My nine year old son has an odor that I can only associate with ketoacidosis. He becomes diaphoretic, nauseous and weak, when he has not eaten in several hours, and I must stay alert to his need for nourishment. He does not, however, awaken with these symptoms after a night’s sleep. He is in good health. His height and weight are within range for his age. My grandfather, grandmother and aunt have/had Type�2 diabetes. I am unfamiliar with the paternal history, except that my son is the first generation American of Chinese decent. On two occasions, his pediatrician ordered a fasting blood sugar. Each time, the results were within normal limits. I’m baffled and concerned. Any suggestions?

I think that your son may well be suffering from what is called ‘ketotic hypoglycemia’ which is a relatively common and easily remedied condition. In brief, if the diet contains insufficient carbohydrate the body resorts to body fat breakdown to meet the energy gap and this in turn results in ketosis. Energy requirements are less at night which explains the morning relief and treatment.as you have found, is to have frequent carbohydrate feeds, snack items like NiteBites which contain uncooked starch are useful. This condition has no connection with any form of diabetes.

Just to make quite sure that what you recognise if acetone really is acetone, you should ask your son’s doctor to give you test strips for acetone in urine and, in any case, you should discuss this suggestion with him/her.

DOB