent substance abuse
• Immunosuppressive therapy
• Investigational drug treatment

Evaluation

• Number of ulcers healed during the trial
• Change in ulcer area
• Number of complications (adverse events reported)
• Length of hospital stay

Outcomes:

• Ozone treatment improved glycemic control, prevented oxidative stress, normalized levels of organic peroxides, and activated superoxide dismutase. 
• Ozone treatment significantly improved healing of the lesions, resulting in fewer amputations than in the control group. 

Metabolic syndrome

Study Overview

The study evaluated pathological changes and metabolic syndrome (MS) complications using a numerical system to quantify disease manifestations (DM-II, hypertension, atherosclerosis, obesity, concomitant diseases) on a three-point scale. The clinical assessment resulted in a numerical diagnosis for each patient [36].

100 patients (aged 40-60) with various forms of MS were compared to 55 healthy individuals (no chronic or acute diseases).

Treatment Protocol

• Ozone Therapy: Low doses of ozone administered at the Nizhny Novgorod Medical Center of Ozone Therapy
• Course: Six to eight procedures every second day
• Procedure: Intravenous infusions (200 ml) of ozonated saline (0.9% NaCl) with ozone concentration of 300-400 mcg/L, using the "Kvazar" ozonator

Evaluation 

• Biochemical Parameters: Total cholesterol, free cholesterol, triglycerides, Chol-LPHD, Chol-LPLD, NEFA (measured with Dia Sys test-system)
• Insulin levels
• Antioxidant Enzymes: SOD, catalase, glutathione peroxidase, glutathione reductase (Redox reagents)
• Albumin: Total and effective concentration measured with Albumin-Zond1 device
• Detoxifying Enzyme: Glutathione-S-transferase activity (Karpischenko method)

Outcomes:

• Ozone significantly improved lipid metabolism (p <0.05)
  • Decreased triglycerides by 35%
  • Decreased free cholesterol by 33%
  • Decreased fasting glucose by 9%
• Normalized antioxidant enzyme balance
  • Increased SOD and catalase activity
  • Decreased GPx and glutathione-reductase activity

Potential Complications, Drug Interactions, and Contraindications for Ozone Therapy and Diabetes

Complications

• Oxidative Stress: While ozone therapy aims to induce controlled oxidative stress to boost antioxidant defenses, excessive exposure can lead to increased oxidative damage, potentially worsening neuropathy or retinopathy.

If this is a concern, the solution is to start small and slowly ramp up the dose to find the sweet spot.

• Respiratory Issues: Inhalation of ozone, even in small amounts, can irritate the respiratory system, leading to the following issues that can worsen any comorbid respiratory conditions:
  • Coughing
  • Shortness of breath
  • Potential lung damage

Drug interactions

• Antioxidant Supplements: Concurrent use of antioxidant supplements (e.g., vitamin C, vitamin E) with ozone therapy might blunt the therapeutic oxidative effects of ozone, reducing its efficacy. However, some clinical trials do add antioxidant supplements at least a few hours away from the ozone therapy session. 
• Antidiabetic Medications: Ozone therapy can alter the oxidative balance in cells, potentially affecting the pharmacokinetics of antidiabetic drugs like metformin and insulin, possibly requiring dosage adjustments.
• Blood Thinners: Since ozone therapy can impact blood flow and clotting mechanisms, it may interact with anticoagulants (e.g., warfarin), increasing the risk of bleeding or clotting complications. Also, ozone IV therapy may include a small amount of blood thinners.

Understanding these potential complications and drug interactions is crucial for safely integrating ozone therapy into diabetes treatment plans. Proper monitoring and consultation with healthcare providers are essential to mitigate risks and optimize therapeutic outcomes.

Ozone therapy presents a promising adjunctive treatment for diabetes, showing potential benefits in improving:

• Insulin sensitivity
• Boosting mitochondrial function
• Supporting circulation and tissue oxygenation
• Enhancing antioxidant defenses
• Supporting immune functions and wound healing

Clinical studies have demonstrated its efficacy in managing diabetic complications such as:

• Foot ulcers
• Neuropathy
• Retinopathy
• Hearing loss

However, careful consideration of potential complications and drug interactions is essential to ensure safety and effectiveness. Integrating ozone therapy with conventional treatments could offer a comprehensive approach to managing diabetes, but further research and clinical trials are needed to fully understand its long-term impacts and optimize treatment protocols.