Unless something is binding up in your drivetrain...
Do a rev test.
Engine at operating temperature.
Transmission in Neutral or Park, parking brake on.
From idle, fully depress the throttle for a few seconds and watch the tack. It should travel evenly and smoothly to redline and hold (You won't hurt it, Cummins calls this "High Idle").
IF it hesitates, shudders, studders, coughs etc, you have a problem with your fuel system, or intake (check your air filter & turbo lately?). Possibly valves out of adjustment but you'd hear that at idle as well as a regular miss (delivery valve on the pump or bad injector).
Repeat, this time watching your passenger mirror and watch for smoke. You should see maybe a little puff of black then clean.
Black smoke - not completely burned fuel
White smoke - unburned fuel, water, air in fuel
Blue smoke - oil
Repeat again, this time slowly increase the RPM and see if there is a particular range where it is really bad and stays bad.
If you are getting white smoke at idle or slightly above idle, start cracking the injection lines and see if there is one or more that either does not make a difference to the idle or makes very little difference. Check them all. A studder, shudder, ect. that is not erratic is a bad thing and you need to find the source ASAP before you roast a cylinder.