What is the connection between acetone on breath and diabetes?

[zoobyshoe]

A couple months ago the side/rear of my left canine tooth sort of exploded off for no reason I can think of. I thought at first I must have had a filling in it I'd forgotten about since I can't see back there.

Anyway, I got to the dentist this morning and after examining it she started asking me over and over if there'd been any changes in my health lately. The first time this question is routine, The second and third time it's fishy, and I asked her what was up.

She said my breath smelled of acetone and that this was a red flag for diabedes.

When I got home I googled and the wikipedia confirmed this. However, I don't have any other of the symptoms mentioned. Yet, I'm really bothered by this because, as a dentist, she must be a sort of expert on people's breath and acetone is a pretty distinctive aroma.

This ticks me off because only fat people are supposed to get diabedes and I've just been on a diet and lost 35 pounds of middle aged gut. I'm very lean and skinny: you can see all my stomach muscles. It's like, the people who pass out diseases ought to keep up with this stuff: I'm not an internet potato anymore. I take a walk every day. No more doughnuts.

I'm trying to spin this into something positive in my mind. Like: with solvent breath I should be able to breath on a cigarette lighter at will and become a kind of Godzilla for entertainment purposes at parties, but I've had no luck with getting my exhalations to ignite. Haven't been able to strip any paint with it either.

Anyway, now I guess I have to have this checked by a GP. There's some slim chance the dentist was having olfactory hallucinations but from what I read this smell is pretty much a definitive sign. This is VERY annoying.

 

[hypatia]

Type 2 can hit around middle age, any family history of it? And no, it dosent just plague fat people.

 

[Evo]

She said my breath smelled of acetone and that this was a red flag for diabedes.

When I got home I googled and the wikipedia confirmed this. However, I don't have any other of the symptoms mentioned. Yet, I'm really bothered by this because, as a dentist, she must be a sort of expert on people's breath and acetone is a pretty distinctive aroma.

Were you on a low carb diet at the time, or any diet? It can cause ketosis, which gives you acetone breath.

http://en.wikipedia.org/wiki/Ketosis

"Deliberately induced ketosis through a low-carbohydrate diet has been used to treat medical conditions. The ketogenic diet is an approach to treating epilepsy, and the Atkins Nutritional Approach is marketed for treating obesity. The very low calorie, medically supervised Lighter Life diet also uses ketosis for weight loss"

"Ketones are a normal and efficient source of fuel and energy for the human body. They are produced by the liver from fatty acids, which result from the breakdown of body fat in response to the absence of glucose/sugar. In a ketogenic diet, such as Atkins ... or diets used for treating epilepsy in children, the tiny amounts of glucose required for some select functions can be met by consuming a minimum amount of carbs - or can be manufactured in the liver from PROTEIN. When your body is producing ketones, and using them for fuel, this is called "ketosis".

http://www.lowcarb.ca/tips/tips011.html

 

[Ivan Seeking]

The important thing is to get checked out. My neighbor didn't realize that he had a problem until he went blind while driving to work one morning. Luckily he managed to pull over before running off the road, and his sight did eventually return.

 

[zoobyshoe]

Were you on a low carb diet at the time, or any diet? It can cause ketosis, which gives you acetone breath.

http://en.wikipedia.org/wiki/Ketosis

"Deliberately induced ketosis through a low-carbohydrate diet has been used to treat medical conditions. The ketogenic diet is an approach to treating epilepsy, and the Atkins Nutritional Approach is marketed for treating obesity. The very low calorie, medically supervised Lighter Life diet also uses ketosis for weight loss"

"Ketones are a normal and efficient source of fuel and energy for the human body. They are produced by the liver from fatty acids, which result from the breakdown of body fat in response to the absence of glucose/sugar. In a ketogenic diet, such as Atkins ... or diets used for treating epilepsy in children, the tiny amounts of glucose required for some select functions can be met by consuming a minimum amount of carbs - or can be manufactured in the liver from PROTEIN. When your body is producing ketones, and using them for fuel, this is called "ketosis".

http://www.lowcarb.ca/tips/tips011.html

There's some hope in this since, yes, I have radically altered what I eat in the past few months. Basically I adopted a no fat diet which means no meat, no breads. No breads means no bread, doughnuts, cookies, muffins, croissants, etc. All those breads are made with a lot of shortening, butter, or are deep fried.

I do eat: a lot of fruit, raw vegetables, rice, beans, tuna fish, cottage cheese, and anything that seems low calorie, like say, pickles.

The ketogenic diet for epilepsy is often called a "high fat" diet, and that can't be causing my acetone breath. All you eat on that diet is full of fats.

The way I eat now may constitute a low carb diet, though, even though I'm not specifically intending some sort of Atkin's approach.

"Ketones are a normal and efficient source of fuel and energy for the human body. They are produced by the liver from fatty acids, which result from the breakdown of body fat in response to the absence of glucose/sugar."

I've greatly reduced sugar, too, from how much I used to eat.

This info makes me feel better. There didn't seem to be any alternative to diabedes causing this acetone breath before this. Thanks Evo.

 

[zoobyshoe]

Type 2 can hit around middle age, any family history of it? And no, it dosent just plague fat people.

No family history. I can't think of one relative with diabedes.

And, although obese people are most often mentioned as being at risk, the very first person I ever met who got the diagnosis was very lean and skinny. He'd fainted suddenly at the office, which is what tipped them off.

The important thing is to get checked out. My neighbor didn't realize that he had a problem until he went blind while driving to work one morning. Luckily he managed to pull over before running off the road, and his sight did eventually return.

