Comparative Evaluation of the Effect of Doxycycline As An Adjunct to Non-Surgical Periodontal Therapy on the Metabolic Control of Poorly Controlled Type 2 Diabetic Subjects with Chronic Generalized Periodontitis – A Clinical Study
Background: The association between diabetes and periodontal disease has long been discussed with conflicting conclusions. Earlier studies demonstrating the relationship between diabetes and severity of periodontal disease has been equivocal. However, recent studies have clearly proven that diabetes increases the risk of periodontal disease progression. Less clear is the impact of periodontal disease on diabetes. It has been hypothesised that periodontal therapy may improve the metabolic control of diabetes. Aim: To determine the effect of doxycycline as an adjunct to non-surgical periodontal therapy in improving the metabolic control of poorly controlled type 2 diabetic subjects with chronic generalized periodontitis. Method: 30 poorly controlled type 2 diabetic subjects with chronic generalized periodontitis and receiving antidiabetic therapy were selected for the study. The subjects were randomly allotted to either of two treatment groups containing 15 subjects each: Group 1 (scaling and root planing(SRP)+ 15 days Doxycycline) or Group 2 (scaling and root planing(SRP). The Glycated haemoglobin (HbA1c) values, Gingival Index(GI), and Probing pocket depth of both the groups were assessed at baseline and after 3 months. Results: Both the treatment groups exhibited reductions in HbA1c, G I and Probing pocket depth compared to baseline over time. The amount of reduction in the glycated haemoglobin and gingival parameters was higher in Group I compared to group 2 after 3 months. Conclusion: Both treatments improved glycemic control in patients with type 2 diabetes; however, the reduction in HbA1c values reached statistical significance only in the group receiving doxycycline as an adjunct to scaling and root planing.
Metabolic effects of bariatric surgery in patients with moderate obesity and ...Apollo Hospitals
Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: Analysis of a randomized control trial comparing surgery with intensive medical treatment
Effect of fruit restriction on glycemic control in patients with type 2 diabe...Runa La-Ela
The prevalence of type 2 diabetes (T2DM) is still rising and has reached epidemic proportions in most countries.
The importance of medical nutrition therapy (MNT) is recognized as one of the cornerstones in the treatment of T2DM.
Most guidelines recommend eating a diet with a high intake of fiber-rich food including fruit as it has many positive effects on human health.
Metabolic effects of bariatric surgery in patients with moderate obesity and ...Apollo Hospitals
Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: Analysis of a randomized control trial comparing surgery with intensive medical treatment
Effect of fruit restriction on glycemic control in patients with type 2 diabe...Runa La-Ela
The prevalence of type 2 diabetes (T2DM) is still rising and has reached epidemic proportions in most countries.
The importance of medical nutrition therapy (MNT) is recognized as one of the cornerstones in the treatment of T2DM.
Most guidelines recommend eating a diet with a high intake of fiber-rich food including fruit as it has many positive effects on human health.
Presentation performed for highlighting VERIFY: Galvus-met trials superiority in managing newly diagnosed DMT2 patients with preserving B cell function, evidence.
PEPTIC (Holden Young - Roseman University College of Pharmacy)HoldenYoung3
PEPTIC (Holden Young - Roseman University College of Pharmacy)
Effect of stress ulcer prophylaxis with proton pump inhibitors vs histamine-2 receptor blockers on in-hospital
mortality among ICU patients receiving invasive mechanical ventilation (PEPTIC).
JAMA . 2020; 323(7):616-626
Effect of the_glycemic_index_of_the_diet_on_weight (2)AmineYahyaoui2
Effect of the glycemic index of the diet on weight loss, modulation of
satiety, inflammation, and other metabolic risk factors: a randomized
controlled trial1–3
Journal of Schizophrenia Research is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of a mental disorder often characterized by abnormal social behavior and failure to recognize what is real with common symptoms including false beliefs, auditory hallucinations, confused or unclear thinking, inactivity, and reduced social engagement and emotional expression. The journal focuses upon the latest research in finding causes, understanding mechanisms, diagnosis, prevention, management, prognosis, epidemiology, ancestral history and treatment of schizophrenia.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and medicine with intent to bridge the gap between academia and research access.
