Fruity Breath: Is it a Sign of Diabetes?

Fruity breath

Diabetes and Fruity Breath

A bad breath is experienced by everyone at some point of time or another. Sometimes it is harmless and is a consequence of your eating habits and poor mouth hygiene. However, if that is not the reason it could indicate something dangerous. A fruity or bad breath could be a signal of a health condition.  Researchers found that ‘Infrared breath analyzers’ can be effective in identifying prediabetes in the early stages.

diabetes and fruity breath

It could be a sign of diabetes and diabetic ketoacidosis. In some cases, it could be a sign of liver disease. If your breath has a fruity smell, it could be a signal of a complication of diabetes called ketoacidosis. If your doctor detects the smell of ammonia, it may indicate kidney disease. A distinct odor is also caused by conditions like asthma, lung cancer, and cystic fibrosis. These conditions can be dangerous or even fatal. Therefore, it is important to know the reason behind your fruity breath.

It is usually caused by the food we eat like onion or garlic. Another reason for fruity breath could be the intake of excessive fat and protein. During the digestion of fat and protein in your body, some chemicals are released that can cause a fruity smell when you breathe out. 

Causes Of Fruity Breath

Although diabetes is the main cause of acetone breath, it can be the result of many other conditions like- 

Diabetic Ketoacidosis/ketones

Diabetes accumulates the sugar in the bloodstream causing high blood sugar levels. It happens due to the lack of insulin, which is a hormone that helps sugar move into blood cells from the bloodstream. When body cells do not get sugar for the energy, your body starts breaking down fat and protein for the same. This process is known as ketosis, and this breakdown of fat secretes and builds up acid in your blood called ‘ketones’. Diabetic ketoacidosis usually occurs in people with type 1 diabetes but can occur in people with type 2 diabetes

Generally, when the fat is broken down, ketones levels do not rise in the blood. But in the case of diabetes when glucose is not available for energy, fat is broken down most of the time, therefore, raising ketone levels.

If the condition does not get treated, it may lead to Diabetic Ketoacidosis. Fruity breath is a sign of high levels of ketones in the blood. So, a fruity breath is a symptom of diabetic ketoacidosis.

 If you have bad breath and are wondering if it is diabetic ketoacidosis. Check out for other symptoms of ketoacidosis like-

Diabetic ketoacidosis symptoms

  • Frequent urination
  • Nausea
  • Pain in abdomen
  • Difficulty in breathing
  • State of confusion
  • Dry skin
  • Blurred vision

Keto Diet & Fasting

keto diet

Many people, especially diabetics go on a keto diet or low carb diet to enter a state of ketosis. People follow this diet to lose weight, often. In this process, the body uses fat for energy thus producing ketones and acetone which can cause fruity or bad breath.

People even measure their ketone levels to make sure if their body is burning fat or not. 

You may also experience fruity breath when you are fasting. That is because your body is using fat rather than blood sugar for energy. The fruity smell is not a sign of anything bad in these conditions and may disappear in a while. 

Alcoholic Ketoacidosis

alcoholic ketoacidosis

This phenomenon is also one of the causes of fruity smell. Alcoholic ketoacidosis is just like ketoacidosis caused by excessive intake of alcohol. Drinking alcohol in excessive amounts, throwing up, and not eating can increase the ketone levels in your blood. Alcoholic ketoacidosis can get better if treated right away, otherwise it is severe. It is also hard to diagnose because of the symptoms. Throwing up, bad stomach, sickness, and pain are all symptoms of alcoholism, so it can be tough for doctors to diagnose alcoholic ketoacidosis.

Periodontal Disease

periodontal disease

Periodontal disease is an inflammatory disease commonly called gum disease. It also includes gingivitis, mild, periodontitis and advanced periodontitis. Bacteria cause inflammation in the muscles that support your teeth. This inflammation can worsen diabetes by increasing blood sugar levels. According to studies, one in three patients with diabetes is likely to experience periodontal disease. Some other complications of diabetes like heart disease or stroke are also linked to periodontal disease. 

High blood sugar can damage blood vessels which can affect blood flow throughout your body. When the gums do not receive blood properly, they may become weak and more prone to infection. Periodontal problems can be hard to heal as high blood sugar weakens your immune system. You will experience red, bleeding, tender gums in periodontal disease. But if you do not have diabetes it can be cured easily providing relief from fruity breath.

Dry Mouth 

Diabetics may experience the problem of dry mouth, which could be a reason for bad breath. A dry mouth lacks saliva in the mouth which can attack the surfaces of your teeth and lead to tooth decay. Saliva also helps wash away leftover food particles that can accumulate bacterias. To avoid a bad breath or dry mouth, drink a lot of water. There are some sugar-free gums available in the market which helps in saliva production. A diabetic can consume them to get rid of bad breath. A diabetic should keep the doctor informed about such problems because there could be other serious problems causing bad breath.

Hyperglycemic Hyperosmolar Syndrome(HHS)

Hyperglycemic hyperosmolar syndrome is a condition similar to diabetic ketoacidosis. It occurs in people with type 2 diabetes causing extremely high blood sugar. This condition is serious and can even cause a diabetic coma or death if left untreated. 

