Common cause of halitosis ( bad breathing) are oral or dental, respiratory or GIT problem or chronic sinusitis. Without any apparent infection, I found halitosis in many persons. Ultimately these persons are tested for blood sugar and found to be mostly diabetic. And some of them (known diabetic) shown raised blood sugar than usual with drug.
Diabetes is associated with increased risk of periodontal disease, which is the most likely link in my opinion. It is also possible that poorly controlled diabetes may lead to halitosis via the blood borne mechanism (pulmonary excretion of odorant volatiles during gas exchange). Abnormal levels of acetone and other alkanes are reported on the breath of diabetics. Finally, diabetes is reported to create subjective (phantom) halitosis complaints via its potential associated with dysgeusia (taste disturbance).
In diabetic conditions SGLT1 expression increases in the luminal membrane of salivary gland ductal cells and the salivary flow decreases. This study highlights the water transporter role of SGLT1 in salivary glands, which, by increasing ductal water reabsorption, may explain the hyposalivation of diabetic subjects. http://www.ncbi.nlm.nih.gov/pubmed/24499577
The hyposalivation is associated with halitosis in diabetic patients.
I just want to add to the answers of Mathew and Robinson that besides dry mouth, acetone breath, and periodontal disease, there is also the possibility of oral candidiasis. This also may be a source of halitosis together with the tongue coating that harbors anaerobic bacteria.
Dear Colleague
In diabetic persons a sweet odor comes from the oral cavity and nose. Keton bodies from the metabolism flow in the blood stream and travel to the lungs and get out the respiratory pathways by exhaling . This odor is characteristic and is distinguished from all other kind of gases emanating from oral cavity. it is similar to ripped apple.
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