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Do you live with family members who have diabetes? Have you noticed changes in the way they smell? Few people realize that uncontrolled blood sugar levels can alter body odor — and there’s a scientific explanation behind this phenomenon. Sweat odor can be an important indicator of overall health, especially for those with diabetes. In this article, learn what diabetes body odor smells like, its connection to blood sugar levels, and tips for managing your health.

Key Takeaways

  • Diabetes can change your natural body odor to a sweet, fruity, or urine-like smell.
  • The leading cause of this fruity smell is ketones, chemicals the body produces from burning fat for energy instead of sugar.
  • In addition to poorly controlled blood sugar, other factors that may contribute to changes in body odor are age, gender, genetics, diet, hormonal changes, and certain health conditions.
  • You can eliminate or minimize diabetes-related body odor by controlling blood sugar levels using medications such as fast-acting insulin.
  • The change in body odor, especially in those diagnosed with diabetes, can be a sign of diabetic ketoacidosis. This complication happens when the blood becomes too acidic because of unhealthy amounts of ketones.

Body Smell and Its Link to Health

It’s well known that babies have a different scent than older adults — this is one of the many cases where body odor can help indicate a person’s age. Your scent can predict several other factors related to your well-being. In fact, it can be a window to your overall health, as certain smells are linked with conditions like diabetes. 

Did you know that sweat itself is odorless? After interacting with bacteria on your skin, it becomes a sour, tangy odor, resulting in a unique body odor. Several factors influence body odor, such as: 

    • Gender: Men typically have a more intense rancid smell than women. Women’s hormonal changes may also affect how they smell. A woman with a strong body odor may be menstruating, pregnant, or going through menopause. 
    • Genetics: Genetics influence the types of bacteria your skin has and the composition of your sweat. 
    • Age: Older adults have a distinct body odor from younger ones, which is influenced by several age-dependent changes, such as deteriorating sweat gland activity. 
    • Diet: People who eat certain foods like onions and garlic tend to have stronger body odors. 
    • Medications: Some medications may also change how the body smells naturally.
    • Health conditions: People with diabetes or liver disease may smell differently than healthy individuals. 

Like a fingerprint, each person has an individual body odor determined by these combined factors. 

Can Diabetes Really Affect How You Smell? 

Yes — and it may affect many people with diabetes.. If you or a loved one has diabetes, you may notice a sweet or fruity odor coming from them. Uncontrolled or poorly managed diabetes can lead to this scent. 

Does diabetes make you smell bad? Not necessarily, as others may not find this change in body odor unpleasant to the nose. However, it can be a sign of a serious health concern. This happens due to high blood sugar interfering with normal metabolic function, resulting in alterations in body odor. 

If you have diabetes, this “sickly sweet” body odor can be an early sign of diabetic ketoacidosis (DKA), a fatal complication with an estimated death rate of around 0.2%-2.5% in developing countries. 

The change in body scent may also be linked to kidney disease. In a case report involving a woman with DKA, researchers found abnormally high levels of ammonia in her blood. Too much ammonia puts strain on the kidneys, potentially harming them.

In a nutshell, if you have diabetes and your body odor isn’t the same, it may be an early warning sign of a complication. Consult your doctor for an examination. 

What Does Diabetes Body Odor Smell Like? 

Here are the most common odors associated with diabetes — and what they mean:

  • 1

    Sweet or Fruity Odor

    A sweet, fruity scent that others often compare to acetone or nail polish remover is caused by the buildup of ketones in the blood. This scent is a sign of high levels of ketones that, if left untreated, can progress to DKA. 

  • 2

    Ammonia or Urine-like Smell

    Some people with diabetes release sweat that smells of ammonia, which is also associated with DKA. It happens when the kidneys struggle to eliminate excess ketones and other waste products in the blood. The odor may be more noticeable after an intense exercise. This smell from someone with diabetes could be an early sign of diabetic kidney disease.

