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Item
#1
Low-Dose
Doxycycline Effective for Periodontitis in Diabetics
A
subantimicrobial dose of doxycycline effectively controls
periodontitis in diabetics, reducing
A1c
and resulting in a significant decrease in tooth pocket depth.
At
the 32nd annual meeting of the American Association of Dental
Research in San Antonio, Texas, researchers reported that this
treatment is actually more effective in diabetics than
nondiabetics with periodontal disease.
Dr.
Sebastian G. Ciancio of the University of Buffalo presented
results of a randomized placebo-controlled trial of 20 adult
diabetics with stable blood glucose levels and generalized
periodontitis. Half the patients received doxycycline 20 mg bid
and the other half placebo bid for 12 weeks. All patients
underwent scaling and root planing.
Dr.
Ciancio reported that not only did doxycycline therapy reduce
tooth pocket depth by 1.7 mm, it also reduced glycated
hemoglobin levels (HbA1c). Active treatment was 25% more
effective in reducing pocket depth than was scaling and root
planing alone, he added.
In
previous studies of nondiabetics with periodontitis, Dr. Ciancio
said that sub-antimicrobial doses of doxycycline reduced tooth
pocket depth by 0.4 mm. "Periostat (doxycycline) achieved
results that were 75% better in the diabetics than in nondiabetic
patients."
This
dose of doxycycline inhibits collagenase and elastase, resulting
in a strengthening of bone and connective tissue, Dr. Ciancio
explained. But he stressed that the dose given in this study
"is not antibiotic. It is 20 mg per dose, and it must be
given twice a day. Otherwise, you get into bacterial
problems."
Dr.
Ciancio and his colleagues have been discussing the possible
mechanism by which sub-antimicrobial doxycycline reduces HbA1c.
"It probably has a molecular basis, but I don't know what it
is, to be honest...One of my colleagues thinks that maybe it
reduces inflammation--that is probably how it works."
The
Buffalo researcher added that active treatment lowered IL-2 levels
significantly at the 6-week mark and lowered C-reactive protein
levels at 12 weeks, "but not significantly."
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