Journal of Schizophrenia Research accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of schizophrenia including, finding causes, understanding mechanisms, diagnosis, prevention, management, prognosis, epidemiology, ancestral history and its treatment.
THE EFFECTS OF PERIODONTAL TREATMENT ON DIABETIC PATIENTS: THE DIAPERIO RANDO...sDJKFhjh
While many systemic diseases have been considered to be associated with periodontitis, the link between diabetes and periodontitis has been the subject of the most intensive research over the past decades.
Both periodontitis and diabetes are highly prevalent in modern societies and have a negative impact on quality of life.
Periodontal therapy might help to reduce local inflammation, and consequently, the putative systemic entry of bacterial by- products (e.g., lipopolysaccharides from Gram - negative bacterial walls) and pro- inflammatory molecules.
Relationship between Severity of Periodontal Disease and Control of Diabetes ...Dr. Anuj S Parihar
Background: Both diabetes mellitus (DM) and periodontitis
are chronic diseases affecting large number of the population
worldwide. Changes in human behavior and lifestyle over the
last century have resulted in a dramatic increase in the incidence
of diabetes in the world. This study was designed to evaluate the
relationship between severity of periodontal disease and control of
diabetes (glycated hemoglobin [HBA1c]) in patients with Type 1
DM in a hospital based study.
Materials and Methods: Fifty patients (n = 50) with Type 1
diabetes were enrolled in the study. They were divided into three
groups based on the degree of glycemic control by measuring
HbA1c levels as: “Good” (HBA1c ≤7) Group A, fair (HBA1c = 7-8)
Group B and poor (HBA1c >8) Group C. All enrolled patients
underwent detailed history and dental checkup. Evaluation for
periodontal disease was done by measuring dental plaque (plaque
index), inflammation of gums (gingival index), probing pocket
depth (PPD), and clinical attachment level.
Results: Type 1 diabetics with poor glycemic control had
increased gingival inflammation (P < 0.05), more dental plaque
(P < 0.05), increased PPDs (P < 0.05) and attachment loss
(P < 0.05) as compared to those with fair and good glycemic
control, respectively.
Conclusion: Severity of periodontal disease increases with poor
glycemic control in patients with Type 1 DM.
Key Words: Glycated hemoglobin levels, periodontal disease,
Type 1 diabetes mellitus
Abstract—Periodontal disease is a destructive inflammatory disease inducing profound changes in the plasma concentrations of cytokines leading to a catabolic state characterized by altered lipid metabolism and hypertriglyceridemia. This study was conducted with the aim find out association of chronic periodontitis with serum lipid parameters. Study group consist of 30 cases of chronic periodontitis (case group) and control group consist of 30 healthy individuals. Age range was kept 25-60 years to avoid extreme ages. Periodontal parameters including Plaque Index, Gingival Index, Probing Depth and Clinical Attachment Level were recorded. Lipid profile comprising of total cholesterol, Triglycerides, HDL- Cholesterol and LDL was assessed and co related with periodontal parameters. This study confirms significantly higher levels of mean cholesterol, triglycerides and LDL in periodontitis group as compared to healthy group. Also, there is significant negative co relation of HDL with probing depth and clinical attachment loss. Association of hyperlipidemia and chronic periodontitis is evident in developed state of disease. With this study, this relation is confirmed based on Factor and Outcome.
Presentation performed for highlighting VERIFY: Galvus-met trials superiority in managing newly diagnosed DMT2 patients with preserving B cell function, evidence.
PEPTIC (Holden Young - Roseman University College of Pharmacy)HoldenYoung3
PEPTIC (Holden Young - Roseman University College of Pharmacy)
Effect of stress ulcer prophylaxis with proton pump inhibitors vs histamine-2 receptor blockers on in-hospital
mortality among ICU patients receiving invasive mechanical ventilation (PEPTIC).