  • 3

    Sickly Sweet or Sour Smell

    Some people naturally have a mild, tangy body odor, but to people with glucose problems, this odor may be more pronounced. They may emit a strong, sweet odor, bordering on sour or fermented. 

  • 4

    Onion-like or Strong Body Odor

    Why does your body odor smell like onions all of a sudden? This type of scent isn’t always associated with diabetes — your diet may cause it. 

    Garlic and onions are some of the foods that can change your body odor by boosting your sweat, body heat, and metabolism. The unpleasant odor results from sweat mingling with the bacteria on your skin. 

The Science Behind Body Odor and Diabetes

Food provides your body with glucose, your primary energy source. Through the digestion process and with the help of a hormone called insulin, glucose can get into the cells to be immediately used for energy. However, some people can’t make enough insulin to support this process. 

So, where does your body get energy to function if the cells can’t collect glucose from the blood? It turns to stored fat as its fuel source. As the body burns fat, it releases ketones as a byproduct, changing your body odor. 

Ketones increase the acidity of your blood, potentially leading to metabolic acidosis. Metabolic acidosis happens when there are unhealthy levels of acid in the blood, which can damage your kidneys. 

But why does your sweat smell like ammonia and not the usual fruity odor? It’s likely because of the increased ammonia in your blood. When the body can’t digest glucose or fat, it turns to protein for energy as its last resort. Breaking down protein raises levels of ammonia in circulation. How is this connected to diabetes? Insulin resistance can impact the kidneys’ normal function, preventing them from maintaining the balance of ammonia. High levels of ammonia may lead to complications. 

Insulin resistance may not be directly life-threatening. However, it throws off the balance of your metabolism, resulting in a ripple of health conditions that put you at greater risk. 

The Science Behind Body Odor and Diabetes

Diabetes vs. Other Causes of Strong Body Odor 

What does diabetes body odor smell like compared to others? Of course, diabetes isn’t the only reason you might smell different. Other factors that can alter your natural scent include:

  • 1

    Poor Hygiene

    Not bathing regularly and ignoring personal care can lead to an unpleasant, musty, and sour odor, but certainly not fruity or sweet, which is what diabetes odor smells like.
  • 2

    Infections 

    Certain infections can alter the skin’s or sweat’s bacterial composition, leading to changes in your body odor. For instance, urinary tract infections (UTIs) can make the urine smell fishy or with a hint of ammonia.
  • 3

    Hormonal Changes

    If you’re a female with a strong body odor, know you’re not the only one experiencing this problem. Hormonal fluctuations tend to affect women more significantly, especially during key life transitions, leading to changes in body odor.  For instance, the decline in estrogen levels during menopause can cause excessive sweating and hot flashes, resulting in a musky or sour body smell. Many women may also give off a stronger body odor during pregnancy due to increased sweating and hormonal fluctuations.
  • 4

    Conditions Associated With Metabolic Imbalances

    Certain metabolic disorders can be diagnosed by their distinct smell. For example, trimethylaminuria — also known as fish odor syndrome — happens when the body can’t convert trimethylamine in the urine, sweat, and reproductive fluids into its odorless form, resulting in a fishy smell. It’s primarily caused by a genetic mutation.

If you have diabetes and notice changes in your body odor, don’t ignore the symptoms. A sweet-smelling sweat is not always associated with diabetes, but there’s a slight chance it may indicate a health complication. It’s best to stay on the safe side by speaking about it with your doctor.

How to Manage or Reduce Diabetes Body Odor 

If you notice a new or worsening body smell due to diabetes, here are some steps you can take. 

Drinking water, mature man and hydration in home, lounge and thinking for wellness, liquid and glas

  • Stabilize Your Blood Sugar Levels

    Take fast-acting insulin like Humalog or Novolog, or any medications prescribed by your doctor to lower the ketone and ammonia levels in the blood.

