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January 16, 1967


JAMA. 1967;199(3):210-211. doi:10.1001/jama.1967.03120030114023

Every medical student learns that the odor of acetone on an unconscious patient's breath should cause a search for further evidence of diabetic coma. Now this gross clinical sign may be harnessed by modern technology, providing information to aid in diagnosis and in management of diabetes.

Investigators from Sweden1 report a rapid new technique whereby patients breathe directly into a gas chromatograph. Forty seconds later a measurement of alveolar acetone concentration is available. Since acetone moves from blood to alveolus by simple diffusion, the alveolar level of this substance reliably mirrors blood concentration. And clinicians have sought an accurate measure of blood acetone, considering it a useful guide to the management of diabetics.

In the patients reported, those with an adultonset type of diabetes showed approximately the same concentration of acetone as did a control group of nondiabetics; however, alveolar acetone levels rose with loss of control of the