This is what the dentist said: it can be more or less asymptomatic in some people for a while.

 

[turbo]

This is what the dentist said: it can be more or less asymptomatic in some people for a while.

Zooby, please get it checked out promptly. Diabetes can have some severe health consequences, and many of them involve your eyesight. I used to maintain the fundus cameras, lasers, etc for a large opthalmic practice and many of the patients with serious problems were diabetics.

 

[Math Is Hard]

No way this is possible. Zoobies don't get diabetes. I think you reached for the mouthwash in the dark and accidentally gargled with nail polish remover.

 

[larkspur]

Go to your pharmacy get some http://www.drugstore.com/products/p...=37671&trxp3=1&trxp4=0&btrx=BUY-PLST-0-BRAND"and test your urine for ketosis. That will provide a quick answer to the ketosis question. These are kept behind the pharmacy counter so you will have to ask for them.

 

[zoobyshoe]

Zooby, please get it checked out promptly. Diabetes can have some severe health consequences, and many of them involve your eyesight. I used to maintain the fundus cameras, lasers, etc for a large opthalmic practice and many of the patients with serious problems were diabetics.

I just went and made an appointment. They're going to see me this Tuesday afternoon.

I'm not sure what to do in the meantime. Should I eat a little sugar everyday, or avoid it all together? Anything else I should or shouldn't eat assuming the worst?

Go to your pharmacy get some http://www.drugstore.com/products/p...=37671&trxp3=1&trxp4=0&btrx=BUY-PLST-0-BRAND"and test your urine for ketosis. That will provide a quick answer to the ketosis question. These are kept behind the pharmacy counter so you will have to ask for them.

I may do this out of curiosity.

 

[hypatia]

Just eat as you would do normally, if you plan to eat this way for the rest of your life..which is a good sense diet your following. Don't change anything until the Dr tells you somethings up.

 

[turbo]

I just went and made an appointment. They're going to see me this Tuesday afternoon.

I'm not sure what to do in the meantime. Should I eat a little sugar everyday, or avoid it all together? Anything else I should or shouldn't eat assuming the worst?

I may do this out of curiosity.

Good deal! I watched my father in law suffer amputations and other problems - he was a good man!

 

[Evo]

Glad that you're going to the doctor, but I wouldn't worry, after that diet you described, it's probably ketosis.

My mom has had the mild form of diabetes for years, she just watches her diet, doesn't need insulin.

So don't worry. Worry will kill you.

 

[Moonbear]

Glad that you're going to the doctor, but I wouldn't worry, after that diet you described, it's probably ketosis.

I don't think so. I thought the diet he described sounded pretty healthy with fruits and vegetables, rice, and somewhat low in protein. That's not a ketogenic diet. That sort of diet would actually be good for someone with diabetes, which might be why he hasn't noticed other major symptoms yet. He may be keeping his blood sugar somewhat controlled with his diet.

Zooby, stick with the diet you're on until you see the doctor, and they can tell you if you need to change it.

In any case, everyone here is talking like diabetes is a death sentence. It's only bad if you don't treat it. If you get to the doctor before you start having any major problems with it, and follow their instructions/take any medications prescribed so that you keep it under control, it need not be anything more than a minor inconvenience. Depending on the type and severity of your case, you may only need to take a pill for it. Be thankful your dentist noticed the symptoms before they got bad enough for you to notice yourself. It's much better than not noticing until you start having vision problems or go into a diabetic coma.

 

[Ivan Seeking]

Diabetes is a real pain in the rear, but if that's it, you will adjust. Just avoid bee hives and sweet berries, and stick with the leaves, nuts, backpackers...

For me it was a relief to be diagnosed as this explained why I always felt like crap.

 

[Evo]

I often develop ketosis from bad eating habits. It's a signal for me to eat normally again.

But I know I'm healthy otherwise. I agree zoob needs to see a doctor to make sure, but not worry himself to death in the meantime.

 

[DaveC426913]

I was diagnosed early, and that was a blessing. I've avoided (so far) all the bad things that can happen with undiagnosed Diabetes.

So I live a completely normal life. No drag for me. Frankly, it has been great.

The silver lining about (Type II) Diabetes is that the majority of management is actually a matter of good health practices - eat well, exercise, keep your weight in check. If everyone lived their lives as if they had Diabetes, we'd be a much healthier people.

So I take better care of myself - I eat better and exercise (a little) more. Getting Diabetes may have actually increased my life span.

 

[FredGarvin]

If it's any consolation, my father was diagnosed when he was in his early 50's. He is now 75 and is doing wonderfully. He adjusted and manages his diet and blood sugar so the effects have been minimized. No one on my Dad's side had ever been diagnosed with it. He was the first. Of course, it doesn't look good that my older brother was diagnosed with it when he was in the Navy. He was in good shape and was definitely not overweight. Ironically, my brother was at the dentist when he "found out." He ended up passing out in the chair.

 

[selfAdjoint]

It's now now ttwenty years since I was diagnosed with type II diabetes (Fall 1986). I am in excellent health, my blood sugar runs between 80 and 130, and the only "symptoms" I have are some neuropathy effects in my toes. But many nondiabetic men my age have that too.

Type II diabetes is NOT like type I diabetes; it is in no way a sentence of early death. Diet and excercise can control it. My doctor told me that if push came to shove, my lifestyle would control my blood sugar even without medication.

