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Effect of Diabetes, Hypoglycemia, and Ketosis on Breathalyzers

In driving under the influence cases, some medical conditions can be mistaken by breath testing devices as evidence of alcohol. Diabetes is an illness that has other health effects that can cause inaccuracies in breath tests. This is why diabetes is a defense against DUI cases.

People with diabetes frequently experience "hypoglycemia." Hypoglycemia is the condition when the blood sugar (glucose) levels in the body become lower than normal.[1] When a person experiences hypoglycemia, its symptoms can look like that of intoxication.

"Ketosis" is another related health effect to diabetes. It is a metabolic process that happens when there is not enough glucose in the body and the body turns to stored fat instead to produce energy.[2] This in turn causes the liver to produce ketones. Ketones that are released through the breath can fool breathalyzers and can result in inaccurately high BAC readings.

In the following article, our West Covina defense attorneys will discuss some important points to know about diabetes, its effects, and how it relates to DUIs.

Hypoglycemia and DUI

Diabetic hypoglycemia happens when someone with diabetes does not have enough sugar (glucose) in their blood.[3] This can happen when a person with diabetes:

  • takes excess insulin;
  • skips a meal;
  • excessive exercise.

When a person experiences hypoglycemia, the physically visible symptoms often look similar to that of intoxication. Some symptoms include:[4]

  • shakiness
  • dizziness
  • sweating
  • hunger
  • fast heartbeat
  • inability to concentrate
  • confusion
  • anxiety or nervousness

Due to the similarity in symptoms between hypoglycemia and intoxication, it is not unusual that for people with diabetes to be suspected of DUI or DUI of drugs.

Hypoglycemia for Non-Diabetics

Hypoglycemia is often experienced by people with diabetes. However, people without diabetes also experience hypoglycemia. The symptoms a person exhibits when experiencing hypoglycemia is the same, regardless of whether or not they have been diagnosed with diabetes. Therefore, it is quite possible for people who experience non-diabetic hypoglycemia to be charged with a DUI because of the hypoglycemia symptoms.

Ketosis and DUI

Diabetic ketosis and its symptoms can be mistaken for intoxication because they appear similar and hard to distinguish from one another. Ketones that are released through urine and the breath can also fool breath testing devices into high BAC readings. Due to this, a person experiencing ketosis is at risk of being suspected of committing DUI.

How Ketosis Can Lead to a DUI Arrest

The body's cells use glucose as the primary form of energy. Ketosis happens when there is not enough glucose available in the body, the body then turns to an alternative energy source which is the fat stored in the body. The byproduct of this process is called ketones.

Ketones can be released in the urine and the breath.[5] In small amounts, ketones merely indicate that the body is breaking down fat for energy. But for people with diabetes, the liver tends to produce more ketones than the body can fully eliminate. An abnormally high level of ketones in the body is called ketoacidosis. The symptoms can be easily mistaken for intoxication as they appear to be visibly similar. Here are some symptoms of ketoacidosis that look like intoxication:[6]

  • excessive thirst
  • frequent urination
  • nausea and vomiting
  • stomach pain
  • weakness or fatigue
  • fruity-scented breath (this can be mistaken for alcohol breath)
  • confusion

Diabetic Ketosis and Breathalyzers

As mentioned previously, the ketones produced by the body when undergoing ketosis can fool breathalyzers and can result in inaccurately high BAC readings which can lead to DUI charges.

The reason that breath testing devices confuse ketones with intoxication is because ketones share a similar composition to that of isopropyl alcohol.[7] The type of alcohol found in alcoholic drinks is ethyl alcohol. However, isopropyl alcohol is read by breath testing devices the same way as ethyl alcohol and likewise cannot distinguish between ketones and isopropyl and ethyl alcohol. In correlation, California laws prohibit the use of alcohol disinfectants like isopropyl alcohol when collecting blood samples as this can affect the accuracy of BAC testing results.[8]

In sum, when a diabetic person undergoes ketosis, a breathalyzer can read these excessive ketones released in the breath as proof of alcohol consumption even when they have not been drinking at all.

Ketosis for Non-Diabetics

While ketosis is something that is more commonly experienced by people with diabetes, ketosis also happens to non-diabetics. The most common cause of ketosis for non-diabetics is diet (such as the Ketogenic Diet, Atkins Diet, Paleo Diet, etc.). So even if you don't have diabetes, ketosis is still a viable DUI defense strategy.

What to do if you have diabetes, ketosis, hypoglycemia, and you were charged with a DUI

It would be in your best interest to contact an experienced DUI defense attorney if this happens to you. Your attorney, with the help of a possible expert witness, can convince the prosecutor or the jury about the nature of your condition and how this can affect breathalyzers. This can lead to a reduction of charges or dismissal of the charges against you.

Mistakes Happen. A DUI Record, Losing Your License and Jail Don't Have To.

An illness can be mistaken for a DUI and navigating a DUI charge is a difficult thing to manage on your own. You will want to consult and secure the services of an experienced DUI defense attorney to assist you in navigating the complexities of fighting against a DUI charge. You will want to avoid a conviction at all costs because nobody wants to be convicted for something attributed to their medical condition and a DUI conviction can have severe effects on your life. Although we are fielding inquiries from a lot of people in similar situations, we will do our best to put you in contact with an experienced lawyer from our firm.

If you need assistance with a DUI charge, do not hesitate to contact us at (626) 827-7222 to schedule your consultation with one of our experienced attorneys at no cost.


[1] Please see https://www.diabetes.org/diabetes/medication-management/blood-glucose-testing-and-control/hypoglycemia

[2] Please see https://www.medicalnewstoday.com/articles/180858

[3] Please see https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525

[4] Id.

[5] Alice and Fred Ottoboni, Ketosis, Ketone Bodies, and Ketoacidosis: Modern Nutritional Diseases, 2nd Edition, Chapter 8 (Lipids), February 20th, 2013.

[6] Please see https://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/symptoms-causes/syc-20371551

[7] Jeanette Allen Behre, Studies in Ketone Body Excretion, Journal of Biological Chemistry, June 25, 1931, J. Biol. Chem. 1931, 92:679-697.

[8] 17 CCR § 1219.1 (b) – "Alcohol or other volatile organic disinfectant shall not be used to clean the skin where a specimen is to be collected. Examples of suitable aqueous disinfectants include: aqueous povidine-iodine (Betadine) or aqueous benzalkonium chloride (zephiran chloride)."

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