My teenage son, a type 1 diabetic for 2 years, recently failed a breathalyzer test for alcohol. I know he had not consumed alcohol of any kind. His blood sugars had been very high for several days before the test and his reading at the time of the test was 383. Could he have failed the test due to acetone in his breath?

The simple answer is that yes indeed breath acetone could interfere with older versions of the breathalyzer test and cause a false positive result. I don’t know the circumstances in which the test was required; but if this is a drunk-driving case then you should know that modern test instruments can distinguish between acetone and other volatile compounds in the breath like ethyl alcohol, isopropanol and methyl ethyl ketone and so of course can a blood test. You might want to press for evidence that the positive test really was due to alcohol and not acetone.

There is a considerable literature on this theme and if you have access to a medical library you might want to explore it. Some relevant examples are as follows:

Jones AW. Interfering substances identified in the breath of drinking drivers with the Intoxilyser. J.Analytical Toxicology. 20:522,1996.
‘Driving under the influence of acetone’. Jour. Toxicology-Clinical Toxicology 35:419,1997 (letter).
Smith DJ et al. Jour. Forensic.Science 30:349,1990 -A review of the incidence of contaminants in a large number of tests in the Seattle area.
Gullberg.RG Forensic Science International 67:65,1994. ‘Frequency of apparent acetone in a group of alcohol data…’

You might also want to review further using PubMed searching under ‘Acetone in breathalyzer tests’.

DOB