 

[zoobyshoe]

Thanks everyone for the stories of how you're dealing with it and still doing well, and for the encouragement to make sure and get to a doctor about it. I think there is a good chance Evo is right since I am still on the diet and still losing fat. That is: my calorie intake is still less than maintenance level.

If the worst turns out to be the case, though, I may be consulting with you for tips and such.

 

[zoobyshoe]

According to this, and other sites, ketoacidosis the state in which one's breath has a fruity and/or acetone smell, is an emergent condition requiring immediate medical attention:

Ketoacidosis

Ketoacidosis (key-toe-ass-i-DOE-sis) is a serious condition that can lead to diabetic coma (passing out for a long time) or even death. Ketoacidosis may happen to people with type 1 diabetes.

Ketoacidosis occurs rarely in people with type 2 diabetes. But some people -- especially older people -- with type 2 diabetes may experience a different serious condition. It's called hyperosmolar nonketotic coma (hi-per-oz-MOE-lar non- key-TOT-ick KO-ma).

Ketocidosis means dangerously high levels of ketones. Ketones are acids that build up in the blood. They appear in the urine when your body doesn't have enough insulin. Ketones can poison the body. They are a warning sign that your diabetes is out of control or that you are getting sick.

Treatment for ketoacidosis usually takes place in the hospital. But you can help prevent ketoacidosis by learning the warning signs and checking your urine and blood regularly.
What are the warning signs of ketoacidosis?


Ketoacidosis usually develops slowly. But when vomiting occurs, this life-threatening condition can develop in a few hours. The first symptoms are:

* Thirst or a very dry mouth
* Frequent urination
* High blood glucose (sugar) levels
* High levels of ketones in the urine
* Next, other symptoms appear
* Constantly feeling tired
* Dry or flushed skin
* Nausea, vomiting, or abdominal pain (Vomiting can be caused by many illnesses, not just ketoacidosis. If vomiting continues for more than 2 hours, contact your health care provider.)
* A hard time breathing (short, deep breaths)
* Fruity odor on breath
* A hard time paying attention, or confusion

Ketoacidosis is dangerous and serious. If you have any of the above symptoms, contact your health care provider IMMEDIATELY, or go to the nearest emergency room of your local hospital.

Is this correct or not? Do all of you with diabetes frequently have fruity/acetone breath in non-emergency situations?

 

[Moonbear]

Do you have any of those other symptoms, such as frequent urination or insatiable thirst, or vomiting, or generally feeling very tired? You may not have even noticed something like drinking more frequently if you're just thinking it's a hot summer and you're thirsty from the heat. And when you called your doctor, did you mention that the dentist noticed acetone odor on your breath?

If any of the other symptoms start to appear, call your doctor again and see if you can get your appointment moved earlier. Maybe you can schedule a nurse's appointment sooner just to have a finger stick blood test done to check where your glucose levels are and if they are high enough to need immediate treatment, and to reassure yourself a bit until the appointment with your doctor arrives (if it's really high, they won't let you leave once there until you see the doctor anyway, so you won't have to sit around several days wondering and worrying if it's too high).

I've never actually heard of the acetone breath odor as a first symptom before, but maybe those with more personal experience with diabetes know otherwise. I've usually heard of it more in the context of someone who is staggering around in an altered mental state and then collapses to identify when giving first aid that they are likely diabetic in need of insulin, not drunk and passed out.

Do you have a relative or friend or neighbor nearby who you can check in with once or twice a day and who can keep an eye out for you in case you get to a stage where you're not able to call or drive yourself before your doctor's appointment? When my step-father was diagnosed, it got to that point...the symptoms came on pretty suddenly, or at least the ones they recognized as symptoms...overnight he suddenly started with the unquenchable thirst, and since he started drinking milk and juice instead of water, he really drove up his glucose levels quickly, so that by morning, he was already showing signs of confusion, and my mom got him to a doctor immediately...at that point, he would not have been able to call for a doctor himself or to get there without someone else driving. It'll be a good idea to have someone else around who knows you well to check in for the first few weeks you're treating the diabetes too, if that's what it turns out to be, just in case your blood sugar levels fluctuate too much as you're adjusting to your medication doses and schedules.

 

[zoobyshoe]

So, Ivan, Dave, SelfAdjoint, and others with relatives who have it: do you see acetone breath as a normal, non-critical part of this disease?

I'm not going to cancel my appointment to have it checked, but this is seeming more and more like a false alarm, since I was, and have continued, to feel perfectly normal and the acetone breath of ketoacidosis seems to be exclusively a part of a diabetic crisis from the sites I've checked.

 

[selfAdjoint]

So, Ivan, Dave, SelfAdjoint, and others with relatives who have it: do you see acetone breath as a normal, non-critical part of this disease?

I'm not going to cancel my appointment to have it checked, but this is seeming more and more like a false alarm, since I was, and have continued, to feel perfectly normal and the acetone breath of ketoacidosis seems to be exclusively a part of a diabetic crisis from the sites I've checked.

What do you suppose a diabetic "feels like"? There is no feeling that will tell you you're a diabetic any more than there's one to signal high blood pressure. Get the damn test! Bad ketone metabolism is NOT A GOOD SIGN in a diabetic. Not panic time but time to have your blood checked professionally and an internist to look you over.

 

[DaveC426913]

So, Ivan, Dave, SelfAdjoint, and others with relatives who have it: do you see acetone breath as a normal, non-critical part of this disease?

Ah OK, in the context of Diabetes, acetone breath is bad. It is an indication that your body is past the stage of ridding sugar through your urine and starting to break down muscle (ketones are from the proteins). I'm no doctor, but I've never heard of acetone breath being non-critical in regards to diabetics.

