
July 25, 2001
Meal Planning, Food and Diet
Question from Altamonte Springs, Florida, USA:
If a middle aged man with type 2 diabetes were to not eat for a day would it cause acidosis and make him smell like he had been drinking alcohol?
Answer:
It is possible for people who have not eaten for an extended period to enter a state sometimes called “starvation ketosis.” This happens when the body is breaking down fat for the energy it needs, but there is no carbohydrate being taken in to “burn” with the fat. When fat is burned for energy without carbohydrate, small amounts of chemicals called ketones could be produced. The ketones are breathed out through the lungs to some degree producing a sweet or fruity odor. Could this be what you’re smelling?
This is, by the way, unrelated to the more severe form of DKA [diabetic ketoacidosis] that can happen in type 1 diabetes when insulin is seriously lacking. The amounts of ketones produced in that situation are much greater and have more serious consequences.
BB