Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and β-hydroxybutyrate. Ketoacidosis is a pathological metabolic state marked by extreme and uncontrolled ketosis. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased. In extreme cases ketoacidosis can be fatal. Ketoacidosis is most common in untreated type 1 diabetes mellitus, when the liver breaks down fat and proteins in response to a perceived need for respiratory substrate. Prolonged alcoholism may lead to alcoholic ketoacidosis. Ketoacidosis can be smelled on a person's breath. This is due to acetone, a direct by-product of the spontaneous decomposition of acetoacetic acid. It is often described as smelling like fruit or nail polish remover. Ketosis may also give off an odor, but the odor is usually more subtle due to lower concentrations of acetone. Treatment consists most simply of correcting blood sugar and insulin levels, which will halt ketone production. If the severity of the case warrants more aggressive measures, intravenous sodium bicarbonate infusion can be given to raise blood pH back to an acceptable range. However, serious caution must be exercised with IV sodium bicarbonate to avoid the risk of equally life-threatening hypernatremia. Cause Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively. In diabetic ketoacidosis, a high concentration of ketone bodies is usually accomp Continue reading >>
7 Surprising Body Odor Causes
SVGiles via Getty Images We’re going to assume you bathe, at least somewhat regularly. And yet, somehow, you still find yourself wondering... IS THAT ME?! Turns out, there are the occasional smells that no amount of scrubbing or brushing or deodorant-applying can deter. Here are a few of the most surprising. You’re Stressed Believe it or not, there are different types of sweat, chemically speaking. And the stinkiest sweat of all is stress sweat. That’s because it’s produced from a category of sweat glands called apocrine glands. Aprocrine glands produce a less-watery sweat, and bacteria go crazy for the fats and proteins in the mix. That feeding frenzy is what releases the odor, according to the Mayo Clinic. Sweat from your workouts or just because it’s too dang hot outside, on the other hand, is composed mostly of water and electrolytes, according to YouBeauty. You’ve Been “Blessed” With Stinky Feet That same all-you-can-eat buffet for bacteria happens with the sweat on your feet. And since your tootsies are tucked away in a dark, warm, moist environment, they really nurture bacteria — especially if you’re sans socks. But about 10 to 15 percent of people have extra-sweaty feet just by the luck of the genetic draw. Those ultra-moist dogs can then become home to a specific type of bacterium called Micrococcus sedentarius, which produces truly awful smelling sulfur compounds. Lucky you. You Have Too Few Favorite Bras Ladies: ‘fess up. How often do you wash your favorite bra? Yep, we thought so. “Many women overwear — and consequently underwash — bras because they have too few that fit properly,” bra expert (really!) Susan Nethero told Prevention. Because that lacy number is probably made of odor-trapping fabrics and definitely touches skin in Continue reading >>
Getting To Know Ketones
People with diabetes, particularly those with Type 1 diabetes, have been at least vaguely aware of the word ketones for a long time. With the recent resurgence of popular interest in low-carbohydrate diets, however, just about everyone seems to be talking about ketones these days. But does anyone really know what ketones are? Are they a danger to your health (as in diabetic ketoacidosis), or a sign that you have lowered your carbohydrate intake enough to cause weight loss (as some people who follow low-carbohydrate diets believe)? What are ketones? Ketones are end-products of fat metabolism in the body. That is, they are formed when fat is burned for energy by the muscles. Chemically, they are acids known as ketone bodies, and there are three types: beta-hydroxybutyric acid, aceto-acetic acid, and acetone. But you don’t have to be a chemist to understand what role they play in the body. To get to know ketones, it’s helpful to understand how your body burns fuel. A simple analogy is that of an automobile. For a car engine to run, the engine must burn fuel (gasoline), and when the fuel is burned, exhaust (carbon monoxide) is created. The carbon monoxide is the end-product of gasoline combustion. Your body also has an engine that must burn fuel to operate. The engine is muscle, and the fuel is fat, carbohydrate (glucose), and, in certain conditions, protein. When fat is burned, the “exhaust” is ketones, and when glucose is burned, the “exhaust” is lactic acid. Fat is more desirable as a fuel than glucose because there are more calories in a gram of fat (9 calories per gram) than there are in a gram of glucose (4 calories per gram), so you get more energy per gram of fat burned. In a sense, you could call fat a high-test fuel. But there is one catch to burning f Continue reading >>