Now, truth be told, that does NOT mean there aren't false positives. There can be other reasons for this symptom that have nothing to do with diabetes.

Acetone breath is only an indicator. There are lots of other symptoms you might be experiencing:
intermittent blurry vision
unexplained weight loss
frequent urination
excessive thirst
tingling in the feet
numbness in the feet
confusion, inability to concentrate
plus the usual irritability, fatigue, etc.

Before being diagnosed, I experienced all but the foot problems - and I was only an undiagnosed Diabetic for a mere year (meaning the symptoms showed up rapidly).

 

[Ivan Seeking]

Hey Zooby, your pm box is full.

This wouldn't apply to me. Mine is a variant much like hypoglycemia but worse. Once I start making insulin I make too much. This is why I could tell that something was wrong. My blood sugar can drop as low as 20...right after a large meal filled with carbs.

If you know someone who has diabetes, maybe they would let you use their blood tester. It only takes a minute.

 

[zoobyshoe]

Ah OK, in the context of Diabetes, acetone breath is bad. It is an indication that your body is past the stage of ridding sugar through your urine and starting to break down muscle (ketones are from the proteins). I'm no doctor, but I've never heard of acetone breath being non-critical in regards to diabetics.

I haven't found anything to this effect either. However, I'm not taking a few brief summaries I've read as complete. I know from reading about seizures that some medical summaries leave gaps that just about constitute misinformation. It could be that some subset of diabetics get this breath without it being associated with a critical state.

Now, truth be told, that does NOT mean there aren't false positives. There can be other reasons for this symptom that have nothing to do with diabetes.

Acetone breath is only an indicator. There are lots of other symptoms you might be experiencing:
intermittent blurry vision
unexplained weight loss
frequent urination
excessive thirst
tingling in the feet
numbness in the feet
confusion, inability to concentrate
plus the usual irritability, fatigue, etc.

Before being diagnosed, I experienced all but the foot problems - and I was only an undiagnosed Diabetic for a mere year (meaning the symptoms showed up rapidly).

I don't have any of those except the irritability. That's part of being a zoobie.

Hey Zooby, your pm box is full.

That's because I refuse to delete one precious word of the tender PM's I've received from Lisa!.

However, There should be some room now if you still need to reply.

This wouldn't apply to me. Mine is a variant much like hypoglycemia but worse. Once I start making insulin I make too much.

So, it seems obvious you don't treat this type by taking insulin. Do you get away with just a tablet of some sort?

If you know someone who has diabetes, maybe they would let you use their blood tester. It only takes a minute.

I actually met a girl, only 18, with a full blown case a few months ago. She wears a kind of permanent installation: an insulin delivery device that is plugged into her belly. That is: there is a line from the device to a circular piece of plastic with a small needle on the back. The needle goes just through her skin and the circular piece that holds the needle is taped in place.

I'm not sure what prompts the delivery of insulin from the device, though, whether it be a timer or if she checks her level and pushes a button. I haven't been to the cafe where I met her in a few weeks. My initial appointment is this afternoon, anyway, and I'm sure they'll check everything they can.

 

[Moonbear]

I actually met a girl, only 18, with a full blown case a few months ago. She wears a kind of permanent installation: an insulin delivery device that is plugged into her belly. That is: there is a line from the device to a circular piece of plastic with a small needle on the back. The needle goes just through her skin and the circular piece that holds the needle is taped in place.

I'm not sure what prompts the delivery of insulin from the device, though, whether it be a timer or if she checks her level and pushes a button.

It's both. I knew someone who had one of those too, and it had a regular infusion of insulin to keep his levels steady during the day, but then if he ate certain foods (pizza was one that he said caused particular trouble for diabetics for some reason...that was actually how I learned about the pump, when we were at a meeting with pizza being served) he could push a button and adjust the program to compensate for the different insulin levels needed for that food. That's a pretty drastic step, and something that would only be done if you absolutely could not keep the diabetes under control with regular monitoring and insulin injections. A lot of adult-onset type diabetes can be treated with just a daily pill rather than having to resort to insulin injections, especially if you have mild symptoms to suggest you do have some function of the cells involved in regulating your sugar levels, just not full function anymore. The medication gets the functioning cells to function better.

 

[DaveC426913]

This wouldn't apply to me. Mine is a variant much like hypoglycemia but worse. Once I start making insulin I make too much.

1] I have never heard of such an ailment. Can you point me at some literature?

2] I wish to meet with you over coffee to discuss the viability of having yourself and myself grafted together at the hip so as to share blood systems. Our two ailments will nicely cancel each other out and we can live normal happy full lives. I hope you like brunettes. And are a heavy sleeper.

 

[DaveC426913]

I often develop ketosis from bad eating habits. It's a signal for me to eat normally again.

Well, I guess I've learned something today.

 

[zoobyshoe]

O.K. We've completely eliminated that possibility."

The GP I saw today listened to my report that the dentist had warned me of an acetone on my breath and the possibility this meant diabetes. She (the GP) said, "We'll have a look at your blood sugar". This took about 10 seconds. She said my blood sugar was 79 and that that was perfectly alright.

"O.K." she said, "We've completely eliminated that possibility."

!

I said "What could the dentist have been smelling on my breath?"

"Oh, she was probably just being hypervigilant."

I wanted to ask her more questions but, of course, she had a bunch of other patients waiting.