JAMA . 2020; 323(7):616-626
Effect of the_glycemic_index_of_the_diet_on_weight (2)AmineYahyaoui2
Effect of the glycemic index of the diet on weight loss, modulation of
satiety, inflammation, and other metabolic risk factors: a randomized
controlled trial1–3
Journal of Schizophrenia Research is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of a mental disorder often characterized by abnormal social behavior and failure to recognize what is real with common symptoms including false beliefs, auditory hallucinations, confused or unclear thinking, inactivity, and reduced social engagement and emotional expression. The journal focuses upon the latest research in finding causes, understanding mechanisms, diagnosis, prevention, management, prognosis, epidemiology, ancestral history and treatment of schizophrenia.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and medicine with intent to bridge the gap between academia and research access.
Journal of Schizophrenia Research accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of schizophrenia including, finding causes, understanding mechanisms, diagnosis, prevention, management, prognosis, epidemiology, ancestral history and its treatment.
Ibalizumab - Journal Club Handout (Holden Young - Roseman University of Healt...
Similar to Comparative Evaluation of the Effect of Doxycycline As An Adjunct to Non-Surgical Periodontal Therapy on the Metabolic Control of Poorly Controlled Type 2 Diabetic Subjects with Chronic Generalized Periodontitis – A Clinical Study
THE EFFECTS OF PERIODONTAL TREATMENT ON DIABETIC PATIENTS: THE DIAPERIO RANDO...sDJKFhjh
While many systemic diseases have been considered to be associated with periodontitis, the link between diabetes and periodontitis has been the subject of the most intensive research over the past decades.
Both periodontitis and diabetes are highly prevalent in modern societies and have a negative impact on quality of life.
Periodontal therapy might help to reduce local inflammation, and consequently, the putative systemic entry of bacterial by- products (e.g., lipopolysaccharides from Gram - negative bacterial walls) and pro- inflammatory molecules.
Relationship between Severity of Periodontal Disease and Control of Diabetes ...Dr. Anuj S Parihar
Background: Both diabetes mellitus (DM) and periodontitis
are chronic diseases affecting large number of the population
worldwide. Changes in human behavior and lifestyle over the
last century have resulted in a dramatic increase in the incidence
of diabetes in the world. This study was designed to evaluate the
relationship between severity of periodontal disease and control of
diabetes (glycated hemoglobin [HBA1c]) in patients with Type 1
DM in a hospital based study.
Materials and Methods: Fifty patients (n = 50) with Type 1
diabetes were enrolled in the study. They were divided into three
groups based on the degree of glycemic control by measuring
HbA1c levels as: “Good” (HBA1c ≤7) Group A, fair (HBA1c = 7-8)
Group B and poor (HBA1c >8) Group C. All enrolled patients
underwent detailed history and dental checkup. Evaluation for
periodontal disease was done by measuring dental plaque (plaque
index), inflammation of gums (gingival index), probing pocket
depth (PPD), and clinical attachment level.
Results: Type 1 diabetics with poor glycemic control had
increased gingival inflammation (P < 0.05), more dental plaque
(P < 0.05), increased PPDs (P < 0.05) and attachment loss
(P < 0.05) as compared to those with fair and good glycemic
control, respectively.
Conclusion: Severity of periodontal disease increases with poor
glycemic control in patients with Type 1 DM.
Key Words: Glycated hemoglobin levels, periodontal disease,
Type 1 diabetes mellitus
Abstract—Periodontal disease is a destructive inflammatory disease inducing profound changes in the plasma concentrations of cytokines leading to a catabolic state characterized by altered lipid metabolism and hypertriglyceridemia. This study was conducted with the aim find out association of chronic periodontitis with serum lipid parameters. Study group consist of 30 cases of chronic periodontitis (case group) and control group consist of 30 healthy individuals. Age range was kept 25-60 years to avoid extreme ages. Periodontal parameters including Plaque Index, Gingival Index, Probing Depth and Clinical Attachment Level were recorded. Lipid profile comprising of total cholesterol, Triglycerides, HDL- Cholesterol and LDL was assessed and co related with periodontal parameters. This study confirms significantly higher levels of mean cholesterol, triglycerides and LDL in periodontitis group as compared to healthy group. Also, there is significant negative co relation of HDL with probing depth and clinical attachment loss. Association of hyperlipidemia and chronic periodontitis is evident in developed state of disease. With this study, this relation is confirmed based on Factor and Outcome.