As fat is broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis. Diabetic ketoacidosis (DKA) is sometimes the first sign of type 1 diabetes in people who have not yet been diagnosed. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or surgery can lead to DKA in people with type 1 diabetes. People with type 2 diabetes can also develop DKA, but it is less common. It is usually triggered by uncontrolled blood sugar, missing doses of medicines, or a severe illness. Continue reading >>
What is alcoholic ketoacidosis? Cells need glucose (sugar) and insulin to function properly. Glucose comes from the food you eat, and insulin is produced by the pancreas. When you drink alcohol, your pancreas may stop producing insulin for a short time. Without insulin, your cells won’t be able to use the glucose you consume for energy. To get the energy you need, your body will start to burn fat. When your body burns fat for energy, byproducts known as ketone bodies are produced. If your body is not producing insulin, ketone bodies will begin to build up in your bloodstream. This buildup of ketones can produce a life-threatening condition known as ketoacidosis. Ketoacidosis, or metabolic acidosis, occurs when you ingest something that is metabolized or turned into an acid. This condition has a number of causes, including: shock kidney disease abnormal metabolism In addition to general ketoacidosis, there are several specific types. These types include: alcoholic ketoacidosis, which is caused by excessive consumption of alcohol diabetic ketoacidosis (DKA), which mostly develops in people with type 1 diabetes starvation ketoacidosis, which occurs most often in women who are pregnant, in their third trimester, and experiencing excessive vomiting Each of these situations increases the amount of acid in the system. They can also reduce the amount of insulin your body produces, leading to the breakdown of fat cells and the production of ketones. Alcoholic ketoacidosis can develop when you drink excessive amounts of alcohol for a long period of time. Excessive alcohol consumption often causes malnourishment (not enough nutrients for the body to function well). People who drink large quantities of alcohol may not eat regularly. They may also vomit as a result of drinking too Continue reading >>
Low Blood Sugar Levels & Funny Taste In The Mouth
When you consume carbohydrates in things like breads, pasta, fruit and sweets, your body converts them to glucose, a type of sugar. Your body then burns the glucose to create energy. Simple carbohydrates such as fruits, refined sugar and white rice are converted to energy quickly and are used up just as quickly. Complex carbohydrates like whole grains give you longer-lasting energy and leave you feeling full longer. You should try to consume more complex than simple carbohydrates. Your body needs a steady diet of carbohydrates because it doesn't store them like it does fat. If you haven't consumed enough carbohydrates to keep your blood glucose up, that's known as having low blood sugar or hypoclycemia. When that happens, your body begins burning fat for energy. When your body burns fat for energy, the fat breaks down and creates chemicals called ketones. This is called ketosis. A byproduct of ketones is a chemical called acetone. Your body gets rid of the acetone in your body by breathing it out, which is why you may have a funny taste in your mouth. Your breath may smell funny to others when you're experiencing ketosis as well. Some people describe the taste and smell as a fruity or sweet taste, while others say it tastes metallic. Who Experiences Ketosis People with diabetes who experience a drop in blood glucose and insulin often experience ketosis; in this case it's known as diabetic ketoacidosis. If you are experiencing diabetic ketosis it's important to eat or take a glucose tablet as soon as possible and call your doctor or an ambulance if your condition doesn't improve. People who are following a weight loss diet low in carbohydrates and high in protein also frequently experience ketosis as their bodies burn off the fat they're trying to lose. Ketosis may be se Continue reading >>
All The Things That Make Your Pee Smell Weird, And Why