So, the whole thing was over just like that. They have no plans to put me through the more extensive tests.

 

[Cyrus]

Good to hear, zoob.

Hey, check out my art teachers work. What cha think about it? His work is at a local CC right now.

http://www.howardcc.edu/arts_and_humanities/Art_Gallery/Current_Show.htm

...I like it.

 

[Math Is Hard]

glad to hear you are OK!

 

[Evo]

The GP I saw today listened to my report that the dentist had warned me of an acetone on my breath and the possibility this meant diabetes. She (the GP) said, "We'll have a look at your blood sugar". This took about 10 seconds. She said my blood sugar was 79 and that that was perfectly alright.

"O.K." she said, "We've completely eliminated that possibility."

!

I said "What could the dentist have been smelling on my breath?"

"Oh, she was probably just being hypervigilant."

I wanted to ask her more questions but, of course, she had a bunch of other patients waiting.

So, the whole thing was over just like that. They have no plans to put me through the more extensive tests.

I KNEW IT!

As soon as I saw your diet, I was sure that was the cause.

 

[Moonbear]

As soon as I saw your diet, I was sure that was the cause.

I'm still failing to see a connection with his diet here. The diet sounds like one you would put a diabetic on to control it, which is generally a healthy diet anyway, not something that would cause ketosis. And, since they didn't seem to be worrying about that when he saw the doctor, how could it be the diet? It sounds more like it was nothing, or just some odor that wafted the way of his chair that wasn't his breath at all.

Anyway, I'm glad it all worked out to be a false alarm. Not that all that stress is good for you with the worry it put you through, but at least it turned out to be nothing in the end. Too bad you couldn't have gone in sooner just for the 10 second test and put your mind at ease a couple days ago. Maybe MIH was right, you just grabbed the nailpolish remover instead of mouthwash that day.

 

[Ivan Seeking]

Good news Zooby, diabetes is not the end of the world but it is no fun.

So, it seems obvious you don't treat this type by taking insulin. Do you get away with just a tablet of some sort?

At this point I am managing by watching what I eat. I was on Precose for about a year but that stuff is really hard to tolerate. Luckily, after taking it for a time I was able to back off, but how long I can keep this up, I don't know. It is a constant struggle and I don't feel well much of the time.

DaveC426913, when I was diagnosed [edit: cripes, it has been over eight years now! ] it was simply called "adult diabetic syndrome". Beyond that I don't know what else it might be called. I ended up having to go to one of the nations leading specialists before it was diagnosed. At the time there was no literature available.

Another interesting side note: When I finally landed in the office of a true expert, the difference was like night and day. Not only did he nail it withing a few minutes, he also explained all sorts of things that I had never understood. For example, I thought that I was allergic to alcohol. It affected me differently than everyone else, and eventually I realized that I just can't drink. Even one beer was enough to make me feel absolutely terrible. But it was the blood sugar all along.

 

[zoobyshoe]

Good to hear, zoob.

glad to hear you are OK!

Thanks you guys.

Cyrus, I'll look at art later. I'm de-stressing here.

I KNEW IT!

As soon as I saw your diet, I was sure that was the cause.

I think you are probably right. It is my main suspect.

From the Wikipedia article you linked to:

"The breath of people in a ketagenic state commonly contains acetone, detectable as a sweet smell that may be mistaken for ethyl alcohol."

That article describes two ketogenic diets: 1.) the high fat ketogenic diet for treating epilepsy in children, and 2.) the low-carb (Atkin's type) diet. I'm pretty sure that what I've been eating amounts to the latter, low carb diet. The bulk of the carbs I eat probably come from the, approximately 1 cup of rice and 1 cup of beans I eat almost every day. I eat no bread whatever, nothing made with flour, no potatos. I usually snack all day long about once an hour: an apple here, a carrot there, a stalk of celery, a nectarine, a fistful of raw green beans, and so forth. There's just no doubt I've been burning fat off. When they weighed me today while taking vitals I found out I'm now 40 lbs lighter than when I started.

My limited understanding is that carbs convert easily to fuel for energy. If you don't eat many carbs you force the body to convert stored fat into ketones which are the fuel. This is ketosis. Not the same thing as ketoacidosis, but produces the same fruity/acetone breath.

The only other suspect is the med I take. If I burp after taking it it has a strong chemical taste in my mouth. The thing is, I've been taking it for years, and also going to that same dentist for years, and she's never noticed any smell before. Also, since this visit was 9 AM, I hadn't taken any of it that day, so there was none in my stomach to burp up.

 

[zoobyshoe]

Good news Zooby, diabetes is not the end of the world but it is no fun.

I'm certainly relieved. I'm a pretty chaotic person with a wandering mind and the prospect of my life depending on me checking something on a regular schedule was pretty scary.

At this point I am managing by watching what I eat. I was on Precose for about a year but that stuff is really hard to tolerate. Luckily, after taking it for a time I was able to back off, but how long I can keep this up, I don't know. It is a constant struggle and I don't feel well much of the time.

The side effects of some meds are so bad the person ends up feeling they've just exchanged one disease for another. I've heard a million stories.

 

[DaveC426913]

She (the GP) said, "We'll have a look at your blood sugar". This took about 10 seconds. She said my blood sugar was 79 and that that was perfectly alright.

"O.K." she said, "We've completely eliminated that possibility."

Um. I hate to be a poopiehead about this, but ...

Your GP has not done a proper test - she has not eliminated Diabetes at all.

Diabetics are perfectly capable of having normal blood sugar levels.