Obesity and hyperlipidemia is international /worldwide problem causing heart disease leading to major predisposing factor for morbidity and death. Conventional medicine used in allopathy include statins, fibrates, niacin and resins but are going to defame due to their adverse effects. Herbal medicine ginger has proved itself as one of the potent anti hyperlipidemic and anti obesity herb with least adverse effects. We did try to compare its hypolipidemic effects with placebo effects when used in mild to moderate hyperlipidemic patients. It was placebo-controlled single blind research study. Research was conducted at National hospital, Lahore, from July to November 2016. Consent was taken from sixty hyperlipidemic patients age range from 25 to 60 years. Both gender male and female patients were enrolled. Patients were randomly divided in two groups, 30 patients were on drug ginger pasted-powder advised to take 5 grams in divided doses with their normal diet for the period of three months. Thirty patients were on placebo pasted-wheat powder, with same color as of ginger powder, advised to take 5 grams in divided doses with their normal diet for the period of three months. Their base line lipid profile and body weight was recorded at start of treatment and were advised to come for check-up, fortnightly.
International Journal of Medical Science in Clinical Research and Review Vol 03, Issue 02,April – 2020 Page |
229
When duration of study was over, their lipid profile and body weight was measured and compared statistically with pre-treatment values. Three months treatment with 5 grams of ginger decreased total cholesterol from 233.11±1.53 mg/dl to 198.44±1.23 mg/dl, LDL cholesterol reduced from 202.21±1.88 mg/dl to 187.72± 1.98 mg/dl, reduced body weight from 76.01±2.66 kg to 72.80±1.87 kg. Both plasma total cholesterol and LDL cholesterol reduction was statistically significant, but body weight decrease was non-significant when analyzed biostatistically.
Understanding the nutrition care needs of patients newly diagn.docxgibbonshay
Understanding the nutrition care needs of patients newly diagnosed
with type 2 diabetes: a need for open communication
and patient-focussed consultations
Lauren BallA,C, Ruth DavmorA, Michael LeverittB, Ben DesbrowA, Carolyn EhrlichA
and Wendy ChaboyerA
AMenzies Health Institute Queensland, Griffith University, Gold Coast 4222, Qld, Australia.
BSchool of Human Movement and Nutrition Sciences, The University of Queensland,
Brisbane 4072, Qld, Australia.
CCorresponding author. Email: [email protected]
Abstract. Patients who are newly diagnosed with type 2 diabetes mellitus (T2DM) commonly attempt to modify their
dietary intake after receiving nutrition care from primary health professionals. Yet, adherence to dietary recommendations
is rarely sustained and factors influencing adherence are poorly understood. This study exploredT2DMpatients’ experiences
of dietary change and their views on how primary health professionals can best support long-term maintenance of dietary
change.Apurposive sample of 10 individuals recently diagnosedwithT2DMparticipated in three individual semi-structured
qualitative telephone interviews: at baseline, then at 3 and 6 months after recruitment. Interview questions were modified
from the initial interview inorder to investigate emergingfindings.A two-step data analysis process occurred throughcontent
analysis of individual interviews andmeta-synthesis of findings over time. Participants initiallymadewide-ranging attempts
to improve dietary behaviours, butmost experienced negative emotions from the restraint required tomaintain a healthy diet.
Participants felt confused by the conflicting advice received from health professionals and other sources such as friends,
family, internet and diabetes organisations. Participants frequently reported feeling rushed and not heard in consultations,
resulting in limited ongoing engagement with primary healthcare services. These findings suggest that there is opportunity
for primary health professionals to enhance the dietary support provided to patients by: acknowledging the challenges of
sustained improvements in dietary intake; open communication; and investing in patient relationships through more
patient-focussed consultations.
