Type 2 Diabetic with sweet breath Odor.

Patient: I have a question. I am a type 2 diabetic with high blood pressure, pcos, pseudotumor cerebri and recently had kidney stones removed and my gall bladder removed. I exercise everyday and i work and take my medicine like i am supposed to. I have been smelling something that smells like nail polish remover, i am constantly thirsty and urinating and i had a 2 step tb test done for my job and they were negative but that was two weeks ago and i have a bruise in both spots. what are my options as to what is wrong?

Doctor: You have mentioned that you are suffering from type 2 diabetes(on metformin), high blood pressure (taking methyldopa), p cos and pseudotumor cerebri. You have also mentioned about smelling something like a nail polish remover and being constantly thirsty and increased urination. The condition that I’m worried for here is diabetic ketoacidosis which initially presents with increased thirst and urination and also may present with a fruity breath odor due to the excess acetone in breath. Other symptoms include nausea, vomiting, abdominal pain, muscle cramps, blurred vision.It is important that you immediately consult your physician in regards to the development of these symptoms. Diabetic ketoacidosis is caused when there is decreased insulin in the body leading to hyperglycemia and subsequent breakdown of fat in the liver cells leading to formation of ketones and metabolic acidosis. Diabetic ketoacidosis is a medical emergency and requires urgent treatment and close monitoring in a specialized health-care setup.