Diabetes and Taste Disorders

People tend to take their ability to taste for granted — until they’re literally left with a bad taste in their mouths, or favorite foods no longer hold appeal to them. Impaired taste and taste disorders can lead to health and nutritional problems, and can affect one’s quality of life, as well. There’s some evidence that people who have diabetes are more prone to developing taste disorders.

Some stats
According to the National Institute on Deafness and Other Communication Disorders (NIDCD), about 15% of adults may have a taste or a smell issue; however, only about 200,000 people each year seek medical help for these conditions. It’s also estimated that almost 75% of adults ages 57–85 have impaired taste.


What is taste, anyway?
Your ability to taste is due to taste cells that are clustered within taste buds on the tongue, the roof of the mouth, and within the lining of the throat. You’re born with about 10,000 taste buds; this number may decline as you get older.

When you chew, drink, and digest food, molecules in the food are released that stimulate the taste cells. The taste cells have receptors that respond to the basic taste qualities of sweet, sour, salty, bitter, and umami (the savory taste that comes from foods containing glutamate, such as chicken broth and meat extracts).

You also experience taste from thousands of nerve endings in the surfaces of the mouth, nose, throat, and even eyes. The nerve endings help you experience the heat from hot and spicy foods, the cool tingle from minty foods, and the aroma from a freshly brewed cup of coffee. The aroma of a food also contributes to a food’s taste. This gives you the ability to distinguish between, say, eating a banana and eating an apple.

Taste disorders
Common taste disorders come with funny names, although there’s nothing funny about being unable to taste your food.

Hypogeusia: a reduced ability to taste sweet, sour, salty, bitter, or umami
Dysgeusia: a bad, sour, or salty taste persists in the mouth
Parageusia: a metallic or otherwise abnormal taste in the mouth
Ageusia: the inability to taste anything (which, fortunately, is pretty rare)

Causes of taste disorders
Some people have the unfortunate circumstance of being born with a taste disorder. Most taste disorders, however, are a result of an injury, illness, or medication. For these reasons, taste disorders are often temporary. Here are some common causes:

• The common cold or the flu
• Sinus infection
• Strep throat
• Nasal polyps
• Gum disease
• Smoking
• Acid reflux
• Head injury
• Ear surgery
• Wisdom tooth extraction
• Radiation therapy to the head or neck
• Exposure to certain chemicals, like pesticides, solvents, or paint thinners
• Nutritional deficiencies of vitamin B12 or zinc
• Some nervous system disorders, such as multiple sclerosis or Bell’s palsy

While not as common, a brain tumor can cause problems with taste, as well.

Some medications can affect your taste, too. For example, antibiotics and antihistamines can leave you (literally) with a bad taste in your mouth. Other medications can cause parageusia. These include:

• Metformin
• Certain antibiotics, such as clarithromycin (brand name Biaxin) and metronidazole (Flagyl)
• Some blood pressure medications, including captopril (Capoten)
• Glaucoma medications
• Osteoporosis medications

In addition, some women experience a metallic taste in their mouths early in pregnancy, likely due to changes in hormones. A metallic taste that occurs soon after eating a specific food, such as seafood, could be a sign of a food allergy.

Having diabetes may raise your risk of a taste disorder, too. Studies show that people who are newly diagnosed with Type 2 diabetes are more likely to have trouble tasting sweet foods. In another study of 57 people who had Type 1 diabetes, 73% of them had impaired taste compared to just 16% of people who did not have diabetes. People with diabetes who have neuropathy may have impaired taste, as well.

Treating taste disorders
If you notice any change in your ability to taste, talk with your doctor. He or she should refer you to an otolaryngologist (an ear, nose, and throat doctor) who can evaluate you and help pinpoint the problem. Many taste disorders are actually related to a problem with your ability to smell; an otolaryngologist will evaluate you for both. You’ll likely have a physical examination of your ears, nose, and throat; an assessment of your teeth and oral hygiene; and smell and taste tests. The specialist will also ask you about your health history and medications that you’re taking.

Treatment of a taste disorder depends on the cause. If a medication is the culprit, it may be possible to switch medications. In the case of antibiotics, your taste will likely come back once you finish your course. If taste loss or change is a result of a medical condition, like the flu, acid reflux, or an allergy, for example, the next step is to treat the condition. Nutritional deficiencies that are causing a taste issue will be treated with the specific nutrient that’s lacking, such as vitamin B12. And if smoking is the culprit, stopping smoking is your best bet.

Sometimes taste impairment can’t be treated. If that’s the case, working with a dietitian can help you get more enjoyment from your food. Tips to try include:

• Eating foods with a variety of textures and colors.

• Using spices, herbs, and black pepper on foods to boost flavor (avoid adding too much salt or sugar, however).

• Adding more savory foods to your eating plan, like olives, nuts, or small amounts of bacon or cheese.

• Foods often taste better when they’re served hot. Likewise, foods that are supposed to be served cold will taste better eaten cold.

Benny Madrigal wants to show people with diabetes what they can do, not what they can’t. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more from Amy Mercer.