Let’s talk about gas. Yeah, you heard that right: gas. Everyone has it—on average, humans pass it about 14 times a day. But some people with diabetes find themselves suddenly having an excess of flatulence that can be upsetting—and embarrassing. So embarrassing, in fact, that they might not even want to talk to their health care provider about it. That’s a mistake. Because problems like this are usually treatable. And some “yuck factors”—for example, chronic yeast infections—are actually symptoms of poor blood glucose control or complications of diabetes, which need medical attention, pronto. Read on for some of the more common ailments associated with diabetes, and then let your doctor know if you’ve got ’em.
PROBLEM: I have morning breath … all day long.
The cause of bad breath may be as simple as that garlicky salad dressing you ate at lunch, but breath that reeks consistently can indicate a bigger problem. “Diabetes is a big risk factor for periodontal disease,” says Robert Eber, DDS, MS, clinical professor of dentistry and associate chair of periodontics and oral medicine at the University of Michigan School of Dentistry. Periodontal disease occurs when plaque and bacteria in the mouth cause gum inflammation, tissue damage, and even loss of bone beneath the teeth. Since periodontal disease is an infection, it can raise your blood glucose levels by increasing insulin resistance. Untreated, it will lead to tooth loss.
Periodontal disease is usually painless; no throbbing toothache will spur you to seek treatment. Bleeding whenever you brush or floss is a warning sign, but by the time you have other symptoms—swollen or red gums, loosening teeth, plaque buildup, bad breath, or widening spaces between your teeth—the disease is in its later stages. Periodontal treatment focuses on stopping progression, not reversing damage, so it’s important to get frequent checks to prevent problems in the first place. “After you initially get diagnosed with diabetes, it would be a good idea to get screened by a dentist or periodontist,” says Eber. Then, aside from regular dental checkups, prevention is up to you. Brush twice a day, floss daily (flossing is the only way you’ll scrape plaque and bacteria from your teeth and gums between regular cleanings), and keep your blood glucose in control; poor glucose control puts you at greater risk for periodontal disease.
PROBLEM: I can’t keep my food down.
Having diabetes (particularly type 1) is a major risk factor for gastroparesis, a condition in which delayed stomach emptying causes nausea, bloating, extreme fullness after a meal, vomiting, unwanted weight loss, and pain in the upper abdomen. The disease itself can be debilitating, but it can also make diabetes management seem impossible. Because it takes extra time for the stomach to empty and glucose levels to rise, premeal insulin can lead to hypoglycemia. Then, an hour or two later, when the stomach finally releases food, blood glucose levels can spike.
The solution? “You have to get the stomach to work better or change the consistency of food,” says Michael Camilleri, MD, a gastroenterologist at the Mayo Clinic. Since liquids move through the stomach faster than solids, Camilleri puts patients on a diet of pureed food to regain weight and add much-needed nutrients. Many people can go on to eat solid foods again, with modifications (nix the fiber and fat, and eat small meals often). “It’s manageable with a change of diet,” Camilleri says, noting that medications to treat the disease may have side effects and typically are not effective in the long run. If you’ve been diagnosed with gastroparesis, you’ll need to work with a registered dietitian to reshape your diet. You’ll also need to work with your doctor on ways to adjust your insulin. Since high blood glucose can delay stomach emptying even in people without gastroparesis, good control is key.
PROBLEM: My skin is thick and waxy-looking.
Ten to 15 percent of people with diabetes will experience the skin condition known as scleredema (not to be confused with the autoimmune disease scleroderma). Over time, high blood glucose can change the structure of the skin’s collagen, a fibrous protein, causing skin on the neck, upper back, and shoulders to thicken and become tough. If you catch it early, you can treat scleredema before a new collagen structure permanently reduces your skin’s elasticity, says Intekhab Ahmed, MD, an endocrinologist at Jefferson Medical College in Philadelphia who studies skin diseases in people with diabetes. Prevention is key. “[People with diabetes] are more prone to develop skin conditions,” says Ahmed. “The moment they see something they should consult their doctor—before things get out of hand.”
PROBLEM: I can’t have—or keep—an erection.
Despite those omnipresent Viagra, Cialis, and Levitra commercials, “a lot of physicians never ask if a patient has erectile dysfunction,” says Ronald Tamler, MD, PhD, MBA, CNSP, an assistant professor of medicine, endocrinology, diabetes, and bone disease at Mount Sinai Medical Center in New York, whose research focuses on erectile dysfunction in people with diabetes. The connection between erectile dysfunction and diabetes is strong: Men with diabetes are three times as likely to experience the problem as those without diabetes. The link is similar to the diabetes–heart attack connection: Blocked arteries in the heart can lead to heart attack, but smaller arteries typically clog up first, such as those in the penis. “That’s one of the reasons why erectile dysfunction is not just more complications of diabetes but also precedes other complications like coronary artery disease,” says Tamler. Other risk factors for erectile dysfunction include old age, obesity, and low testosterone, a problem common to men with diabetes.
Now here’s the good news: Most of the time, the problem can be alleviated. If a man is overweight or obese, losing weight may do the trick. Exercising may help, too. Controlling blood glucose can stop erectile dysfunction. And medications can also be effective. If you think erectile dysfunction is just an embarrassing annoyance, it’s time to start taking it seriously. “See this as a potential warning sign of complications [like heart attack or stroke],” says Tamler. “Force or initiate changes that will benefit [your] cardiovascular system.”
Next: Vaginal itch, crumbly toenails, and more