Why do you smell like acetone?

Diabetes mellitus has many faces. He has an impressive number of manifestations and hypostases. It can be limited to single symptoms or “please” the patient with a whole bunch of clinical signs. One of the important signals, indicating with a significant degree of probability the presence of a disease, will be discussed below.

Acetone in the body: where and why

There are hardly any people with a normal sense of smell who do not know what the smell of acetone is. This hydrocarbon is found in many chemical products such as solvents, adhesives, paints, varnishes. Women know him well for the scent of nail polish remover.

If, for some reason, you have never dealt with the named substances, then you should know that it is rather harsh and has sweet and sour tones. Some describe it as “the smell of pickled apples.” In a word, this substance is absolutely unnatural for human respiration and it is very difficult not to feel it.

But how does it get into the body and how is it related to diabetes?

In general, acetone, along with other compounds of the ketone group, is always present in the blood of a healthy person, but its amount is extremely small. In the case of a significant increase in the amount of glucose and the inability of the body’s cells to assimilate it (most often this happens in type 1 diabetes due to a lack of insulin), the mechanism of splitting the existing fat reserves is triggered. The products of this process are ketones (including their most characteristic representative – acetone) together with free fatty acids.

How it is eliminated: urine, exhaled air, sweat

The accumulated excess of acetone and related compounds begin to be intensively excreted by the kidneys, and a corresponding odor appears when urinating.

When the content of acetone exceeds a certain threshold, it can no longer completely leave the body in this way. This may be facilitated by a decrease in urination against the background of high blood sugar. From this moment, ketone molecules begin to enter the exhaled air, and can also be excreted with sweat.

It should be noted here that the patient himself may not feel the characteristic odor. Our nasopharynx is so arranged that we do not feel the aromas of our own breath. But it will be difficult for others and close people to miss this moment. Especially in the morning.

What to do if you smell acetone from your mouth

Strictly speaking, acetone in exhaled air can be felt not only in diabetes mellitus. There are a number of pathological conditions in which the appearance of this symptom is also possible (we will talk about them below). However, in the case of diabetes, it signals a very dangerous condition – diabetic ketoacidosis, which can result in coma and death.

If you have already been diagnosed with type 1 or 2 diabetes mellitus, when the above symptom appears, you should immediately call an ambulance and be hospitalized!

Unfortunately, there are times when ketoacidosis appears as the first manifestation of the disease. This happens, as a rule, in childhood and adolescence, but not necessarily. It is extremely important to know additional diagnostic signs that will help to sound the alarm in time.

In most cases, the development of diabetic ketoacidosis occurs within a few days and is accompanied by the following characteristic symptoms:

• permanent feeling of thirst, increased fluid intake;
• polyuria – frequent urination, in the later stages alternating with anuria – lack of urination;
• fatigue, general weakness;
• rapid weight loss;
• decreased appetite;
• dryness of the skin, as well as mucous membranes;
• nausea, vomiting;
• symptoms of “acute abdomen” – pain in the corresponding area, tension of the abdominal wall;
• loose stools, abnormal bowel motility;
• cardiopalmus;
• the so-called breathing of Kussmaul is difficult, with occasional breaths and extraneous noise;
• disturbances of consciousness (lethargy, drowsiness) and nervous reflexes, up to complete loss and falling into a coma in the later stages.

If, on the eve of or simultaneously with the appearance of the smell of acetone, the patient has noticed any of the above signs, it is necessary to seek emergency medical help.

What is the treatment tactics

You need to treat not a symptom, but the underlying disease! Of course, you need to treat not a symptom in the form of an unpleasant odor, but the underlying disease, in our case, diabetes mellitus. If ketoacidosis is suspected, patients are hospitalized, in the later stages they are sent straight to the intensive care unit. In a hospital setting, the diagnosis is confirmed by laboratory tests and drug treatment is prescribed with hourly monitoring of the patient’s condition until it returns to acceptable levels.

Further treatment will most likely be based on compensating for diabetes by administering insulin at regular intervals. The attending physician will select the dose individually. If ketoacidosis has arisen against the background of a previously diagnosed diabetes mellitus, then it will be necessary to revise the already prescribed dosage of the drug or adjust the diet and physical activity.

Non-diabetic acetone

There are other conditions in which ketones are released from the exhaled air. Often they do not pose an immediate threat to life, but in the long term they also do not bode well.

1. The so-called “hungry” ketosis occurs when there is a prolonged absence of food or a low content of carbohydrates in it. If glucose is not supplied with food, the body begins to use its own glycogen stores, and when it comes to an end, the breakdown of fats begins with the formation and accumulation of acetone. This is exactly what happens in people who adhere to various extreme diets or who are fond of “curative” fasting.
2. Nondiabetic ketoacidosis, also known as acetonemic syndrome, which is mostly typical for children. Among the manifestations is recurrent vomiting. This is due to errors in the diet (a lot of fat or long pauses in food intake), as well as certain concomitant diseases, including infectious ones.
3. Diseases of the kidneys (nephrosis of various types) – organs responsible for removing excess ketones from the body. If it is impossible to exit the traditional way, acetone finds other options (sweat glands, lungs).
4. Diseases of the liver (hepatitis, cirrhosis) – the organ responsible for the formation of glucose in the body. If this process is disrupted, a bypass pathway for obtaining energy is launched through the breakdown of lipids to form ketones.
5. Hyperthyroidism (thyrotoxicosis) is a dysfunction of the thyroid gland, which affects almost all metabolic processes in the body. It leads to an increased consumption of carbohydrates, as a result, the body seeks other possibilities for obtaining energy and intensively synthesizes ketones.
6. Some acute infectious diseases (influenza, scarlet fever) can also affect metabolism, causing increased production of acetone and related compounds.

The listed conditions, in addition to the pronounced acetone odor from the mouth, may have other symptoms similar to the manifestations of diabetic ketoacidosis, so you should not try to diagnose yourself on your own. If you have the slightest doubt, you should urgently seek medical help.

If the diagnosis of diabetes mellitus is still ruled out, this is not a reason to relax. The sharp sweet and sour aroma of exhaled air in 90% of cases indicates a problem with the hormonal background, so it is better not to postpone a visit to an endocrinologist.