If the body’s ability to metabolize sugar is diminished by either lack of insulin (Type I diabetes) or tissues being resistant to insulin (Type II diabetes) then glucose builds up in the bloodstream. Because the tissues are not able to consume this glucose they instead call on the body to provide them with fats for use as an energy source. The chemical reaction that takes place to change the fats to usable glucose is what creates the keytones. Having an elevated level of keytones in the body changes the pH level of the body making tissues more acidic. There is often a detectable odor on the breath that smells ‘fruity’ or like ’souring milk’. The substances being expelled from the body that cause this odor (typically acetones) can be detected by breathalyzers and mistaken for ethanol. (FYI this is also why people on certain diets test with false positives, their bodies are burning fats, not glucose.)

The behavior that commonly mimics intoxication by alcohol is associated primarily with HYPOglycemia which occurs when there is an overabundance of insulin and thus the tissues consume too much glucose from the bloodstream. Without a supply of blood glucose the central nervous system begins to malfunction which causes the slurred speech, dizziness, loss of motor functions, and many more adverse effects including unconciousness.

I am not certain whether the same symptoms of HYPOglycemia manifest with HYPERglycemia. As a Type I diabetic myself I have distinctly different symptoms for the two conditions. It should be said, however, that if a diabetic has poor blood glucose control they could be having a HYPOglycemic event shortly after having a HYPERglycemic event and that could explain the presence of both keytones and erratic behavior.

I agree that individuals suffering from Diabetes are at risk for having a medical condition severely misunderstood or prejudged by a law enforcement officer. I also agree that the laws as written do not logically pursue justice. However, if we do not want a legitimate defense stigmatized as trickery, then all facts must be checked. Keytones build up in the body during HYPERglycemia, not HYPOglycemia.