Ask D"Mine: Fear and Denial of Diabetes

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Got questions about life with diabetes? So do we! That"s why we offer our weekly diabetes advice column, Ask D"Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois.

This week, Wil is coming to the rescue for a woman whose family has a history of diabetes and she"s living in fear of symptoms that could indicate she"s about to join the D-Club.

Got your own questions? Email us at AskDMine@diabetesmine.com

Martha from Georgia, writes: My family has a history of diabetes so I am kind of afraid with these symptoms: Terrible bad breath (mouth odor) and frequent urine late at night.

Wil@Ask D’Mine answers: Your fear is justified.Get to your doctor. Pronto. Here’s why: You probably have diabetes. And if you don’t, you have some other serious medical problem that needs attention. Right away.

Of the two symptoms you’re afraid of, it’s your frequent urination at night that rings alarm bells. The medical term for it is polyuria. Well, actually, that’s less than accurate. As your bathroom runs tend to be after the sun sets, the proper term is nocturia.

The number one cause of nocturnal bathroom runs is elevated blood sugars, signaling undiagnosed and uncontrolled diabetes. Given your family history, I’d put money on that. Of course, there are other pissibilities… sorry, I meant to say possibilities.

It could be a bladder obstruction. Or bladder cancer.

It could be congestive heart failure.

Less commonly, peeing frequently can signal kidney failure or sickle cell anemia. Or it could be as simple as a medication reaction, or drinking too many beers before bed.

If you excrete a lot of urine each time you get up, it’s much more likely to be a blood sugar issue. If you get up frequently and only dribble, it’s more likely to be something with the bladder.

But big pee or little pee, given that the list of possible causes include a lot of serious diseases that, left untreated, could kill you—and a couple of simple quick-fixes that would return you to a good night’s sleep—don’t you think you should have this checked out?

OK. Enough toilet talk. Let’s talk about the potty breath. Because while the nocturia alone is reason enough to go to the doc, you also have something else going on, too. Bad breath, called halitosis, can be caused by a wide spectrum of things that may or may not have anything to do with the possible diabetes.

Bad breath can be caused by acid reflux, excessive alcohol consumption, smoking, and assorted dental problems ranging from cavities to simply not flossing enough. Or at all. Plus some more serious stuff like respiratory tract infections and liver disease, and some not-so-serious stuff like medication reactions. According to the prestigious Mayo Clinic, a leading cause of bad breath in young children, “can be caused by a foreign body, such as a piece of food, lodged in a nostril.”

Huh.

OK, I’m not thinking that’s the case with you.

Anyways, if bad breath were your only symptom, I’d be less inclined to blame diabetes. But because of the nighttime peeing, I’m thinking the two could be connected. Here’s how the connection between diabetes and bad breath works: A common cause of bad breath that I haven’t mentioned yet is bacteria in the mouth. Bacteria thrive on glucose. So if your blood sugar is high, your mouth becomes a breeding ground for bacteria.

Yeah. I know, it sounds yucky. But that’s because it is yucky.

Top of the list when it comes to blood-sugar-driven mouth issues is periodontal disease, which left untreated can actually trigger a nasty feedback loop in which the growing infection actually makes your blood sugar worse, and the higher the sugar gets the more the infection grows, and the more the infection grows… Well, you get the idea.

Plus, the bad breath is just the tip of the iceberg when it comes to periodontal disease. Down below the gums, the infection eats away at your jawbone. You can lose your teeth. And worse.

Oh. Right. All of the above assumes garden-variety foul breath. If your breath smells like rotting fruit, stop reading this and drive to the emergency room. Right now. Rotting fruit breath is the warning sign of imminent diabetic coma.

So there’s plenty to be afraid of here. I understand fear, but there’s more than fear happening here. You are worrying, but doing nothing. That’s called denial. I get it that there’s a certain safety in worrying rather than knowing. But here’s the deal: You really do need to know. If it’s diabetes and you ignore it, it will kill you. And it won’t be pleasant or fast. Given your family history, you might have already seen this. Maybe some of your kinfolks suffered in the past, or aren’t doing too well right now.

But that doesn’t need to be you.

Diabetes treatment has come a long way. So far, in fact, that I think we should rebrand it as “New and Improved Diabetes.” Now with less blindness, amputations, and kidney failure! Ask your doctor if New and Improved Diabetes is right for you!

Ahem... my point is that the outcomes of your elders don’t need to be your outcomes. We’ve come a long way, baby. And the key to a long and healthy diabetes life is to find diabetes early and get it contained before it starts hurting you.

Get this checked out.

If it turns out not to be diabetes, then you can stop worrying about that. If it turns out to be simple medication reactions, then that can be fixed. And if it turns out to be something else serious other than diabetes, the sooner you get it treated, the better.

After all, in the entire history of the human race, nobody ever got better by ignoring the signs of a serious, chronic, progressive illnesses.

So get to your doctor, pronto.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.

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