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."
Source: Diabetes In Control Dot Com.
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