Additional keywords: chronic disease, general practice, primary care, nutrition therapy, nutritional management.
Received 28 April 2015, accepted 18 August 2015, published online 5 October 2015
Introduction
Type 2 diabetes mellitus (T2DM) is a lifestyle-related chronic
disease and leading cause of morbidity andmortality in Australia
(Australian Institute of Health andWelfare 2007). Over 5%of the
Australian population has been diagnosed with T2DM, and an
additional 0.9% is predicted to be diagnosed annually (Australian
Bureau of Statistics (ABS) 2012). T2DM is typically diagnosed
and managed in the primary healthcare setting, and patients with
T2DM receive health care from a variety of primary health
professionals (Diabetes Australia 2012). Impor ...
Diabetese- One reason not to Worry ! A new Clinically researched NATURAL PROD...VISHAL CHANDRA
DBC-24 is a new researched product from TULIP LAB.
Clinical Trail has established good efficacy and safety of the product in lowering blood glucose levels and reducing insulin resistance with regular usage.
The product is devoid of side effects of Chemical based Drugs.
The product is also effective in management of Irregular menstrual cycle on account of Cyst formation in Ovaries
( Poly Cystic Ovarian Syndrome- PCOS )
International level clinical trail has been registered on WHO PORTAL : See the link in the slides
For
Long term benefit of microbiota transfer therapy on autism symptoms and gut m...BARRY STANLEY 2 fasd
Many studies have reported abnormal gut microbiota in individuals with Autism Spectrum Disorders (ASD), suggesting a link between gut microbiome and autism-like behaviors.
Modifying the gut microbiome is a potential route to improve gastrointestinal (GI) and behavioral symptoms in children with ASD, and fecal microbiota transplant could transform the
dysbiotic gut microbiome toward a healthy one by delivering a large number of commensal microbes from a healthy donor. We previously performed an open-label trial of Microbiota Transfer Therapy (MTT) that combined antibiotics, a bowel cleanse, a stomach-acid suppressant, and fecal microbiota transplant, and observed significant improvements in GI symptoms, autism-related symptoms, and gut microbiota. Here, we report on a follow-up with the same 18 participants two years after treatment was completed. Notably, most improvements in GI symptoms were maintained, and autism-related symptoms improved even more after the end of treatment. Important changes in gut microbiota at the end of treatment remained at follow-up, including significant increases in bacterial diversity and relative abundances of Bifidobacteria and Prevotella. Our observations demonstrate the longterm safety and efficacy of MTT as a potential therapy to treat children with ASD who have GI problems, and warrant a double-blind, placebo- controlled trial in the future.
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Comparative Evaluation of the Effect of Doxycycline As An Adjunct to Non-Surgical Periodontal Therapy on the Metabolic Control of Poorly Controlled Type 2 Diabetic Subjects with Chronic Generalized Periodontitis – A Clinical Study
2. Comparative Evaluation of the Effect of Doxycycline As An Adjunct to...
*Corresponding Author: Dr. Roshni Ramesh 18 | Page
beneficial effect on glycemic control in either type 1 or type 2 diabetes7,8
. It has been observed that nonsurgical
periodontal therapy (scaling & root planing) has positive effects on glycemic control of subjects with type 2
diabetes9
.But complete elimination of all subgingival bacteria is not achievable by nonsurgical therapy alone
and re-colonization occurs over a period of time. The use of adjunctive systemic medication has been shown to
improve the healing response following mechanical periodontal therapy. The use of systemic antibiotics can be
effective in decreasing the total count of bacteria in periodontal infection, with ensuing down-regulation of the
inflammatory mediators leading to an improvement of glycemic control in type 2 diabetes mellitus subjects.
