The smell of acetone from the mouth

Symptoms
Related diseases

The smell of acetone from the mouth, often described as a fruity or sweet odor, is a distinctive symptom that occurs when the body produces high levels of ketones, which are byproducts of fat metabolism. This symptom can be a warning sign of several metabolic conditions and warrants medical attention.

Relation to Type 1 Diabetes:

In type 1 diabetes, the smell of acetone from the mouth is a common symptom of diabetic ketoacidosis (DKA), a serious and potentially life-threatening complication. When the body lacks sufficient insulin, it cannot use glucose for energy and instead begins to break down fat for fuel. This process produces ketones, including acetone, which accumulate in the blood and are expelled through the breath. Diabetic ketoacidosis requires immediate medical treatment.

Other Possible Causes:

While the smell of acetone from the mouth is strongly associated with diabetic ketoacidosis, it can also occur in other conditions, including:

  1. Starvation or Fasting:
    • When the body enters a state of ketosis due to prolonged fasting or severe calorie restriction, it produces ketones as an alternative energy source. This can lead to a fruity odor from the mouth.
  2. Low-Carbohydrate Diets (e.g., ketogenic diet):
    • Similar to fasting, low-carbohydrate diets can induce ketosis, resulting in an acetone-like smell on the breath.
  3. Alcoholic Ketoacidosis:
    • This condition occurs in chronic alcoholics, especially after a binge, combined with little or no food intake. The metabolism of alcohol, along with malnutrition, can cause the body to produce ketones.
  4. Hyperglycemia:
    • In extreme cases of uncontrolled type 2 diabetes, hyperglycemia can also lead to the production of ketones and the associated breath odor.
  5. Metabolic Disorders:
    • Some rare metabolic disorders, such as maple syrup urine disease and certain amino acidemias, can cause the body to produce unusual compounds that result in fruity breath odor.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology