Which of the following is a sign or symptom of diabetic ketoacidosis?

• A. Shortness of breath
• B. Rash
• C. Fruity breath smell
• D. Wheezing

Answer: (C)

Fruity breath smell is a classic clue for diabetic ketoacidosis because it reflects acetone, one of the ketone bodies produced when the body doesn’t have enough insulin to use glucose and starts breaking down fat for energy. This process creates a buildup of ketones, leading to metabolic acidosis, and acetone is volatile enough to be exhaled, giving that distinctive fruity odor.

In DKA, other signs you might see include dehydration from polyuria and vomiting, rapid heart rate, and abdominal pain or nausea, with deep, rapid breathing (Kussmaul respiration) as the body tries to compensate for the acidosis. Rash isn’t associated with DKA, and wheezing is more typical of airway conditions like asthma or an allergic reaction, not the metabolic picture of DKA.