Having acetone breath with blood sugar in the upper normal limit

Patient

Q: Ihave recently lost 5 and a half stone on a weight watchers diet and 6 mths ago developed an acetone smell from my breath and sometimes from my wind .I upped my carbs and put on 7 lbs and the smell gradually disappeared over a few mths . Last week the smell came back for no reason .I was told that I had ketosis breath caused by a low carb diet yet I eat plenty of carbs . I checked my ketone level with ketostix and each time the result came back negative . I had a diabetes test which came back as on the high side of normal. The smell seems to come and go every few days but when it comes back it seems extra strong .I visit the dentist twice a yr and he said I have no gum disease. I am at my wits end , can you please help ?

Doctor

A:   The most common cause (and almost the only one) of a fruity or acetone breath is Ketoacidosis in diabetic patients. It occurs as the body attempts to get rid of excess acetone through the breathing. Ketoacidosis is a potentially life-threatening condition. You mentioned that you blood sugar last time was in the upper normal limit, may be you require a Glucose tolerance test to rule out in your case a possible Diabetes Mellitus.

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