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January 30, 2001

Hyperglycemia and DKA

Question from Toronto, Ontario, Canada:

When a person with diabetes is in ketoacidosis can there be a false reading of being intoxicated when having to take a breathalyzer test since ketones are an alcohol (or so I've been told)?

Answer:

With the help of my local laboratory pathologist, we have located two reports in the medical literature which addresses this question. However, there is not a consensus of opinion on the subject. A report in the Journal of Forensic Science in July, 1995 by Jones and Andersson indicates that ketones eliminated in the lungs can be transformed to another compound known as isopropanol. It is the isopropanol which is the agent which interferes the measurement of alcohol in the breath sample. The study was supported by the negative result for ethanol in a blood sample from the same patient.

Another study from Diabetes Medicine in March of 1989 by Slama et al. says there is no cross-reactivity and ketones could not cause a false positive alcohol breath test. As I am not a forensic pathologist, I cannot offer any additional information to the above.

JTL