Can Diabetes Complications Mimic a DUI?

Courtesy of Godoy Medical Forensics



The American Diabetes Association (ADA) reports that there are 30.3 million American adults with diabetes. This is approximately 9.4% of the American population.  The ADA also reports that 1.5 million Americans are diagnosed with diabetes every year and that in 2015, it was the 7th leading cause of death in the United States. What is this disease that has affected so many Americans? Diabetes is a chronic health condition that affects the body’s ability to use food for energy. Most of the food we eat is broken down into sugar (also called glucose).  This glucose gets released into the bloodstream where it signals the pancreas to release insulin, a hormone that moves glucose into the body’s cells so that it can be used as energy.  If a person has diabetes, their body either does not make enough insulin or their body cannot utilize the insulin efficiently. As a result, too much glucose stays in the bloodstream, which, if not managed effectively, can lead to heart disease and stroke. Diabetes is not curable; however, no matter what type of diabetes one has, it is a very treatable disease.

Symptoms When Diabetes Is Not Managed Effectively

Hypoglycemia (low blood sugar) may occur if too much diabetes medication is taken. Hypoglycemia causes symptoms such as:

  • Tremors.
  • Anxiety.
  • Sweating.
  • Dizziness.
  • Weakness.
  • Drowsiness.
  • Delirium and confusion.
  • Blurry vision.

Hyperglycemia (high blood sugar) may occur if the diabetes treatment is not being followed or is not effective.  Hyperglycemia causes symptoms such as:

  • Blurry vision.
  • Fatigue or lethargy.
  • Hunger and thirst.
  • Frequent urination.
  • Headache

Ketone bodies are produced when the body’s cells don’t get the glucose it needs for energy so it turns to burning fat as an energy source, which then produces ketones. When these ketones build up in the body, the following symptoms may occur:

  • Fatigue.
  • Dry or flushed skin.
  • Nausea, vomiting, or abdominal pain.
  • Confusion.
  • Difficulty paying attention.
  • Fruity odor on breath as a result of isopropanol (type of alcohol) elimination.

Ineffective Diabetes Management Mimicking DUI

There are several symptoms and behaviors associated with hypoglycemia, hyperglycemia and the production of ketone bodies that resemble those associated with driving under the influence. In one study, it was also reported that most alcohol detection devices used today cannot distinguish between ethanol and isopropanol. Therefore, there can be a strong possibility of false positive results when using breathalyzers to detect blood alcohol content in diabetics who may be hyperglycemic due to ineffective management of their medical condition. Conversely, alterations in sugar or ketone levels do not appear to affect blood alcohol results. Whether it is Diabetes or any other medical condition, it is important to consider the symptoms associated with the person’s medical condition that can be mistakenly be identified as symptoms of driving under the influence.


(Centers for Disease Control and Prevention, 2018) (American Diabetes Association, 2018) (MD, 2019) (MD, Overview of Medical Care in Adults with Diabetes Mellitus, 2018) (Andreas T. Guntner, 2018).