Can diabetes cause shortness of breath? It can be linked to breathlessness in several ways, but shortness of breath has many possible causes, and a clinician has to sort out which one applies. MedlinePlus says the causes include problems with the heart, lungs, and airways, and also anemia, anxiety, and obesity. Some of these are more common in people with diabetes. In diabetic ketoacidosis (DKA), a medical emergency, the Centers for Disease Control and Prevention (CDC) lists fast, deep breathing among the signs.
Key takeaways
- MedlinePlus lists lung, airway, heart, and other causes of breathing difficulty, including anemia, anxiety, and obesity. A symptom with so many causes needs an exam.
- Diabetes-related routes include DKA, heart disease, and anemia that comes with kidney disease. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says people with chronic kidney disease and diabetes are at greater risk of anemia and tend to develop it earlier.
- The American Lung Association says breathlessness with chest pain or pressure, fainting, or nausea is a medical emergency. MedlinePlus says sudden or serious breathing trouble is too.
- Breathlessness is a feeling only you can judge, according to MedlinePlus. Report anything new or getting worse, even if it seems mild.
- The American Lung Association says breathlessness lasting four weeks or longer may point to a chronic condition.
Diabetes and Shortness of Breath: The Short Answer
- Diabetes can be one link in the chain. Heart disease, kidney disease, and a diabetes emergency can each cause breathlessness.
- Many causes have nothing to do with diabetes. Asthma, pneumonia, a blood clot in the lungs, anxiety, and low fitness are all on the lists.
- Some patterns are emergencies. Sudden onset, chest pain, fainting, or fast, deep breathing with other signs of DKA need a 911 call.
- A new pattern needs a call. MedlinePlus says to contact your provider for any new or worsening breathing difficulty.
- A record of your pattern helps. When it happens, what you were doing, and what came with it are the details a clinician asks for.
Causes of Breathlessness in People With Diabetes
| Cause | Why it can cause breathlessness | Link to diabetes | Read next |
|---|---|---|---|
| Heart failure | MedlinePlus says the heart may be unable to pump enough blood to supply oxygen to the body | Diabetes is a risk factor for heart failure | Does diabetes cause heart failure? |
| Angina or heart attack | MedlinePlus lists poor blood flow to the heart and heart attack as causes | Symptoms can be atypical or silent in diabetes | Can diabetics have a silent heart attack? |
| Diabetic ketoacidosis | CDC lists fast, deep breathing among the signs when ketones build up | Most common in type 1, but CDC says people with type 2 can develop it | What is diabetic ketoacidosis? |
| Anemia from kidney disease | NIDDK lists shortness of breath among the symptoms of anemia in chronic kidney disease | NIDDK says people with both conditions tend to develop anemia earlier and have more severe anemia | Early signs of diabetic kidney disease |
| Lung or airway disease | MedlinePlus lists COPD, pneumonia, a blood clot in the lungs, and high blood pressure in the lung arteries. The American Lung Association adds an asthma flare-up | Lung function tends to be lower, on average, in groups of people with type 2 diabetes | How diabetes affects the lungs |
| Extra weight or low fitness | The American Lung Association lists obesity and physical deconditioning as causes of chronic shortness of breath | Extra weight and low activity are both common risk factors for type 2 diabetes | Insulin resistance and belly fat |
| Anxiety or panic | MedlinePlus lists emotional distress, anxiety, and panic attacks | Living with diabetes can add stress | Diabetes and anxiety |
Diabetic Ketoacidosis: A Breathing Pattern That Is an Emergency
CDC explains that DKA develops when the body does not have enough insulin to let blood sugar into cells for energy. The liver then breaks down fat for fuel and makes acids called ketones, which can build up to dangerous levels. Early symptoms are strong thirst and frequent urination. If untreated, CDC says more severe symptoms can appear quickly: fast, deep breathing, dry skin and mouth, a flushed face, fruity-smelling breath, headache, muscle stiffness or aches, tiredness, nausea and vomiting, and stomach pain.
Clinical reviews describe this deep, rapid pattern as the body's attempt to blow off carbon dioxide and correct rising acid. The German physician Adolf Kussmaul described it in people with diabetes in coma in 1874, and it is still called Kussmaul breathing.
