Health
March 5, 2021
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It is important to stay safe with "Shelter in Place.”

By: George Malkemus
January 22, 2021

This includes good oral hygiene, particularly brushing and flossing.  Good oral hygiene is particularly important for the diabetic patient.  Both diabetes and periodontal disease are chronic inflammatory diseases, which weaken the immune response.  A strong immune response is necessary to fight COVID-19, as well as fighting other infections.   

My father would have been 95 on Thursday, January 26.  Not long after celebrating his 94th birthday with family and friends, he peacefully passed away in February 2020.  My father amazingly dealt with late onset type I diabetes for over 47 years, half of his lifetime.  He was a special positive man and had a full wonderful life.   In his honor, I am revisiting an article that I wrote in 2017. It follows.

My Father’s personal experience with Diabetes

From my last article, I discussed how gum disease is correlated with a higher risk of developing type 2 diabetes. Periodontal disease increases blood sugar levels and increases the risk of harming the eyes and kidneys, as well as increases the risk of heart attack and stroke in diabetics.  The following is a case history of my father’s 40 years of having diabetes and trying to control his blood sugar levels, and how his good gum care has helped stabilize his diabetes.  

Diabetes runs in my family.  Genetics is the number one risk factor for getting type 1 diabetes.  My father and two of my uncles on my father’s side had late onset type 1 diabetes.  My mother was hyperglycemic.  So far, I have been lucky and have not gotten diabetes.   

My father’s older brother Ed got late onset type 1 diabetes at age 45 in the early 1960s and passed away ten years later at age 55.  Uncle Ed did not have good blood sugar control, due to the lack of medical understanding of the disease at the time, lack of blood sugar level testing at that time and his lifestyle method of controlling his blood sugar level using alcohol and candy bars.   

In 1973, my father Gene, at age 47, lost 30 pounds in one month.  He was consistently thirsty and drank large quantities of liquids.  His wife Margaret kept making him milkshakes to fatten him up to no avail.   He was diagnosed with late onset type 1 diabetes.  His pancreas had shut down and stopped producing insulin.  My father began to give himself insulin shots and tried to control his blood sugar level in an era when diabetes control was still little understood.  The only home test for monitoring sugar levels was a urine test on litmus paper that registered color when the sugar level was too high in the urine.  If it did not change color, then the sugar level was normal or low. Urine sugar levels can be much different and delayed in comparison the one’s blood sugar level.  His first physician only gave him three unit of insulin a day when he needed 65 units.  After struggling for many weeks, my father switched doctors and they worked together to establish a good program. 

 My father began eating a regular balanced diet and stopped drinking alcohol.  Even so he had difficulties.  His blood glucose levels would vary depending on his energy exercise output.  Many nights, his wife Marge would awaken in the middle of the night and find my father delirious, headed for insult shock due to his low blood sugar level. She would awaken a neighbor friend Mike and have him come help her hold my father down and force-feed him honey.  Shortly he would come around and be fine. Often my father’s blood sugar level would get too low while golfing and he would become a spacey drunk. His buddies would get him to drink juice to revive him.  Within five to 15 minutes, he would be normal again.  

One time in 1984, my father had a run in with the law because of his diabetes. It started when he was playing in a golf tournament at Rohnert Park Municipal Golf Course, now called Foxtail.   He had the best score of his life, an 81, which with a 22 handicap won the tournament.  He was so excited that he had a beer to celebrate; he had not had a drink since the diabetes began in 1973. And his big mistake was he forgot to have lunch due to low blood sugar and the beer.  He drove off to meet his wife Marge at her sister Rose’s house off Roberts Road, not far from the golf course.  Happy as a clam, he drove right past the turn off; the low blood sugar stupor had begun.  He was driving slow; weaving down the road like a drunk.  He kept hearing cars honking and people waving and shouting.  He thought that was funny and wondered what everyone was so excited about.  Finally, he was stopped in Schellville on the other side of Sonoma. The CHP asked him how much he had to drink.  He happily told him, one beer.  “How long ago?”  “About a half an hour ago.” “Sir, I am arresting you for a DUI.  Do you want a breath test, blood test or urine test?”  “Take your pick; I am not drunk.”  Because a blood test is the best evidence in court, the CHP took him a Sonoma Medical Facility.  A nurse took his blood and my father asked her to take extra blood and check for blood sugar levels because he was diabetic.  He also asked for some juice to increase his blood sugar level.  She gave him some orange juice and he began to revive. 

Then the CHP took him to the one room jailhouse just off downtown Sonoma.  The CHP booked him and took his watch, wedding ring and his diabetic bracelet.  My dad told him that the bracelet signified that he was a diabetic and was needed by the paramedics when he passed out to identify his medical problem.  The CHP replied that no jewelry was allowed in the cell.  My father asked him for some food.  “Food is not provided.”  My father said, “Then, I need someone to watch me, for in a little while I will pass out from insulin reaction.”  “There is no one to watch or monitor at this facility.  I will be back when your drunkenness has worn off to let you out.”   My dad replied “I will be dead by then.  I am doing ok now because of the orange juice I had, but it will not last long.  It is like adding a pint of gas to an empty tank.  It runs great for a little while and then stops dead.”    The CHP took another look at my dad and said, “You look pretty normal now after that juice.  How about we do a breath test?”  The breath test showed no alcohol, so he did it again with the same result.  The CHP apologized and took my dad to a coffee shop and then back to his car.   My father was fine after some food and his blood sugar returned to normal.  

I am sure that police forces and public safety in general are better trained in medical problems now. Diabetics are now able to monitor their blood sugar levels with immediate feedback from blood test strip machines like my father uses today. There are much fewer incidents like my father’s dangerous low blood sugar incident.

My father turned 91 in January.  He is doing well. He has had type 2 diabetes for over 40 years.  He has outlived three of his doctors over that span.  Sixteen years ago, he got a new doctor that told him drinking moderate amounts of alcohol is ok if his blood sugar levels are monitored.  He started drinking a glass or two of red wine every night with dinner and has been particularly rosy these past years. 

Eight years ago, he switched to a combination of 24-hour insulin and short-acting insulin that has allowed him to adjust his levels even more, so his energy levels have been more consistent and better than ever.  He had been using 2–12 hour and 4-hour doses that left more blood sugar gaps, highs and lows.  He has had some numbness and weakness in his feet and his legs.  But luckily, he has not had any heart or kidney problems that are common with diabetics.  His eyes are still good and he is still driving, though only during the daylight hours.  He also stopped smoking 30 years ago, which has had a positive impact on his diabetes, gums and overall health.  He takes good care of himself, including his teeth and gums.  When I started my practice on April 1, 1985, my father was my first patient.  He had periodontal disease at that time including a loose molar.  With periodontal treatment, the molar tightened up and he still has it today. He is meticulous with his oral hygiene and receives cleanings every three months.  Eliminating periodontal disease has definitely contributed to my father’s control of his diabetes and over all good health.

Enjoy Life and Keep Smiling! 

 

George Malkemus has a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@ malkemusdds.com.  Visit Dr. Malkemus’ Web site at http://www.malkemusdds.com