Please explain why breath smells like acetone in diabetes? Is this condition dangerous?
Dobrinka Mihailova, city of Sliven
The appearance of the smell of acetone from the mouth can be due to serious reasons and is a subjectively frightening symptom. This acetone breath is also described by many as the smell of a sour apple. It should be noted that in young children, the smell of acetone in the breath appears as a result of many different reasons, and in most cases it does not need treatment. In older people, the most common cause of acetone smell from the breath is diabetes, which may first manifest itself with this sign.
Why is this happening?
Diabetes, both of the first and second type, is a key pathogenetic link between the glucose entering the blood from the intestine during meals and the glucose-consuming cells, i.e. absolutely all cells of the body.
Most sensitive to the glucose content are the special, "on-call" centers in the brain that instantly send commands to other structures to improve insulin delivery. The production of insulin, which helps glucose enter the cells, is lower in type 1 diabetes or the cells become insensitive to insulin (in type 2 diabetes). And this means that the cells in the body never receive their energy substrate - glucose, despite its sufficient and even excessive content in the blood.
Our organism has foreseen the development of such cases and begins to mobilize its reserves of energy-intensive compounds of different origins, namely fats and, as a last resort, proteins. Their breakdown products - acetaldehydes - are removed from the body through the lungs and are manifested by a smell in the breath in diabetes.
Consult a specialist
The appearance of acetone (or ketone bodies in general) in the blood and, as a consequence, in the urine and exhaled air of the diabetic, is always associated with an acute situation in which the cells experience hunger and are forced to use energy from the breakdown of fats.
When the condition worsens, from which the body usually cannot get out on its own, the patient's he alth deteriorates. With ketoacidosis (the so-called accumulation in the blood of the three ketone bodies, one of which is acetone), visible symptoms appear that indicate the development of an alarming situation in diabetes: bad breath, dry skin and mucous membranes, nausea and vomiting, palpitations, weakness, low blood pressure.
These symptoms do not develop instantly and there is usually time to seek medical help. In the further development of ketoacidosis, life-threatening conditions occur - diabetic coma. Therefore, the smell of acetone in the breath, especially when it occurs for the first time, should not be ignored.
Does not occur in people with compensated diabetes
In timely consultation with a doctor to stop the signs of ketoacidosis, a simple insulin injection and help to restore the water-electrolyte and acid-alkaline balance of the body helps. Newly diagnosed diabetes requires careful examination and determination of the causes of its occurrence, with subsequent treatment. The smell of acetone on the breath does not appear in people with compensated diabetes.
First aid to an unconscious person
If you notice the smell of acetone on the breath of an unconscious person, under no circumstances try to administer insulin in any dose, as this can lead to extreme decompensation and brain edema. It is enough to put the person to lie on one side so that in case of vomiting the airways are not blocked by the vomit, to monitor breathing and pulse until an ambulance arrives.