Ever settle into the restroom to do your business and, amid the calming sound of your yellow stream, notice an awful smell? You know what your pee should smell like -- you experience it anywhere from six to eight times a day -- so an unfamiliar scent might be a sign that something is awry; a warning message flowing from your body to the toilet. Or it could just be something you ate. It turns out there are lots of things that affect the smell of your pee. How dehydrated you are can not only change its color, but also create a much more pungent smell, as can dietary choices and medical conditions. Here are the biggest culprits of why you're stinking up the toilet bowl. If you notice it's a common occurrence, definitely see your doctor. And in the meantime, invest in some Poo-Pourri. Drinking too much coffee If there is such a thing, that is. Overconsumption of coffee not only makes you wired; it could make your urine smell like a venti latte. Coffee contains caffeol, the fragrant oil you smell after it's brewed, which you smell again when you pee it out, especially if you've downed a lot of it. Coffee is also a diuretic, which doesn't help things. "Too much coffee will make your urine concentrated, and hence will impart a foul odor to your urine," internist Dr. Aditi Gupta, head of the doctor's panel at JustDoc, says. That's also why your pee becomes dark and bad-smelling, she adds, because as your body gets dehydrated from drinking too much coffee, the bacteria become more concentrated in your waste. No matter how funky your mid-morning pee smells, coffee is totally worth it. Heavy boozing "Breaking the seal" isn't a thing, but drinking alcohol definitely makes you have to pee more. That's because, like coffee, alcohol is a diuretic that makes the bacteria in urine more Continue reading >>
Print Overview Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated. If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care. Symptoms Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice: Excessive thirst Frequent urination Nausea and vomiting Abdominal pain Weakness or fatigue Shortness of breath Fruity-scented breath Confusion More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include: High blood sugar level (hyperglycemia) High ketone levels in your urine When to see a doctor If you feel ill or stressed or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit. Contact your doctor immediately if: You're vomiting and unable to tolerate food or liquid Your blood sugar level is higher than your target range and doesn't respond to home treatment Your urine ketone level is moderate or high Seek emergency care if: Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 mill Continue reading >>
Drunk Versus Diabetes: How Can You Tell?
Dispatch calls your EMS unit to the side of a roadway, where police officers have detained a driver on suspicion of driving under the influence of alcohol intoxication. You find the female driver handcuffed in the back seat of a police cruiser. She is screaming profanities and hitting her head against the side window. An officer tells you that she was weaving in and out of traffic at highway speed, and it took several minutes to pull her over. She was noncooperative and it took several officers to subdue her. She sustained a laceration to her head, which the officers want you to evaluate. The woman continues to swear at you as you open the car door. You note that she is diaphoretic and breathing heavily. You can smell what appears to be the sour, boozy smell of alcohol, even though you are not close to her. You can see that the small laceration near the hairline on her right forehead has already stopped bleeding. Her speech is slurred and she appears to be in no mood to be evaluated. The police officers are ready to take her down to the station to be processed for driving under the influence. Sound familiar? It should — this is a scene that is played out often in EMS systems. While it may seem initially that these incidents are not medical in nature, they really deserve close attention by the EMS personnel. In this article we will focus on the challenges of evaluating a patient who is intoxicated versus a patient who is experiencing an acute diabetic emergency. There have been numerous instances where EMS providers have exposed themselves to serious liability secondary to medical negligence. Let's take a closer look. Diabetes Diabetes is a serious disease that affects nearly 29 million people in the United States . Advances in diabetic care have resulted in an impr Continue reading >>