CDC says to go to the emergency room or call 911 right away for any of these: blood sugar that stays at 300 mg/dL or above, fruity-smelling breath, vomiting with no food or drink staying down, trouble breathing, or several signs of DKA together. It also says high ketones are an early sign and a medical emergency. DKA can occur with blood sugar that looks normal, which our guide on euglycemic DKA explains. Our guide on whether people with type 2 diabetes can get DKA covers who is at risk.
Heart-Related Breathlessness
MedlinePlus says to see your provider if shortness of breath wakes you at night or requires you to sleep propped up, and if it comes with chest discomfort, pain, or pressure. The American Lung Association says providers ask whether breathlessness comes with swelling in the feet and ankles or with trouble breathing when lying down. Our guide on leg swelling in diabetes explains how swelling and breathing symptoms fit together, and our heart failure guide lists warning signs from the American Heart Association.
Kidneys and Blood Count
NIDDK says anemia, a lower-than-normal amount of red blood cells or hemoglobin, is a common complication of chronic kidney disease, and that it often gets worse as kidney function drops. Symptoms can include tiredness, shortness of breath, pale skin, dizziness, and a fast or irregular heartbeat. NIDDK says to seek immediate medical care for difficulty breathing or shortness of breath, and to call 911 for chest pain that will not go away. Our guide on how diabetes affects the kidneys explains the kidney side.
Lungs and Airways
MedlinePlus lists COPD, pneumonia, a blood clot in the lungs, and other lung disease. The American Lung Association says that if breathing has changed suddenly for no obvious reason or is getting slowly worse, it may signal a more serious problem, and that symptoms lasting four weeks or longer may be a sign of a chronic condition such as COPD, asthma, or pulmonary fibrosis. Pneumonia is a lung infection that the ADA says people with diabetes are at increased risk for, and our pneumonia vaccine guide covers prevention. Our asthma and COPD guides cover those conditions: Is asthma linked to diabetes? and Is COPD linked to diabetes?
Weight, Fitness, and Anxiety
The American Lung Association says it is normal for strenuous exercise, extreme temperature change, bad air quality, high altitude, and obesity to make breathing harder even for a healthy person. It also lists poor health and physical deconditioning among the causes of chronic shortness of breath, and says lifestyle changes may improve symptoms when they are the cause. MedlinePlus lists anxiety and panic attacks as causes. These are real causes, but they are not a safe assumption. Do not decide on your own that breathlessness is anxiety or low fitness, especially if it is new, if it comes with chest pain, or if it is getting worse.
How a Clinician Sorts It Out
MedlinePlus says your provider will examine you and ask about your history and symptoms, including how long you have had difficulty breathing, when it started, and what makes it worse. The American Lung Association says your provider will also want to know whether it comes with chest pain, dizziness, cough, wheezing, blue lips, trouble breathing when lying down, or swelling in the feet and ankles, and whether it limits daily tasks such as shopping, dressing, or bathing. MedlinePlus says tests that may be ordered include:
- Blood oxygen level (pulse oximetry)
- Blood tests
- Chest X-ray or CT scan
- Electrocardiogram (ECG) and echocardiogram
- Exercise testing
- Lung function tests
Which tests you need depends on what the exam finds.
When to Get Help
| What you notice | What the sources say | What to do |
|---|---|---|
| Breathing trouble that starts suddenly or interferes with talking, or someone stops breathing | MedlinePlus says go to the emergency room or call the local emergency number | Call 911 |
| Breathlessness with chest pain or pressure, fainting, or nausea | The American Lung Association says handle it as a medical emergency | Call 911 |
| Fast, deep breathing with fruity breath, vomiting you cannot keep fluids down, or very high blood sugar | CDC lists these as reasons to go to the emergency room or call 911 | Call 911 or go to the emergency room |
| Breathlessness at rest or after slight activity, waking at night short of breath, needing to sleep propped up, shortness of breath with simple talking, wheezing, or fever | MedlinePlus says to see your provider if any of these occur with breathing difficulty | Call your clinician promptly |
| Breathlessness with a lasting cough, or one that is slowly getting worse | The American Lung Association says gradual worsening can signal a more serious problem | Make an appointment |
What to Write Down Before Your Visit
- When the breathlessness started and whether it came on suddenly or over weeks
- What you were doing when it happened, such as climbing stairs, lying flat, or sitting still
- How far or how long you can go before you stop, and whether that has changed
- Other symptoms, such as chest discomfort, cough, wheezing, swelling in your feet or ankles, dizziness, or fever
- Recent blood sugar readings, and ketone results if you checked them
- Your medicines, including any inhalers, and any recent illness
- Whether you smoke or used to
Questions to Ask Your Care Team
- Could my breathlessness come from my heart, lungs, kidneys, or blood count?
