American Diabetes Association (ADA) Standards of Care in Diabetes 2026

Topical Oxygen Therapy (TOT) has received an “A grade” recommendation for the 4th year in a row as an adjunctive treatment for chronic diabetic foot ulcers (DFUs).

Recommendations with A-level evidence are based on large, well-designed randomized controlled trials or well-done meta-analyses of randomized controlled trials.

Key takeaways:

• Topical Oxygen Therapy (TOT) awarded A-grade adjunctive treatment recommendation for DFUs.
• High participation [in TOT] with very few reported adverse events combined with improved healing rates makes this therapy another attractive option for advanced wound care.

Citation: American Diabetes Association Professional Practice Committee. (2026) 12. Retinopathy, Neuropathy, and Footcare: Standards of Care in Diabetes-2026. Diabetes Care, 49(Suppl 1):S268-S72.