Some Medicaid and Medicare fiscal intermediaries are denying hyperbaric @entity26 (HBO2) therapy for @entity4760 ( @entity4760 ) @entity1 if the glycosylated hemoglobin (HbA1c) > 7.0%. We performed multiple PubMed searches for any @entity6 wound healing clinical trial that documented HbA1c and had a wound healing endpoint. We scrutinized 30 peer-reviewed clinical trials, representing more than 4,400 @entity1 . The average HbA1c from the intervention side of the studies was 8.6% (7.2% - 9.9%) and the control/sham side was 8.3% (6.0% - 10.6%). Twelve studies made a direct attempt to link HbA1c and wound healing. Four retrospective studies and one prospective cohort study assert that lower HbA1c favors wound healing, but review of the studies reveal design flaws that invalidate these conclusions. In total, 25 studies showed no direct correlation between HbA1c levels and wound healing. There was no randomized controlled trial (RCT) data demonstrating that HbA1c < 7.0% improves @entity6 wound healing. In every study reviewed, wounds healed with high HbA1c levels that would be considered poorly controlled by the American @entity6 Association (ADA). Frequently, @entity1 lack optimal blood @entity413 control when they have a limb-threatening @entity4760 . The evidence supports that denying hyperbaric @entity26 to those with HbA1c > 7.0% is unfounded.

Glycosylated hemoglobin and hyperbaric XXXX coverage denials.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity6 :: ('MESH:D003920', 'Disease') :: ['Diabetes', 'diabetic'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose'] @entity4760 :: ('MESH:D017719', 'Disease') :: ['diabetic foot ulcer', 'DFU']
@entity26 :: (MESH:D010100,Chemical) :: ['oxygen']
