The Relationship Between
Diabetes and Bad Breath

If you have both Diabetes and bad breath, you may have Diabetic Ketoacidosis. This should definitely give some cause for concern. On the other hand, having bad breath does not necessarily mean you have Diabetes.

About 12 years ago, long before I was diagnosed as being diabetic, I complained to my doctor about a funny metallic taste in my mouth as well as halitosis. One of the things he tested was my blood sugar. As it turned out, I was not diabetic. I simply treated the symptoms, and everything worked out just fine.

Now that I am a diabetic, I try to take better care of myself and educate myself regarding diabetic complications and their symptoms. If I ever experience Diabetes and bad breath at the same time again, I'll have a full understanding of the risks and potential complications.

The following information has been provided by MedlinePlus®, a service of the U.S. National Library of Medicine and the National Institutes of Health. I hope that it will educate you and help you to take better care of yourself. If you are experiencing both Diabetes and bad breath, this information could save your life.

Diabetic Ketoacidosis, also referred to as DKA or Ketoacidosis, is a complication of diabetes caused by the buildup of by-products of fat metabolism (ketones), which occurs when glucose is not available as a fuel source for the body.

People with diabetes lack sufficient insulin, a hormone the body uses to process glucose (a simple sugar) for energy. When glucose is not available, body fat is broken down instead. The by-products of fat metabolism are ketones. When fat is metabolized, ketones build up in the blood and "spill" over into the urine. A condition called ketoacidosis develops when the blood becomes more acidic than body tissues.

Blood glucose levels become elevated (usually higher than 300 mg/dL) because the liver produces glucose to try to combat the problem and because cells cannot take up that glucose without insulin. Diabetic ketoacidosis may lead to the initial diagnosis of type 1 diabetes, as it is often the first symptom that causes the person to come to medical attention. It can also be the result of increased insulin needs in someone already diagnosed with type 1 diabetes. Infection, trauma, heart attack, or surgery can lead to diabetic ketoacidosis in such cases. This is why it's so important to recognize the simplest things, such as the relationship between Diabetes and bad breath.

People with type 2 diabetes usually develop ketoacidosis only under conditions of severe stress. Poor compliance with diet and treatment is usually the cause when episodes are recurrent.


  • Frequent urination or frequent thirst for a day or more
  • Fatigue
  • Nausea and vomiting
  • Muscular stiffness or aching
  • Mental stupor that may progress to coma
  • Rapid deep breathing
  • Fruity breath (breath odor) [Definite relationship between Diabetes and Bad Breath]

Additional symptoms that may be associated with this disease:

  • Headache
  • Decreased consciousness
  • Breathing - rapid
  • Breathing difficulty - lying down
  • Low blood pressure
  • Appetite - loss
  • Abdominal pain

Signs and tests

  • Low blood pressure
  • Rapid heart rate
  • Signs of dehydration
  • High blood glucose (above 300 mg/dL)
  • Presence of glucose and ketones in urine by home or office testing
  • Serum potassium (may be elevated)
  • Serum amylase (may be elevated)
  • Arterial blood gas (reveals pH of less than 7.3)

This disease may also alter the results of the following tests:

  • Urine pH
  • Sodium - urine
  • Serum sodium
  • Potassium - urine
  • Serum phosphorus
  • Serum magnesium - test
  • CSF collection
  • CO2

The goal of treatment is to correct the elevated blood glucose level by giving additional insulin, and to replace fluids lost through excessive urination and vomiting. A person with diabetes may be able to recognize the early warning signs and make appropriate corrections at home before the condition progresses.

If ketoacidosis is severe, hospitalization is required to control the condition. Insulin replacement will be given, fluid and electrolytes will be replaced, and the cause of the condition (such as infection) will be identified and treated.

Expectations (prognosis)
Cell damage from acidosis can lead to severe illness or death. Improved therapy for young diabetics has decreased the death rate associated with this condition. However, it remains a significant risk in the elderly and in people who fall into a profound coma when treatment has been delayed.


  • Heart attack
  • Death of bowel tissue due to associated low blood pressure
  • Renal failure

Calling your health care provider
This condition can become a medical emergency. Call your health care provider if you notice early symptoms of diabetic ketoacidosis.

Go to the emergency room or call the local emergency number (such as 911) if nausea, vomiting, fruity bad breath, mental stupor, difficulty breathing, or decreased consciousness occur.

Diabetics should learn to recognize the early warning signs and symptoms of ketoacidosis. Measurement of urine ketones in people with infections or people on insulin pump therapy can give more information than glucose measurements alone.Even something as simple as recognizing the relationship between diabetes and bad breath could save your life or the life of someone you love.


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