A sweet, fruity odor from your breath may indicate ketoacidosis, an acute complication of diabetes. An odor of ammonia may be associated with kidney disease, which can sometimes be linked to diabetes.

Your breath has an interesting ability to provide clues to your overall health, including diabetes complications.

Other conditions, such as asthma, cystic fibrosis, lung cancer, and liver disease, may also lead to distinct odors on the breath.

Breathing tests may also help doctors identify diabetes, and research from 2021 has suggested that measuring carbon dioxide in the breath could help diagnose prediabetes or early stage diabetes.

Diabetes-related halitosis may have two main causes: Periodontal disease and high levels of ketones in the blood.

Periodontal diseases

Diabetes can damage blood vessels, reducing blood flow throughout your body, including gums. If gums and teeth don’t have enough blood supply, they may become weak and more prone to infection.

Diabetes may also raise glucose levels in your mouth, promoting bacteria growth, infection, and bad breath. When your blood sugar levels are high, your body may have difficulty fighting infection, making it harder for the gums to heal.

Periodontal diseases, also called gum diseases, include gingivitis and periodontitis. In these inflammatory conditions, bacteria attack the tissues and bone that support your teeth. Inflammation can affect metabolism and spike your blood sugar, which may worsen diabetes symptoms.

Diabetes can lead to periodontal diseases, but these conditions can also create further problems for people with diabetes. Heart disease and stroke, which can be complications of diabetes, are also linked to periodontal disease.

If someone with diabetes develops periodontal disease, it may be more severe and take longer to heal than a person without diabetes.

Bad breath is a common sign of periodontal disease. Other signs include:

  • red or tender gums
  • bleeding gums
  • sensitive teeth
  • receding gums

Ketones

High ketone levels often cause bad breath. One of the ketones, acetone (a chemical found in nail polish), can cause your breath to smell like nail polish.

When your body can’t make insulin, your cells don’t receive the glucose they need for fuel. To compensate, your body switches to burning fat. Burning fat instead of sugar produces ketones, which build up in your blood and urine.

Your body also produces more ketones when you’re fasting or on a high protein, low-carbohydrate diet, although not to the same level as in diabetic ketoacidosis, a medical emergency.

When ketones rise to unsafe levels, your chances for diabetic ketoacidosis increase. Symptoms may include:

  • a sweet and fruity odor on your breath
  • more frequent urination than typical
  • abdominal pain, nausea, or vomiting
  • high blood glucose levels
  • shortness of breath or difficulty breathing
  • confusion

If you have these symptoms, seek medical help immediately.

You can delay gum diseases or lessen their severity. Here are some daily tips to consider:

  • Brush your teeth at least twice a day and floss daily.
  • Don’t forget to brush or scrape your tongue, a prime breeding place for foul-smelling bacteria.
  • Drink water and keep your mouth moist.
  • Keep your blood sugar levels in their target range.
  • Use sugar-free mints or gum to stimulate saliva.
  • Visit your dentist regularly and follow their treatment recommendations. Make sure the dentist knows you have diabetes.
  • A doctor or dentist may prescribe a medication to stimulate saliva production.
  • If you wear dentures, ensure they fit well and take them out at night.
  • If you smoke, consider quitting.

What does diabetic breath smell like?

If a person cannot effectively manage their blood sugar levels, they could develop diabetic ketoacidosis. One symptom of DKA is fruity breath due to high levels of acetone in the body. Other factors common in diabetes, like gum disease, can also cause bad breath.

What does it mean when a person with diabetes has bad breath?

A fruity smell on the breath can be a sign of diabetic ketoacidosis, a medical emergency. A smell of ammonia can indicate kidney disease, a common compilation of diabetes. Halitosis, or bad breath, can be a sign of gum disease.

How do you get rid of diabetic breath?

Diabetic ketoacidosis requires urgent medical attention. If you think you have kidney disease or gum disease, you should seek medical advice as soon as possible. Managing blood sugar levels can help prevent complications that would cause bad breath.

Other tips include regular brushing and flossing, drinking plenty of water, and following a varied diet rich in fruits and vegetables and low in added sugar.

Bad breath in diabetes may indicate a high production of ketones (a medical emergency) or gum disease. Liver and kidney disease may also lead to persistent bad breath and also require medical attention.