She needs to do a proper 3-hour glucose tolerance test.

One of the most challenging things about Diabetes is outdated knowledge - including doctors. Your doctor is basing her test and conclusion on stuff she learned a decade or two ago.

Zoob, I hate to tell you this, but you DO need to get a proper test.

On the plus, side what the test has indicated is that, if you DO have Diabetes, it has not put your glucose levels out of the control, i.e. you are not in imminent danger of damage.

 

[Moonbear]

Having 1 cup of rice and beans daily isn't an Atkin's style low carb diet. All those fruits and vegetables also have carbs/sugars in them. The extreme form of the Atkin's diet that puts people at risk of ketoacidosis eliminates even vegetables and rice. Though, I guess that depends on how much of the other foods you're eating. How quickly have you lost that weight? It may not be the choice of foods so much as that you're eating so little and losing weight so quickly that you're basically forcing your body into "starvation" mode. But, if it was the diet, don't you think that would still be apparent when you saw your doctor? Unless you decided to modify your diet between the dentist and doctor visits.

Who knows, maybe it wasn't an acetone odor at all, but really a fruity odor from eating fruits! Or, some receptionist was doing her nails while the dentist was seeing you and she didn't realize she really was smelling acetone, but it wasn't coming from you. It would have been nice if your doctor had spent a few more minutes with you so you could have asked about the diet and rate of weight loss to make sure it's okay.

 

[Moonbear]

On the plus, side what the test has indicated is that, if you DO have Diabetes, it has not put your glucose levels out of the control, i.e. you are not in imminent danger of damage.

It's possible his diet is helping to keep it in control. My grandfather had part of his pancreas removed due to cancer years ago, and only about two years ago did someone realize he should have been getting monitored for diabetes regularly! (I had been under the impression it was only partially removed, so the remainder was able to compensate, but then the story was suddenly that it was entirely removed...I've never liked his doctor because it seems things like this get miscommunicated too often, but he insists he's a great doctor and keeps going back to him ). I'm still sure he HAD to have some pancreas left or he'd be dead from lack of insulin, but definitely his diet helped keep his blood sugar well under control even with a deficiency so that it took many years before the diabetic symptoms showed up. His diet is very similar to Zooby's, and he really didn't need to modify very much after the official diagnosis other than to cut out some of the sweet snacks he was sneaking in the middle of the night (my grandmother has always been anti-sugar in her house...she's not the fun grandma).

 

[Evo]

It wouldn't be a bad idea to do a "glucola" test. I turned out to be mildy hypoglycemic and I don't even pay any attention to it.

Although Zooby doesn't seem to be having any symptoms, at our age, it's not a bad idea to get a complete check up, something I need to do.

 

[zoobyshoe]

Um. I hate to be a poopiehead about this, but ...

Your GP has not done a proper test - she has not eliminated Diabetes at all.

Diabetics are perfectly capable of having normal blood sugar levels.

She needs to do a proper 3-hour glucose tolerance test.

One of the most challenging things about Diabetes is outdated knowledge - including doctors. Your doctor is basing her test and conclusion on stuff she learned a decade or two ago.

Zoob, I hate to tell you this, but you DO need to get a proper test.

On the plus, side what the test has indicated is that, if you DO have Diabetes, it has not put your glucose levels out of the control, i.e. you are not in imminent danger of damage.

Strictly speaking, you're right: I wasn't given the definitive test. What her statement was meant to convey to me was her certainty that nothing she'd heard gave her the slightest suspicion I actually might have it or need further testing. She was saying "You may put your mind completely at rest about this."

Now, I think when I tell the dentist what the GP said she's going to say: "Glad you had it checked. That smell alarmed me somewhat, so I thought I should tell you about it." I think her concern is that she doesn't want patients passing out in the chair while she's working on them.

Now, the GP just didn't have time to answer the dozen questions I would like to have asked, but I'm guessing her certainty was based on knowing something to the effect that a person probably cannot have diabetic acetone breath without also having incorrect blood sugar. That's my speculation, anyway.

My brother-in-law is an ER doctor, and has online access to any and all current info that's for doctors only. I've kept my sister, his wife, up to date on all this. I'm positive he'll get back to me if he thinks there's still any reason to be concerned about it.

 

[zoobyshoe]

Having 1 cup of rice and beans daily isn't an Atkin's style low carb diet. All those fruits and vegetables also have carbs/sugars in them. The extreme form of the Atkin's diet that puts people at risk of ketoacidosis eliminates even vegetables and rice. Though, I guess that depends on how much of the other foods you're eating. How quickly have you lost that weight? It may not be the choice of foods so much as that you're eating so little and losing weight so quickly that you're basically forcing your body into "starvation" mode. But, if it was the diet, don't you think that would still be apparent when you saw your doctor? Unless you decided to modify your diet between the dentist and doctor visits.

Who knows, maybe it wasn't an acetone odor at all, but really a fruity odor from eating fruits! Or, some receptionist was doing her nails while the dentist was seeing you and she didn't realize she really was smelling acetone, but it wasn't coming from you. It would have been nice if your doctor had spent a few more minutes with you so you could have asked about the diet and rate of weight loss to make sure it's okay.

I'm not sure you're seeing the difference between ketosis and ketoacidosis. According to that wikipedia article the low carb diet induces ketosis which also produces acetone breath. This is low-carb not no-carb. Ketosis seems to be the normal, non-pathological way the body turns stored fat into energy when it lacks other, more immediate fuel. Ketoacidosis also produces acteone breath, but is exclusively pathological and seems to be ultimately triggered by the insulin problems (in the case of diabetics) not by diet.

