Diabetes

Answer

Three different kinds of urine testing kits are available for testing three different substances in the urine: glucose (sugar), ketones, and microscopic amounts of protein (microalbuminuria).

Glucose test kits

Before the development of blood glucose meters, urine testing was the only method for gauging a person's sugar levels. However, it has always been a very imprecise method for testing glucose levels for a variety of reasons:

• Urine test strips cannot detect glucose (sugar) until the blood glucose level is above 180 mg/dl. This means a person's blood sugar level could still be high (hyperglycemia) or even dangerously low (hypoglycemia) but still not be detected.
  
  
• Urine glucose testing is highly subject to user error because it requires color interpretation of the urine test strip via a color-scale comparison. This becomes an issue with people who are colorblind or have poor eyesight, and certain drugs and vitamin C can change the color of the urine and thus provide an invalid measurement.
  
  
• The reading reflects the level of blood glucose from a few hours earlier - not at the present moment - and often is misinterpreted.
  

As a result of these shortcomings, healthcare professionals recommend that anyone needing to closely monitor blood glucose levels use a blood glucose meter. However, urine strips can be useful in certain populations who physically cannot or will not test themselves with a blood glucose meter.

Ketone test kits

Ketone bodies are the byproducts of the body burning fat, rather than glucose, to provide energy. When fat is used for energy instead of glucose, the preferred fuel source, the liver produces substances called ketones. If ketones build up, they can lead to a life-threatening condition known as diabetic ketoacidosis.

Ketone testing should be performed by people with type 1 (insulin-dependent) diabetes when their blood sugar is 240 mg/dl or higher, or as directed by their physician. All people with diabetes who are sick, under stress, or whose blood sugar level is above 300 mg/dl should also test for ketones, as should pregnant women with any type of diabetes (type 1, type 2 or gestational). Anyone who suspects the onset of diabetic ketoacidosis should be tested for ketones immediately. Diabetic ketoacidosis is characterized by fruity breath, extreme fatigue, increased urination and thirst, vomiting, and eventual unconsciousness. Severe cases require patients to seek emergency medical attention immediately.

Microalbuminuria test kits

The presence of protein in the urine (microalbuminuria) is an early sign of kidney disease. Since people with diabetes are at a higher risk for kidney damage, the American Diabetes Association recommends that anyone with diabetes be tested annually for microalbuminuria. This test, which previously was available only through healthcare professionals, is now available in a home-test kit. These simple tests can be performed by the user and mailed to the company for a professional evaluation. Should you test positive, your doctor may recommend specific medications to prevent further damage to your blood vessels and kidneys.

Find more health and self-help information in our comprehensive Diabetes Center.

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