  • Drink Lots of Water

    Hydrating can help flush out excess glucose, ketones, and ammonia through urine and sweat. Drinking plenty of fluids also supports your kidneys.

  • Do Light Exercises After a Meal

    People with diabetes are encouraged to do light physical activities post-meal, such as walking, to prevent blood sugar spikes. A study found that moving for 10 minutes, even at very low intensity, can lower blood sugar levels after a meal. A leisure stroll or climbing the stairs post-meal is helpful for both people with and without diabetes.

  • Pay More Attention to Hygiene

    Proper hygiene can help minimize or prevent body odor. It’s also your first line of defense against infections that can cause diseases. Keep showers short — about five minutes with warm water to avoid drying out your skin. Use gentle body wash or soap with antibacterial properties. Wear breathable clothing if you live in a location with humid weather that makes you sweat more than usual.

  • Adjust Your Diet

    Increase fiber intake while reducing sugar and protein. A high-protein, low-carb diet can contribute to the production of ketones. Additionally, limit garlic and onions, which can intensify body odors.

  • Track Your Triggers

    Keep a daily journal and list factors you suspect affect your body odor, such as foods, medications, or hormonal changes.

When Is Body Odor a Warning Sign of Something More Serious? 

An intense fruity or ammonia smell can be a sign of diabetic ketoacidosis, which may indicate worsening diabetes. Watch for these warning signs along with a sudden change in body odor:

  • Weakness or fatigue
  • Polydipsia or excessive thirst
  • Polyuria or frequent urination
  • Polyphagia or excessive hunger
  • Nausea or vomiting
  • Abdominal pain
  • Rapid weight loss
  • Confusion

DKA is a medical emergency since it can lead to coma or death. If you notice these signs, seek immediate medical attention.

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Uncontrolled Blood Sugar Can Change Body Odor

What does diabetes body odor smell like? People with diabetes don’t make enough insulin, disrupting their normal metabolism and changing their natural scent to that “sickly sweet” body odor. 

Some people may choose to ignore this seemingly harmless sign — but you shouldn’t if you have diabetes. Diabetic ketoacidosis is a complication that can be life-threatening if left untreated. Once you notice changes in body odor, excessive hunger and thirst, and reduced appetite, seek immediate medical attention.

Frequently Asked Questions

Individuals with diabetes have a distinct sweet or fruity odor on their breath or skin. This happens because of the overproduction of ketones due to the body burning fat instead of glucose for energy. 

Lowering your blood sugar levels and good hygiene can help reduce diabetes-related odors. Fast-acting insulin can reduce glucose levels quickly. Light physical activity after a meal can also help avoid sugar spikes and prevent complications.

Someone with kidney disease, especially if related to diabetes, may have a urine- or ammonia-like smell because of the accumulated wastes in the body. The kidneys filter the toxins from the blood. Uncontrolled sugar can make it harder for the kidneys to function normally, leading to waste building up in the blood, which changes body odor. 

Several factors contribute to a distinct smell, such as age, genetics, diet, gender, and health conditions. These things can alter the composition of your sweat or change the skin microbiota. 

Diabetes-related conditions, such as kidney failure and liver disease, can cause body odor. Certain metabolic disorders can also change how you smell. For instance,  trimethylaminuria is associated with a strong fishy body odor, phenylketonuria with a musky scent, and hypermethioninemia with an odor similar to boiled cabbage.
Kenneth Fill, PharmD, MBA

Kenneth Fill, PharmD, MBA, is a clinical pharmacist specialist and medical writer with a strong background in ambulatory care, pharmacogenomics, and medical content development. Based in the state of Michigan, he provides expert guidance on chronic disease state management. Kenneth completed his PharmD and MBA at the University of Toledo and pursued post-graduate residency training in ambulatory care and community-based pharmacy. His diverse background also includes academic detailing, clinical education, and interdisciplinary collaboration to enhance patient outcomes.