(I think, incidently, we'd expect to find acetone breath in anyone following the high fat ketogenic diet for epilepsy as well. This seems to produce ketosis by utilizing mostly fatty foods as the daily energy source.)

At any rate, what I eat now relative to the huge amounts of bread, doughnuts, starchy soups, baked potatoes, popcorn etc., that I used to eat, constitutes a huge drop in carb intake now that I look at it, though my deliberate intention was merely to avoid fats. My body has, indeed, been ridding itself of fat stores, and I assume it's doing this by turning them to ketones. That seems to be the normal way.I wouldn't be the least bit surprised to find out I'd been in ketosis many times during the past 4 1/2 months, burning body fat, rather than anything I'd eaten that day. Otherwise, where did this fat go? Secret nocturnal alien liposuction?

 

[Moonbear]

Ketosis is just the earlier stage of converting fat to ketones. When enough ketones, which are acidic, accumulate, you end up with ketoacidosis, which is life-threatening. If you're experiencing ketosis with your diet, you're playing with fire. You can burn fats without becoming ketotic. As you described your diet, which may or may not be what you always follow, it is not low carb. Rice and vegetables all have carbohydrates. Just because you're leaving out the refined sugars found in bread and doughnuts doesn't mean you're not getting carbs. Your diet is really just low fat. The rice and beans tells me you're not cutting out protein either, so really, it's just the fats you've cut out. You've reduced your carbohydrate/sugar intake, but you haven't eliminated it or entered into what's considered a low-carb diet, mostly you've just changed from a high-carb/high fat diet. It shouldn't be causing ketosis at all, because you're still providing enough carbohydrates for your body, unless you are also cutting back calories/portions to an extremely low level. But, to have lost that weight over 4 1/2 months sounds like a reasonable rate, not too fast at all. Really, you sound like you're on a very sensible diet for weight loss and overall health.

 

[zoobyshoe]

Ketosis is just the earlier stage of converting fat to ketones.

Yes, this is how I understood it. A neutral thing. Likewise, the term "in ketosis" simply means your body is performing this function, as I understand it.

When enough ketones, which are acidic, accumulate, you end up with ketoacidosis, which is life-threatening. If you're experiencing ketosis with your diet, you're playing with fire. You can burn fats without becoming ketotic.

Here it seems to me, you're throwing the terms ketoacidosis, ketosis, and ketotic all in together as if they're equivalent.

From the link in Evo's first post:

But, isn't ketosis dangerous?

Being in ketosis by following a low carbohydrate diet is NOT dangerous. The human body was designed to use ketones very efficiently as fuel in the absence of glucose. However, the word ketosis is often confused with a similar word, ketoacidosis.

Ketoacidosis is a dangerous condition for diabetics, and the main element is ACID not ketones. The blood pH becomes dangerously acidic because of an extremely high blood SUGAR level (the diabetic has no insulin, or doesn't respond to insulin ... so blood sugar rises ... ketones are produced by the body to provide the fuel necessary for life, since the cells can't use the sugar). It's the high blood sugar, and the acid condition that is so dangerous. Ketones just happen to be a part of the picture, and are a RESULT of the condition, not the CAUSE.

You've reduced your carbohydrate/sugar intake, but you haven't eliminated it or entered into what's considered a low-carb diet, mostly you've just changed from a high-carb/high fat diet. It shouldn't be causing ketosis at all, because you're still providing enough carbohydrates for your body, unless you are also cutting back calories/portions to an extremely low level.

I haven't actually looked into how many carbs you have to be eating in order for the term "low carb" to apply. The main point here is not to figure out if the term "low-carb" applies, which, I grant, it may not, but if the way I've been eating could produce acetone breath.

Somehow the way I've been eating has produced fat loss. It seems to me that all this fat must have been turned to ketones to be burned away. Turning fat to ketones is called "ketosis". Therefore, It seems to me I must have been in ketosis many times during this diet. Not "ketotic" or "in ketoacidosis", just in ketosis: turning fat to ketones.

Here and there, I'd imagine, when I was burning more calories than other days, or waited longer than usual after waking up to eat my first meal of the day, I might easily have turned enough fat to ketones to make my breath smell. The Atkin's and epilepsy diets seem to do this without it being dangerous in any way.

 

[Moonbear]

Sorry zoob, but the only place you'll find support for ketosis not being dangerous is on low carb websites. The ketones produced in ketosis ARE acidic, and their build up is what leads to ketoacidosis. Biochemically, there is no distinction between ketosis and ketoacidosis. The build up of ketones is a last-ditch effort by your body to preserve brain function while reserving any other glucose for the function of other vital organs. The physiological distinction between ketosis and ketoacidosis is that ketoacidosis occurs when the ketone bodies have built up even beyond the point where the blood and bodily fluids can still provide a buffering effect, and the blood becomes more acidic. If you are ketotic and excreting ketones, you are also losing other important electrolytes with it (in diabetics, that's a major contributor to the insatiable thirst).

The Atkins and epilepsy diets are dangerous. Most people don't really stick to the Atkin's diet very faithfully, which helps protect them from the worst symptoms. The epilepsy diet is not generally used except as a last resort when medications fail...it works because it DOES change the way the brain functions, but in that case, the other health risks are considered acceptable because the alternative of uncontrolled seizures is worse.