Doxycycline may be preferred because it inhibits metalloproteinase activity in addition to its antimicrobial
effects.10
The present study was undertaken to determine the efficacy of systemic doxycycline as an adjunct to
nonsurgical periodontal therapy in improving the metabolic control of poorly controlled type 2 diabetes subjects
with chronic generalized moderate or severe periodontitis.
II. MATERIALS AND METHODS
Poorly controlled type 2 diabetic patients (HbA1c values ≥ 8) with chronic generalized periodontitis
and receiving antidiabetic therapy were selected for the study. 30 subjects who satisfied the inclusion criteria
and who were willing to participate in the study were included.
Inclusion criteria
Male and female subjects, with age groups ranging from 30 to 70 years
Subjects with moderately and poorly controlled type 2 diabetes mellitus (HbA1c ≥ 10%) and receiving
antidiabetic therapy
Patients with chronic generalized moderate or severe periodontitis with attachment loss of 3mm or more on
at least 8 sites on different teeth as defined by AAP
Exclusion criteria
Subjects with any systemic disease other than type 2 diabetes
Subjects presenting with major diabetic complications
Presence of any concomitant chronic or acute infection
Subjects with history of any systemic antibiotic administration or periodontal treatment within the previous
six months
Any history of allergic reaction to tetracycline
The study was approved by the Institutional Ethics and Research Committee and subjects were asked to
sign consent forms and complete a questionnaire regarding personal data and medical history. The subjects were
randomly allocated to either of two groups containing 15 subjects each: Group 1 (Treatment group) or Group
2(Control group) by block randomization. The Glycated haemoglobin (HbA1c), Probing pocket depth, and
Gingival Index (GI) were recorded at baseline in both the groups and oral hygiene instructions were given.
Patients in the treatment group received full mouth scaling and root planing followed by 0.12% chlorhexidine
mouthwash for two weeks and systemic antibiotic for 15 days (Doxycycline 100mg BD 1st
day followed by
100mg OD for 14 days). Patients in the control group received full mouth scaling and root planing followed by
0.12% chlorhexidine mouthwash for two weeks. Patients were asked to strictly follow the diet as instructed by
the Diabetologist. Patients in both the groups were recalled after 1 month to clinically evaluate whether they
maintained good oral hygiene and oral hygiene methods were reinforced if necessary. Patients in both the
groups were recalled after 3months. During this visit, HbA1c values, Probing pocket depth and Gingival index
were recorded in both the groups.
III. STATISTICAL ANALYSIS
The mean and standard deviation values per site of the clinical parameters for each group were
calculated at each examination and grouped per subject per group. The change in HbA1c values and probing
pocket depth after 3 months were compared to baseline using the paired „t‟ test. The change in GI after 3 months
was compared to baseline using the Wilcoxon test. The Mann- Whitney test was used to determine significant
differences between the two groups. The difference in HbA1c values between the groups was measured using
analysis of covariance(ANCOVA). P values < 0.05 were considered statistically significant.
IV. RESULTS
A total of 30 subjects were selected for the study. Sixteen subjects were men and 14 were women.
Their mean age was 54.6 years. Both groups had similar mean values for age, gender, GI, probing pocket depth
and HbA1c at baseline (Table 1).
Periodontal parameters
3. Comparative Evaluation of the Effect of Doxycycline As An Adjunct to...
*Corresponding Author: Dr. Roshni Ramesh 19 | Page
After 3 months, there was a reduction in the GI and Probing depth (PD) in both the groups. The overall
results showed a mean PD reduction of 1.3 mm. The GI decreased by 38%. The PD reductions for the
SRP+Doxy group was 1.7mm and for the SRP group was 0.8 mm. Thus there was a statistically significant
difference between the groups after 3 months (Table 1). Similarly there was a statistically significant difference
in GI between the groups after 3 months: SRP+Doxy showed a reduction of 43.6% and SRP showed a reduction
of 36%.