How To Avoid Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a possible complication of diabetes caused by extreme hyperglycemia, or high blood glucose. It is a serious and potentially life-threatening complication, one that you should work hard to avoid when you have diabetes. Diabetic ketoacidosis mainly affects people with type 1 diabetes, but it is a very rare possible complication for people with type 2 diabetes. Your doctor and certified diabetes educator will teach you how to recognize and manage diabetic ketoacidosis. It's critical to know and recognize the signs and symptoms of DKA, as well as how to treat it. What Is Diabetic Ketoacidosis? Diabetic ketoacidosis happens when your blood glucose level gets too high—usually higher than 300 mg/dL. Because people with type 1 diabetes do not have the insulin to process this extra glucose, their body cannot break down this glucose to create energy. To create energy for itself, the body starts to aggressively break down fat. Ketones or ketoacids are a byproduct of this process. Your body can handle a small amount of ketones circulating in your blood. However, the sizeable amounts from DKA are toxic. Diabetic Ketoacidosis Causes Illness, infections, stress, injuries, neglecting diabetes care (not properly taking your insulin, for example), and alcohol consumption can cause DKA. Diabetic Ketoacidosis Symptoms Initial symptoms of DKA include a stomach ache, nausea, and vomiting. One problem with DKA is that people could mistake it for an illness that typically gets better over time like the flu or food poisoning. Other symptoms of diabetic ketoacidosis include: fruity breath (when fat is broken down by the body, it creates a chemical called acetone that smells fruity) fatigue frequent urination intense thirst headache If you feel any of these sympto Continue reading >>
Why Does My Dog’s Breath Smell Like Fish, Acetone, Ammonia Etc.
Most people are aware of the fact that dogs can use their powerful sniffers to detect serious diseases in humans such as diabetes and even cancer, but not many dog owners are aware of the fact that they can also put their noses to work and return the favor when a dog’s breath smells weird. Sure, our noses aren’t sensitive enough to detect diseases at their earliest stages like dogs do, but we surely can identify signs of illnesses in our dogs if we are attentive enough and don’t fall into the trap of chalking them up as “normal canine odors.” Following are several odors in dog breath owners may detect that should warrant an emergency vet visit in the most serious cases, or at the most, a veterinary check-up to ensure everything is fine in the health department. What Does Normal Dog Breath Smell Like? First, what does normal dog breath smell like? This is a very good question. Usually, normal dog breath doesn’t have a particular odor. Just as in people, a healthy mouth shouldn’t give off any particularly strong odors. Many dog owners indeed, notice quite a difference after their dogs go in for a dental cleaning, as suddenly, all the bad odors are gone. It’s a common myth that bad breath in dogs is normal, so much so that it has even been given a nickname: “doggy breath.” This misconception is so widespread that Greenies, a company that makes dental treats for dogs, found that 28 million owners believe that it’s normal for their pets to have bad breath! So yes, if your dog has bad breath it’s not normal! Don’t fall into the trap of thinking all dog breath has an odor. “Bad breath is a sure sign of significant oral infection and, while there are other causes, periodontal disease is by far the number 1 cause of halitosis.” ~Dr. Brook A. Niemiec Continue reading >>
How Low-carb / High-protein Diets Can "trick" A California Dui Breath Test
Some medical and physiological conditions can cause California DUI breath tests to produce falsely high results. Such conditions include: hypoglycemia, fasting, and high-protein / low-carbohydrate diets (such as the Atkins and Paleo diets). These conditions involve insufficient carbohydrate intake for energy, or -- in the case of diabetes -- insufficient insulin to keep blood sugar levels in check. The result in both cases is the body's production of "ketones.” Ketones are similar in chemical composition to isopropyl alcohol, the type of alcohol found in solvents such as acetone.1 They are different from ethyl alcohol, the type of alcohol in an alcoholic beverage. Many DUI breath testing devices cannot reliably distinguish ketones from ethyl alcohol. Worse, “ketosis” can produce visible signs that mimic alcohol impairment, including: dehydration and excessive thirst, sluggishness, flushed face, decreased coordination, and even As a result, people with hypoglycemia… or who follow a low carbohydrate diet… are often falsely accused of: To help you better understand how these conditions can lead to a falsely high DUI breath test, our California DUI defense attorneys discuss the following, below: 1. What are ketones? Normally, our bodies get energy from carbohydrates in our diet. When we eat foods containing carbohydrates, our digestive system breaks down the digestible ones into sugar. One of these sugar molecules is glucose, the main energy source for our bodies. Glucose is absorbed into the bloodstream after eating. We often refer to this as “blood sugar.”3 When we don't eat enough carbohydrates to produce the blood sugar we need, our bodies have to burn our fat stores instead.4 Fats are broken down in the liver. There, they are turned into ketones and ketoa Continue reading >>
Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Childhood Ketoacidosis article. Diabetic ketoacidosis (DKA) is a medical emergency with a significant morbidity and mortality. It should be diagnosed promptly and managed intensively. DKA is characterised by hyperglycaemia, acidosis and ketonaemia: Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks). Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of DKA and the blood glucose may rarely be normal or only slightly elevated in DKA). Bicarbonate below 15 mmol/L and/or venous pH less than 7.3. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA. Epidemiology DKA is normally seen in people with type 1 diabetes. Data from the UK National Diabetes Audit show a crude one-year incidence of 3.6% among people with type 1 diabetes. In the UK nearly 4% of people with type 1 diabetes experience DKA each year. About 6% of cases of DKA occur in adults newly presenting with type 1 diabetes. About 8% of episodes occur in hospital patients who did not primarily present with DKA. However, DKA may also occur in people with type 2 diabetes, although people with type 2 diabetes are much more likely to have a hyperosmolar hyperglycaemic state. Ketosis-prone type 2 diabetes tends to be more common in older, overweight, non-white people with type 2 diabetes, and DKA may be their Continue reading >>
Diabetic ketoacidosis (DKA) is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly. DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs. Symptoms of diabetic ketoacidosis Signs of DKA include: needing to pee more than usual being sick breath that smells fruity (like pear drop sweets or nail varnish) deep or fast breathing feeling very tired or sleepy passing out DKA can also cause high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine, which you can check for using home-testing kits. Symptoms usually develop over 24 hours, but can come on faster. Check your blood sugar and ketone levels Check your blood sugar level if you have symptoms of DKA. If your blood sugar is 11mmol/L or over and you have a blood or urine ketone testing kit, check your ketone level. If you do a blood ketone test: lower than 0.6mmol/L is a normal reading 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and should test again in a couple of hours 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible 3mmol/L or over means you have a very high risk of DKA and should get medical help immediately If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA. When to get medical help Go to your nearest accident and emergency (A&E) department straight away if you think you have DKA, especially if you have a high level of ketones in Continue reading >>
Why Does My Breath Smell Like Acetone?
People often associate strong smelling breath with the food someone has eaten or poor dental hygiene. But it may reveal much more than that. If a person's breath smells like acetone or nail polish remover, it could indicate health conditions, including diabetes. The way a person's breath smells can be an indicator of their overall health. This article explores why a person's breath might smell like acetone and what this might mean about their health. Contents of this article: How diabetes can affect breath Diabetes can affect the way a person's breath smells and can cause bad breath, or halitosis. In a 2009 study, researchers found that analyzing a person's breath helped to identify prediabetes when diabetes is in its early stages. There are two conditions associated with diabetes that can cause bad breath: gum disease and a high ketone level. The proper name for gum diseases in periodontal disease, and its forms include: Diabetes can be associated with an increased risk of gum disease, which may cause a person's breath to smell bad. However, gum disease does not cause a person's breath to smell like acetone. If a person has diabetes and their breath smells like acetone, this is usually caused by high levels of ketones in the blood. Diabetes and acetone breath When diabetes is not managed well, the body does not make enough insulin to break down glucose in the blood. This means that the body's cells do not receive enough glucose to use as energy. When the body cannot get its energy from sugar, it switches to burning fat for fuel instead. The process of breaking down fat to use as energy releases by-products called ketones. Ketone bodies include acetone. Acetone is the same substance that is used in nail varnish remover and is distinguished by its fruity smell. When a pe Continue reading >>