Dry Tongue: Possible Links to Stomach Ulcers and Diabetes

Regarding dry tongue?

Hello Doctor, let me describe my condition: Two and a half years ago, during a newborn health check, my fasting blood glucose was 75 mg/dL, with no diabetes, and everything else was normal.
About one to two years ago, I experienced two episodes of dry mouth (which led to increased urination when I drank more water; if I didn't drink, I wouldn't urinate, and this applies to all instances mentioned) along with symptoms of a gastric ulcer.
In between, I had a military health check (during summer service), which did not show any blood sugar issues (I had my blood drawn 2-3 hours after a meal) and no diabetes.
Two months ago, I had another episode (again with dry mouth and gastric ulcer symptoms).
I was a bit afraid to see a doctor, but the next day, he ordered a fasting blood test (including liver and kidney function tests), and I had gained two kilograms compared to six months ago.
He also ordered a urinalysis.
Four days later, when I reviewed the report, the paper copy hadn't been released yet, so I didn't know if he had tested for glycated hemoglobin.
My fasting blood glucose was 99 mg/dL, liver and kidney functions were normal, and there was no glucose in the urine (second morning urine).
He noticed I was still a bit anxious and asked me if I had eaten.
I replied that I had a 350ml unsweetened oat milk about an hour ago.
He said that one hour is acceptable and suggested I do a postprandial test (but upon reflection, it had only been about 40 minutes, which made me worry about the 20-minute discrepancy).
The result was 104 mg/dL.
Additional notes: (1) Sometimes, I notice dry mouth more prominently 10-20 minutes after meals, but not always; (2) There is no family history of illness in the last three generations (at least none have been discovered so far); (3) I am 21 years old, with a BMI of 19, I eat out often, and sometimes go to bed late, around 2-3 AM, but recently adjusted to midnight; (4) The dryness is more noticeable at the back of my tongue; (5) I tend to feel thirstier after a big meal (this has been the case for as long as I can remember).
My questions are: [1] Recently, I have experienced a recurrence of dry mouth and gastric ulcer symptoms, and I am a bit worried that I might have diabetes.
Should I continue testing? [2] Since the gastric ulcer and dry mouth always appear and disappear together, is there a connection between the two? Thank you very much.

Dàxuéshēng, 20~29 year old female. Ask Date: 2020/05/24

Dr. Hong Yuanbin reply Internal Medicine

Hello, regarding your question about dry mouth, it is likely not caused by other underlying diseases.
Typically, a healthy young person should consume around 2000-3000 cc of fluids (including water) per day, especially in hot weather when fluid loss is rapid.
It is advisable to measure how much water you drink in a day when you have time, as it seems you may not be drinking enough, which could be causing your thirst.

As for the gastric ulcer, there are many causes, including Helicobacter pylori infection and certain dietary habits, but it should not be directly related to whether you have diabetes or experience thirst.
Based on your blood sugar levels, it appears you do not have diabetes.
If you are still concerned, you can purchase a blood glucose meter to check your fasting blood sugar levels and then consult with a metabolic specialist.
Thank you for your inquiry.

Reply Date: 2020/05/24

More Info

Hello! Thank you for sharing your concerns regarding dry tongue, stomach ulcers, and the potential link to diabetes. Based on your description, it seems you are experiencing a combination of symptoms that warrant further investigation. Let’s break down your questions and provide some insights.

Understanding Your Symptoms
1. Dry Tongue and Stomach Ulcers: The occurrence of dry tongue (xerostomia) alongside stomach ulcers can be indicative of several underlying issues. Dry mouth can result from dehydration, certain medications, or conditions affecting salivary glands. In your case, the dry tongue appears to correlate with your stomach ulcer symptoms, which may suggest a connection between the two. Stress, dietary choices, and gastrointestinal health can all influence both conditions.

2. Potential Link to Diabetes: Your fasting blood glucose levels have been within normal limits, but the recent reading of 104 mg/dL postprandial (after eating) raises some questions. While this is still considered within the normal range, it is on the higher side, especially for someone your age. The symptoms of dry mouth and increased thirst can be associated with diabetes, but they can also arise from other factors such as dehydration or medications. Given your family history is clear, it may be less likely, but it’s still important to monitor your blood sugar levels regularly.

Recommendations
1. Further Testing: Since you have experienced recurring symptoms of dry tongue and stomach ulcers, it would be prudent to continue monitoring your blood glucose levels. A hemoglobin A1c test can provide a more comprehensive view of your blood sugar control over the past few months. If you notice persistent symptoms or worsening of your condition, consult your healthcare provider for further evaluation.

2. Dietary Considerations: Pay attention to your diet, as certain foods can exacerbate stomach ulcers and contribute to dry mouth. Avoid spicy, acidic, or overly salty foods, and consider increasing your water intake to combat dryness. Eating smaller, more frequent meals may also help manage both your stomach and hydration levels.

3. Lifestyle Modifications: Since you mentioned irregular sleep patterns, try to establish a more consistent sleep schedule. Poor sleep can affect your overall health and may contribute to gastrointestinal issues. Additionally, managing stress through relaxation techniques, exercise, or mindfulness can be beneficial for both your stomach health and overall well-being.

4. Medication Review: If you are taking any medications, review them with your healthcare provider. Some medications can cause dry mouth as a side effect, which may exacerbate your symptoms.
5. Follow-Up: Regular follow-ups with your healthcare provider are essential. If your symptoms persist or worsen, further diagnostic tests, such as an endoscopy for your stomach ulcers or additional blood tests for diabetes, may be necessary.

Conclusion
In summary, while there may be a connection between your dry tongue and stomach ulcers, it is essential to approach this with a comprehensive view of your health. Monitoring your blood sugar levels, making dietary and lifestyle adjustments, and maintaining open communication with your healthcare provider will be crucial in managing your symptoms. If you have any further questions or concerns, don’t hesitate to reach out to a medical professional for personalized advice. Your health is important, and taking proactive steps can lead to better outcomes.

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