Developing ketosis means your body is NOT fully metabolizing fatty acids, due to a lack of carbohydrates to sustain precursors needed for the Krebs cycle, and ketone bodies accumulate rather than being metabolized. You can utilize fat reserves without developing ketosis.

However, if you were developing ketosis due to your diet, you would also have very low blood sugar to accompany it. That is when the body starts producing those ketone bodies, when there is not enough sugar/carbohydrates around. In diabetics, the opposite is true; they will have very high blood sugar to accompany ketone production because despite having lots of sugar in their body, their cells can't use it.

The diet sites trying to promote low-carb diets are spreading misinformation. They are trying to convince the public that ketosis is totally normal and healthy so they can keep making money off their diet books and diet foods, etc. When you see them making claims like, "even physicians and scientists confuse the terms..." don't you think maybe there's some fibbing going on? They're trying to tell you, "Ignore those nutritionists and biochemists who know the science and believe us and buy our product."

 

[Evo]

I agree with Moonbear, low carb diets aren't healthy because they are not balanced. I only furnished the link to explain why a low carb diet would cause ketosis.

I live alone and I'll buy a ham and end up eating nothing but ham (zero carbs) for two weeks and will develop ketosis. I'm not advocating eating this way, I just get lazy, and I like ham.

Low carb is considered an intake of 30 or less grams of carbs per day.

 

[zoobyshoe]

Sorry zoob, but the only place you'll find support for ketosis not being dangerous is on low carb websites. The ketones produced in ketosis ARE acidic, and their build up is what leads to ketoacidosis. Biochemically, there is no distinction between ketosis and ketoacidosis. The build up of ketones is a last-ditch effort by your body to preserve brain function while reserving any other glucose for the function of other vital organs. The physiological distinction between ketosis and ketoacidosis is that ketoacidosis occurs when the ketone bodies have built up even beyond the point where the blood and bodily fluids can still provide a buffering effect, and the blood becomes more acidic. If you are ketotic and excreting ketones, you are also losing other important electrolytes with it (in diabetics, that's a major contributor to the insatiable thirst).

The Atkins and epilepsy diets are dangerous. Most people don't really stick to the Atkin's diet very faithfully, which helps protect them from the worst symptoms. The epilepsy diet is not generally used except as a last resort when medications fail...it works because it DOES change the way the brain functions, but in that case, the other health risks are considered acceptable because the alternative of uncontrolled seizures is worse.

Developing ketosis means your body is NOT fully metabolizing fatty acids, due to a lack of carbohydrates to sustain precursors needed for the Krebs cycle, and ketone bodies accumulate rather than being metabolized. You can utilize fat reserves without developing ketosis.

However, if you were developing ketosis due to your diet, you would also have very low blood sugar to accompany it. That is when the body starts producing those ketone bodies, when there is not enough sugar/carbohydrates around. In diabetics, the opposite is true; they will have very high blood sugar to accompany ketone production because despite having lots of sugar in their body, their cells can't use it.

The diet sites trying to promote low-carb diets are spreading misinformation. They are trying to convince the public that ketosis is totally normal and healthy so they can keep making money off their diet books and diet foods, etc. When you see them making claims like, "even physicians and scientists confuse the terms..." don't you think maybe there's some fibbing going on? They're trying to tell you, "Ignore those nutritionists and biochemists who know the science and believe us and buy our product."

OK. All this is finally coherent. It wasn't clear to me before that you had any objections to these diets. Your main point seemed to be that I wasn't actually on one. So I assumed what it said was OK with you, and I was trying to assimilate apparently contradictory statements.

Still, I remain confused about what to call the normal, healthy conversion of fat stores to ketones.
-------
If the smell came from some source external to me, like the receptionists nail polish theory, I would have smelled it too.

The thing about this dentist is that she's remarkably calm and even tempered. The notion she imagined the smell, or mistook something else on my breath for acetone, suggests something out of character for her.

In the interest of science I have slaughtered one of my meds to smell it's innards. These are gel caps with liquid inside. All I can detect is a faint oder reminiscent of mineral oil.

My other theory is that it is the meds and she has always smelled this on my breath, but didn't learn this smell was associated with diabetes till recently, since my last visit.

 

[zoobyshoe]

I agree with Moonbear, low carb diets aren't healthy because they are not balanced. I only furnished the link to explain why a low carb diet would cause ketosis.

I live alone and I'll buy a ham and end up eating nothing but ham (zero carbs) for two weeks and will develop ketosis. I'm not advocating eating this way, I just get lazy, and I like ham.

And yet you wonder why you're not allowed within 1000 feet of a synagogue.

Low carb is considered an intake of 30 or less grams of carbs per day.

The reason I eat the rice and beans is because someone told me this combination constitutes a "perfect" protein, whatever that means. I'm wondering if when eaten together like this they cease being carbs and become proteins. That would leave just the carbs in the raw vegetables and the fructose (considered a carb, right?). Several times I've added lentils, after someone told me they're packed with protein. It's occurred to me once or twice I should be concerned I don't lose muscle mass in this process.

I mentioned tuna fish. I also eat sardines (packed in water only) and kippered snacks now and then. These are the leanest meat proteins I could think of. I went for a couple chicken kebobs once but they were just too greasy for me to keep in the diet.

The rice and beans I heat up in a skillet with chopped onions and garlic, and top off with even more granulated garlic. I add a chopped celery stalk and a cut up tomato half. Sometimes I add soy sauce to this. I use a bare minimun of olive oil to sautee the onions and garlic, maybe half a teaspoon. Without the garlic and onions it's too bland. I really pour on the granulated garlic.