Sickly sweet smell (ketone)

[Anonymous555]

Posting for traffic. Just woke up to DS14 screaming in pain with cramp in his lower leg. He's not a dramatic kid at all. Thought nothing of it til I got closer and distinctly smelled ketones. He's complained of nausea on and off the past fortnight. No family history of diabetes. What else could it be?
For context, my goddaughter is type 1 diabetic, I know what excessive ketones smell like.

@paddyclampitt

I have T1 diabetes so I get why people are concerned about the ketones. BUT it's also possible to get ketones if you've not been eating properly, especially if low on carbohydrate!

Is this why people who low-carb or do the Atkins diet can sometimes be a little pungent?