Our sense of smell does more than help us enjoy life’s pleasures—it also keeps us safe by alerting us to dangers such as smoke or a gas leak. When you have diabetes, this vital sense can sometimes be impacted. Diabetes has been linked to olfactory dysfunction, which can dull our ability to smell or cause us to perceive odours differently. It can also cause phantom odours, prompting us to smell things that aren’t really there. Let’s learn more about phantom smells and diabetes and why it’s important to check in with your healthcare provider about smelling concerns.
Why do phantom smells happen?
Phantom smells—also called phantosmia—happen when your brain thinks it detects a smell, even though there’s nothing there. This can occur because of problems in your olfactory system, which includes your nose, nerves and the part of your brain that processes smell. While some phantom smells can be pleasant, those with phantosmia often describe smelling things such as burnt toast, cigarette smoke, chemicals or rotting and moldy odours.
Why do people with diabetes sometimes experience phantom smells?
Some studies have noted that olfactory dysfunction, such as phantom smells, is more common in people with diabetes. Research has also shown a higher prevalence for smelling issues in people with COVID-19 and diabetes compared to the general population.
Although more research is needed to determine the cause of this phenomena, one theory is that diabetes can cause nerve damage (neuropathy), which can affect the nerves related to smell. Some medications used to manage diabetes, like insulin, have been linked to phantom smells. Insulin resistance might also play a role by causing inflammation and damage to the nasal lining.
Are phantom smells a warning sign of something more serious?
While phantom smells are often harmless and resolve themselves, they could signal other conditions or contribute to disease risks. When your smell is impaired, for example, it can affect your sense of taste, causing you to eat too little or too much. It can also cause you to add too much salt to foods to improve their taste, which can negatively impact your heart and contribute to hypertension and other heart issues. Along with diabetes and heart complications, smelling disorders such as phantom smells, could signal a head injury, sinus infection or simply uncontrolled allergies. In rare cases they could also be early warning signs for Parkinson’s disease, Alzheimer’s or multiple sclerosis. That’s why it is important to speak with your healthcare provider if you are experiencing phantom or any other smelling disorders to determine what treatment, if any, is needed.
How are phantom smells diagnosed and treated?
Your healthcare provider will go over your symptoms and may run imaging tests and a nasal endoscopy to determine what is causing the condition. Once diagnosed, they can help you devise a treatment plan, which may include adjusting your medications or using saline nose rinses and quitting smoking. Smoking can damage olfactory nerves and disrupt normal smell function.
In rare cases, your provider may suggest surgery to reduce phantom smells, especially if they’re related to polyps or inflamed mucus in the nose.
Is there anything I can do to protect or improve my sense of smell?
High blood sugars can damage nerves, including the ones that impact smell. Managing your diabetes through a balanced diet and regular exercise will help keep your blood sugars in check and reduce your risk of nerve damage in the future.
When should I seek help about phantom smells?
Always be sure to tell your healthcare provider about phantom smells and other nose issues, especially if they are recurring over several days or weeks. Even though they may resolve themselves, your provider can check that there is no underlying issue contributing to the condition.
Fortunately, serious smell disorders in diabetes are not common. But by managing your diabetes well and keeping your blood sugar levels in check, you can help protect your nose—and your health—for the long-term.
