What characteristic is indicative of a patient with hyperglycemia?

The presence of a "fruity" odor of the breath is indicative of hyperglycemia, particularly in cases of diabetic ketoacidosis (DKA). When blood glucose levels are significantly elevated, the body is unable to utilize glucose for energy due to insufficient insulin. As a result, the body begins to break down fats for energy, leading to the production of ketones. One of the ketones, acetone, has a characteristic fruity smell that can become discernible on the patient’s breath. This symptom is a clear indication of a metabolic state associated with uncontrolled diabetes and is a critical identifier for hyperglycemic emergencies.

In contrast, excessive insulin use or lack of food intake typically leads to hypoglycemia, not hyperglycemia. Sudden onset of altered mental status can occur in both hyperglycemia and hypoglycemia, but it is more commonly associated with hypoglycemic episodes. Cool, moist skin and increased heart rate are signs that might be more closely related to shock or other conditions, rather than being distinctly indicative of hyperglycemia.