- Which tests would help find the cause?
- Is there anything about my diabetes or my medicines that makes this more likely?
- Should I have ketone supplies at home, and when should I use them?
- Which changes should send me to urgent care or the emergency room?
Frequently Asked Questions
Can high blood sugar make you short of breath?
Very high blood sugar with ketones is diabetic ketoacidosis, and CDC lists fast, deep breathing among its signs. CDC says high ketones are a medical emergency. Other causes of breathlessness are listed in the sections above, and a clinician sorts out which one applies, so new or worsening breathlessness should be reported.
Is shortness of breath a sign of a heart problem in diabetes?
It can be. MedlinePlus lists heart failure, angina, and heart attack among the causes of breathing difficulty, and diabetes is a risk factor for heart disease. Chest pain or pressure with breathlessness is an emergency, so call 911 rather than waiting.
Can kidney problems cause shortness of breath?
They can, through anemia. NIDDK lists shortness of breath among the symptoms of anemia in chronic kidney disease and says people with both kidney disease and diabetes tend to develop anemia earlier. NIDDK says to seek immediate medical care for difficulty breathing or shortness of breath.
Can anxiety cause shortness of breath?
MedlinePlus lists emotional distress, anxiety, and panic attacks among the causes. That does not make every episode anxiety. A first episode, breathlessness with chest pain, or breathlessness that keeps getting worse needs a clinician's exam before anyone decides the cause.
What is Kussmaul breathing?
It is a deep, rapid breathing pattern that Adolf Kussmaul described in 1874 in people with diabetes who were in coma. Reviews describe it as the body trying to blow off carbon dioxide when acid builds up, as in diabetic ketoacidosis. Fast, deep breathing with other signs of DKA is an emergency.
When should I call 911 for shortness of breath?
MedlinePlus says to go to the emergency room or call the local emergency number if breathing trouble starts suddenly or interferes with talking, or if someone stops breathing. The American Lung Association says breathlessness with chest pain or pressure, fainting, or nausea is a medical emergency.
References
- MedlinePlus. "Breathing difficulty." Medical Encyclopedia. Accessed November 2026.
- American Lung Association. "Shortness of Breath: Causes, Warning Signs & When to Seek Help." Accessed November 2026.
- Centers for Disease Control and Prevention. "Diabetic Ketoacidosis." Accessed November 2026.
- National Institute of Diabetes and Digestive and Kidney Diseases. "Anemia in Chronic Kidney Disease." Accessed November 2026.
- Johnson SK, Naidu RK, Ostopowicz RC, et al. "Adolf Kussmaul: Distinguished Clinician and Medical Pioneer." Clinical Medicine & Research. 2009;7(3):107–112. Accessed November 2026.
- American Diabetes Association Professional Practice Committee for Diabetes. "4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes—2026." Diabetes Care. 2026;49(Suppl. 1):S61–S88. Accessed November 2026.
Next Steps
If breathlessness is new, write down the details above and call your clinician. Call emergency services for sudden or severe trouble breathing, or for breathlessness with chest pain, fainting, or nausea.
For adults with type 2 diabetes or prediabetes who want lifestyle education alongside clinical care, the Done With Diabetes™ program, a guide to lifestyle changes for type 2 diabetes, organizes learning about meals, movement, sleep, and stress. It does not diagnose or treat breathing problems or diabetes, interpret symptoms or test results, change medicines, or replace your care team.