This Weird Change Is an Unexpected Sign of Diabetes Doctors Are Begging People to Pay Attention To
Diabetes can bring a number of symptoms, from blurry vision to frequent urination to fatigue to feeling thirsty and having a dry mouth. But one you might not have heard much about is bad breath.
“While uncommon, a foul, fruity odor on the breath of someone with diabetes is a very serious sign,” says Dr. Richard Calderone, DO, a board-certified osteopathic physician specializing in general public health and internal medicine.
It can be a sign of diabetic ketoacidosis (DKA), a potentially life-threatening condition that happens when the body starts breaking down fat too quickly, and the blood becomes too acidic, according to MedlinePlus. DKA is more common in people with type 1 diabetes, but Dr. Calderone says people with type 2 diabetes can have it too.
But other factors can also lead to bad breath that aren’t life-threatening. Sometimes, people with bad breath have a dry mouth, which can cause bad breath, explains Lori Blanton, MS, CHES, CDCES, program coordinator for AdventHealth Tampa, part of the American Diabetes Association’s Education Recognition Program.
Here’s what doctors want you to know about the relationship between foul-smelling breath and diabetes, and what you can do about it.
Why Can Diabetes Cause Bad Breath?
Not everyone with diabetes experiences bad breath, also known as halitosis, Blanton says.
But there are a few reasons why it might happen, says Dr. Carlo Manzana, MD, a family medicine physician with PlushCare. One is that people with diabetes are at a higher risk for periodontal (gum) disease, such as gingivitis or periodontitis. Research shows that about a third of patients with diabetes experience gum disease.
The high blood sugar levels that often accompany diabetes can lead to excessive amounts of sugar in the saliva, which feeds bacteria in the mouth, promotes plaque buildup and potentially causes gum disease and tooth decay, Dr. Calderone says. It can also lead to bad breath.
Diabetes, especially when uncontrolled, can also reduce saliva production, causing a dry mouth, he adds. Saliva helps control bacterial growth and break down food, so you might get bad breath when you’re not producing as much.
More seriously, bad breath can be a symptom of DKA, a medical emergency that occurs when the body can’t get energy from glucose, often because of a lack of insulin or insulin resistance, Dr. Manzana says. The body then starts burning fat instead and produces ketones, or acids. When ketones are produced too quickly and build up in the blood, they can become toxic and make the blood acidic.
DKA is sometimes an early sign of type 1 diabetes; it’s less common and less severe for people with type 2 diabetes, according to Medline Plus.
Usually, bad breath in type 2 diabetes is a symptom of uncontrolled diabetes, Dr. Calderone notes.
How to Manage Diabetes-Related Bad Breath
Managing diabetes to keep your blood sugar in a healthy range is the first step to minimizing bad breath, Blanton says. That includes regularly monitoring your blood sugar and seeing your doctor, as well as adjusting your diet, exercising and taking insulin and other medications, according to the Mayo Clinic.
Related: What's the Difference Between Ozempic and Metformin, and Which One Is Right for You?
To keep your mouth healthy, the American Dental Association recommends:
Brushing your teeth twice a day for two minutes
Flossing once a day
Seeing a dentist regularly
Limiting sugary foods and beverages
Also, drink plenty of water to stay hydrated, Blanton says. It’ll help keep your mouth moist and wash away bacteria, according to Dr. Calderone.
Avoiding smoking or other tobacco products and excessive alcohol, limiting strong-smelling foods and drinks and using alcohol-free mouthwashes can help too, Dr. Calderone adds.
Can You Get Rid of Bad Breath from Diabetes?
You can usually drastically improve bad breath associated with diabetes, but it might be challenging to completely get rid of it since diabetes is a chronic condition that requires ongoing management, Dr. Calderone explains.
Related: The #1 Food That Helps With Insulin Resistance, According to Dietitians Who Specialize in Diabetes
Still, practicing good oral hygiene, staying hydrated, managing blood sugar and getting regular dental check-ups can help, he emphasizes.
“Individuals with diabetes must receive comprehensive care and support from healthcare professionals to manage all aspects of their health, including oral health and diabetes-related symptoms like bad breath,” Blanton says.
What to Do When You Have Persistent Bad Breath
In addition to diabetes, bad breath can be a symptom of other medical conditions, including oral, nasal, respiratory, gastrointestinal or systemic conditions, Dr. Manzana says.
So if you can’t seem to get rid of your bad breath no matter what you try, see your doctor or a dentist and discuss any other symptoms that you’re dealing with. Dr. Manzana says they can help find the correct diagnosis and appropriate treatment plan.
Next, read about what you should know if you have prediabetes.
Sources:
Richard Calderone, DO, a board-certified osteopathic physician specializing in general public health and internal medicine
Lori Blanton, MS, CHES, CDCES, program coordinator for AdventHealth Tampa, part of the American Diabetes Association’s Education Recognition Program
Carlo Manzana, MD, a family medicine physician with PlushCare
Understanding Type 2 Diabetes, American Diabetes Association
Diabetic ketoacidosis, MedlinePlus
Diabetes and Dry Mouth, Cleveland Clinic
Home Oral Care, American Dental Association