People with the hyperglycemic hyperosmolar syndrome have more severe hyperglycemia than diabetic ketoacidosis. The buildup of ketones in the body can also occur in this condition. It also causes fruity breath. HHS is often seen in people who are unaware of their diabetes or when diabetes is not in control. This condition can be prevented to an extent by drinking gallons of water. 

Liver Disease

A bad breath is also a symptom of liver disease. In some cases, fruity breath related to liver disease is mustier. Whereas fruity breath associated with ketones has an acetone-like scent. 

Bad breath caused by liver disease is called fetor hepaticus. People with liver disease have higher levels of acetone in their body causing bad breath. The link between a fruity breath and liver disease is so telling, that doctors even use it to detect liver disease. 


Who Is At Risk Of Developing Fruity Breath?

A person may be at risk of experiencing fruity breath if-

  • They have type 1 or type 2 diabetes, and their insulin requirement is not met.
  • They are suffering from an insulin reaction
  • A person does not eat enough
  • The blood sugar is not controlled
  • The intake of cocaine or other drugs
  • Intake of alcohol is in large amounts
  • A person has pancreatitis
  • Are not aware of how to take insulin 
  • A heart attack 
  • Somebody does not maintain mouth hygiene
  • They do not floss regularly

It may not look that serious but a fruity breath might be a symptom of a more chronic problem.  


Preventions For Fruity Breath

You can prevent fruity breath by preventing complications of diabetes like diabetic ketoacidosis. There are the following things you can add- 

prevention of fruity breath

Track your blood sugar level- You need to keep track of your blood sugar level to avoid the complications of diabetes. Check your blood sugar levels three to four times a day. Check it after eating or before eating. And if you’re stressed or ill, keep special care of yourself. Eat nutritious food and stay physically active, take a sound sleep of 7-8 hours of sleep. 

Recheck your insulin dosage- If your blood sugar level is often fluctuating, talk to your doctor and tell them about the situation. Sometimes lifestyle affects your blood sugar level more than anything, so try to understand how your body acts to certain things. And do what suits you the best. Follow your treatment plan as prescribed by the doctor and inform them of any changes you feel.

Keep checking your ketone level– Having a bad breath or have experienced fruity breath or diabetes, then keep an over-the-counter urine ketones test kit. Keep checking your ketone levels, if it is high consult your doctor immediately. And if the ketone level is low you may need to increase the amount of your insulin dose.

Maintain mouth hygiene- If you are experiencing a bad breath because of poor hygiene, then it’s time you pay attention to it for your health. Brush your teeth regularly. Also, you can ask your doctor to prescribe you medication for it.

Seek medical help-  When your blood sugar and ketone level are too high, seek medical care immediately. Hospitalization may be needed if you have severe diabetic ketoacidosis. These complications are scary and harmful. Therefore it’s important to take good care of your health and manage your diabetes first hand.

Treatment For Fruity Breath

Treatment for oral health problems like fruity breath related to diabetes differs according to the cause behind it. For example-

For keto diet– If you are following a keto diet or low carb diet, and experiencing fruity breath, then there is nothing to worry about. Drinking a lot of water may help but there is no way to prevent it as long as you are on this diet. There are some gums and mints available that can help mask the fruity breath.

For Diabetic ketoacidosis- Diabetic ketoacidosis can be treated with fluids and electrolytes like potassium sodium, chloride, and most importantly Insulin. Control your blood sugar levels for an early recovery. However, the electrolyte treatment can cause some complications but it is a lifesaving treatment for diabetic ketoacidosis.

For Periodontal disease- Periodontal disease can be treated with procedures like root planing or scaling. These methods deep clean and removes tartar from above and below the tooth line. Your doctor will also give you some antibiotics to treat the disease. Rarely, people with severe periodontal disease will require gum surgery to prevent tooth loss. 


When To Call Your Doctor?

If you have diabetes and are experiencing fruity breath, make sure to consult your doctor and follow the prescribed treatment. If you are experiencing more symptoms of ketoacidosis mentioned above, then you should also call your doctor. The treatment may include taking insulin to stop ketosis and manage your blood sugar level. 

If you are following your treatment and your ketone level is still high, call your healthcare team immediately. You should also contact your doctor if you don’t have diabetes and are constantly experiencing bad breath. 

A Word From Mantra Care

A fruity breath is a problem that anyone can suffer from. if you have it, there is no need to hesitate. it’s important to diagnose the reason behind it. so consult a doctor or your healthcare team.

If you are looking for more information on this topic or on Diabetes treatment, Online Therapy, Hypertension, PCOS treatment, Weight Loss, and Physiotherapy, please visit or feel free to reach out to us at +91-9711118331 or email at [email protected]. You can also download our free Android App or IOS app.

Here at Mantra Care, we have an incredibly skilled team of health care professionals and coaches who will be happy to answer any questions and provide further information so you know what’s best for your unique needs.

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