Your breath has an interesting ability to provide clues to your overall health.

A sweet, fruity odor can signify ketoacidosis, an acute complication of diabetes. An odor of ammonia is associated with kidney disease. Similarly, a very foul, fruity odor may be a sign of anorexia nervosa.

Other diseases, such as asthma, cystic fibrosis, lung cancer, and liver disease, also can cause distinct odors on the breath.

Breathing tests may even help doctors identify diabetes. Research from 2021 has shown that measuring carbon dioxide in the breath might help identify prediabetes or early stage diabetes.

Diabetes-related halitosis has two main causes: periodontal disease and high levels of ketones in the blood.

Periodontal diseases

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

Though diabetes can lead to periodontal diseases, these diseases can also create further problems for people with diabetes.

According to a 2013 report, about 1 in 3 people with diabetes also experience periodontal diseases. Heart disease and stroke, which can be complications of diabetes, are also linked to periodontal disease.

Diabetes can damage blood vessels, reducing blood flow throughout your body, including your gums. If your gums and teeth aren’t receiving a proper 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 sugars are high, it becomes hard for the body to fight infection, making it harder for the gums to heal.

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


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.

Ketones can also be produced when you’re fasting or on a high protein, low-carbohydrate diet, although not to the same level as in diabetic ketoacidosis.

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 ketones rise to unsafe levels, your chances for diabetic ketoacidosis (DKA) increase. Symptoms of DKA 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

DKA is a dangerous condition, mostly limited to people with type 1 diabetes whose blood sugars are uncontrolled. If you have these symptoms, seek medical help immediately.

Along with neuropathy, cardiovascular disease, and other concerns, periodontitis is a common complication of diabetes. But 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.
  • Your 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 manage their blood sugar levels effectively, they could develop diabetic ketoacidosis (DKA). One symptom of DKA is fruity breath due to high levels of acetone in the body. Also, other factors can 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 DKA. 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?

DKA 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 lead to 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 may be a sign of something more. If you have diabetes, it’s essential to be aware of what your breath may be telling you. Your understanding may save you from advanced gum disease or the dangers of DKA.