Metabolic parameter
In our study, the mean HbA1c value was 11.5% for SRP + Doxy group and 10.8 for the SRP group at
baseline. Diabetes was poorly controlled in both the groups. After 3 months, there was a reduction in the
average HbA1c levels in both the groups (Table 1). The difference in HbA1c levels after 3 months were 1.3±
0.7
Table 1. Characteristics of Study Population and Monitored Parameters (mean± SD) at Baseline and 3 months
after periodontal therapy
PD – Probing depth
GI – Gingival index
HbA1c- Glycated Hemoglobin
p-value < 0.05 statistically significant
and 0.3± 1.4 for SRP+Doxy group and SRP group respectively, with a statistically significant difference
between the two groups(Table 1).
V. DISCUSSION
The two way relationship between diabetes and periodontal disease has long been established. There is
sufficient evidence that periodontal infection affects diabetes control. Many studies have corroborated that non-
surgical periodontal therapy may ameliorate periodontal parameters and improve glycemic control. Our study
also clearly shows that in patients with poorly controlled type 2 diabetes mellitus, treatment of periodontal
disease incorporating systemic doxycycline and topicl antimicrobial results in a significant reduction in
periodontal infection and inflammation and a reduction in levels of HbA1c. An improved clinical response as
defined by reductions in gingival inflammation and probing pocket depth was seen in both the groups after 3
months. The clinical improvement was accompanied by a reduction in the glycated haemoglobin values in both
the groups. However, this reduction was statistically significant only in the SRP+Doxy group.
Some studies have failed to produce an enhanced effect of doxycycline on the probing depth13,14
.
The mean values of probing depth has been refuted as an ideal parameter to assess the positive effects of
doxycycline for the following reasons:
Shallow pockets are less likely to respond to non-surgical periodontal therapy and their mean values will also be
included in the recall visits The antibiotics may effectively penetrate deep pockets. PD changes after therapy are
more evident in the sites with deep pockets.
The hypothesis that periodontal therapy using adjunctive systemic antibiotics can improve glycemic
control (HbA1c) was substantiated in the present study. In addition to the improvement in periodontal
4. Comparative Evaluation of the Effect of Doxycycline As An Adjunct to...
*Corresponding Author: Dr. Roshni Ramesh 20 | Page
parameters there was also a significant reduction in HbA1c levels. It has been proposed that tetracyclines
including doxycycline inhibit the glycation of proteins in diabetics, acting by the anticollagenase property.
These antibiotics prevent the activation of latent pro- MMPs, de-escalate MMP expression and counteract
oxidative mechanisms responsible for periodontal tissue destruction15
.
This evidence has provided a basis for therapeutic approach in controlling periodontal disease in diabetic
individuals using tetracycline and its derivatives. In the present study the authors could not observe any adverse
effects to systemic doxycycline in any of the subjects in the SRP+Doxy group. These findings are similar to
those of Llambes etal 14
who used the same drug regimen.
In the present study, Hba1c was used as the parameter to determine the metabolic control because
unlike urine or plasma glucose, Hba1c gives an idea of the long term glycemic control. HbA1c predicts the
average glucose level over the 30-90 days preceding the test and it does not account for short term fluctuations
in plasma glucose levels. On intergroup comparison of SRP+Doxy and SRP groups, there was significant
reduction in HbA1c in the SRP+Doxy group after 3 months. Grossi etal16
in their study noted a similar reduction
in HbA1c values after 3 months. However studies by Jones etal17
, O‟Connell etal13
failed to demonstrate a
significant reduction in HbA1c values in the Doxy group after 3 months. The possible cause for lack of
significant differences in Hba1c values after 3 months may be due to the reduction of the antimicrobial drug
effect.
VI. CONCLUSION
The present study found a clinically significant association between clinical improvement in
periodontal condition and improved metabolic control of diabetes in both the treatment groups after 3 months.
However the reduction in the HbA1c values in the SRP group after 3 months was not statistically significant. On
intergroup comparison, adjunctive use of doxycycline showed improvement in both periodontal parameters and
HbA1c levels which was statistically significant. Further studies with larger sample size and longer duration are
required to substantiate the long term effects of these findings.
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