Diabetes impairs the body’s ability to manage blood sugar, and this disruption can cause a noticeable change in body odor. The alteration in scent is not typical body odor caused by bacteria, but a direct result of internal metabolic changes. This unique smell signals that the body’s fuel source has shifted, creating byproducts expelled through the skin and breath. Recognizing this specific scent indicates a potentially serious medical situation requiring immediate attention.
The Metabolic Cause of the Distinct Odor
The distinct odor arises when cells cannot access glucose, their primary energy source, due to a lack of insulin or the body’s inability to use it. The body switches to breaking down fat stores for energy, a process that produces acidic compounds known as ketone bodies.
The three main ketone bodies are beta-hydroxybutyrate, acetoacetate, and acetone. Acetone is a volatile substance that cannot be used for energy and is excreted from the body through the lungs and the skin. The body attempts to rid itself of the excess acetone through the breath and sweat, which creates the characteristic scent.
The Characteristic Scent: What it Smells Like
The scent associated with this metabolic state is often described as a sweet, fruity, or sickly-sweet odor. This smell is due entirely to the presence of acetone being expelled from the body. Many people compare the specific aroma to that of nail polish remover, or to the smell of overripe fruit or pear drop candies.
While the odor is often most pronounced on the breath, it can also permeate the sweat, making the body’s perspiration smell unusual. The strength of the scent is directly related to the concentration of ketones in the bloodstream. A stronger smell indicates a greater buildup of these acidic byproducts, signaling a worsening metabolic condition.
Recognizing Diabetic Ketoacidosis Symptoms
The presence of this sweet odor, particularly on the breath, is a major warning sign of a severe complication known as Diabetic Ketoacidosis (DKA), which is a medical emergency. DKA occurs when the excessive buildup of ketones causes the blood to become highly acidic. This condition most frequently affects individuals with Type 1 diabetes, but it can also occur in those with Type 2 diabetes under certain circumstances.
The odor is typically accompanied by several other physiological symptoms that indicate the body is in crisis. Individuals may experience excessive thirst (polydipsia) and frequent urination (polyuria) as the body attempts to flush out excess glucose and ketones. Gastrointestinal distress is also common, manifesting as nausea, vomiting, or abdominal pain.
As the condition progresses, a person may begin to exhibit signs of mental status changes, such as confusion or decreased alertness. They might also experience profound fatigue and weakness. A specific type of deep, labored breathing, called Kussmaul respiration, can also develop as the body tries to compensate for the blood’s acidity by rapidly expelling carbon dioxide.
Immediate Steps When Noticing the Odor
If this fruity or sweet odor is detected on a person with diabetes, immediate action must be taken to prevent DKA from advancing. The first step is to check both blood sugar and blood ketone levels, or urine ketones if blood testing is unavailable. Ketone levels are the most direct indicator of the severity of the situation.
Contacting a healthcare professional is necessary if ketone levels are elevated, such as blood ketones between 1.6 and 3.0 mmol/L. Emergency medical services are essential if blood ketone levels are very high (above 3.0 mmol/L) or if the person is experiencing severe symptoms. Seek emergency care immediately if vomiting prevents the person from keeping down fluids, or if confusion or drowsiness is present, as these are signs of advanced DKA.