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Alcoholic Ketoacidosis: Signs, Symptoms, and Treatment

If your breath smells like acetone — the same fruity scent as nail polish remover — it may be a sign of high levels of ketones (acids your liver makes) in your blood. It’s a problem mainly of type 1 diabetes but also can happen with type 2 if you get a serious condition called diabetic ketoacidosis (DKA). And it can happen for a few reasons not related to diabetes, including keto diets, fasting, and heavy drinking.

alcoholic ketoacidosis smell

The next important step in the management of AKA is to give isotonic fluid resuscitation. Dextrose is required to break the cycle of ketogenesis alcoholic ketoacidosis smell and increase insulin secretion. The dextrose will also increase glycogen stores and diminish counterregulatory hormone levels.

Does alcohol affect eating habits?

Ethyl alcohol oxidizes at a rate of 20 to 25 mg/dL per hour in most individuals. These symptoms are similar to some of the nutritional ketosis side effects, which can make detecting diabetes problematic. This is why it’s always a good idea to consult with your doctor before starting a keto diet. The odor is often described as “fruity,” but not in a good way.

  • For example, breath that has a fruity or acetone-like scent may be a sign of ketosis from your diet, excessive alcohol intake, or liver disease.
  • Alcoholic ketoacidosis (AKA) is a condition seen commonly in patients with alcohol use disorder or after a bout of heavy drinking.
  • Patients are usually tachycardic, dehydrated, tachypneic, present with abdominal pain, and are often agitated.
  • If you experience fruity breath that’s not caused by intentional changes to your diet, the scent of your breath may have more dire causes.
  • Additional conditions and complications may require extra care.

If you need help creating a nutritional plan to help control your blood sugar levels, ask your healthcare provider for a referral to a registered dietitian. People with liver disease have higher levels of certain chemical compounds, including acetone. The link between liver disease and fruity, musty breath is so strong that healthcare providers use breath smell as an indication of liver disease. Hyperglycemic hyperosmolar syndrome (HHS) is extremely high blood sugar that occurs in people with type 2 diabetes who don’t have their diabetes under control. It’s similar to DKA in that it can cause a diabetic coma or death if left untreated. If a person does not have enough insulin, their body is unable to convert blood sugar to glucose, which the body uses as fuel.

Risk Factors

If you believe you are experiencing HHS, contact a healthcare provider or go to the emergency room immediately. Wearing medical identification can help others know what to do in an emergency related to diabetes. Anyone who finds it difficult to reduce their alcohol consumption should ask a doctor for advice. The ADA recommends testing for ketones every 4–6 hours when a person is ill, such as with a cold or the flu. Ketone and blood glucose testing kits are available for purchase online. The American Diabetes Association (ADA) advises people to not exercise if they have signs of DKA and to seek medical assistance immediately.

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