Urine Tests for Diabetes
Diabetes can damage
your kidneys. To check for this, your doctor will perform a
urine test that measures the amount of protein in your urine,
called microalbuminurina. This test should be done every year,
starting when you are diagnosed with type 2 diabetes. If you have
type 1 diabetes, you may not need this test until five years after
you are first diagnosed.
What is microalbuminuria?
Microalbuminuria is small
amounts of albumin (the main protein in your blood) that may have
leaked into your urine. When the test is positive, it indicates
that the blood vessels to your kidneys are damaged. It also
reflects more widespread blood vessel disease that can increase
your risk of heart problems.
What happens if the test
If the test is positive,
your doctor may recommend starting specific medicines to prevent
further damage to your blood vessels and kidneys. If the
microalbumin level is very high, your doctor may recommend that
you have another type of urine test that involves you collecting
your urine for 24 hours to more accurately determine the extent of
damage to your kidneys and see how well they are working.
Sometimes, your doctor may
perform a urine test to determine of your blood sugar is
dangerously high and you are producing substances called ketones.
What are Ketones?
Hyperglycemia, or high
blood glucose, happens when there is too much sugar in the blood
and not enough insulin. If there is not enough insulin, your body
is unable to use the glucose. The glucose then gets too high and
your body breaks down its own fat for energy instead of glucose.
When fat is used for energy, the liver produces substances called
ketones. Ketones are the waste-products of fat burning, and in the
absence of insulin, keto-acids are also produced, which can be
toxic when they build up in the blood.
Ketones appear in the urine
and can be measured using special test equipment. For a person
with type 1 diabetes, a blood glucose level more than 300 mg/dl
may indicate there is not enough insulin, and there is a risk of
building up ketones. Too many ketones in your blood can cause an
emergency condition called ketoacidosis.
How do I test for
Testing for ketones is done
by dipping a test strip into your urine. The test strip changes
color and is then compared to a color chart.
When should I test for
If you have type 1
diabetes, test your urine for ketones when:
- Your blood glucose is
over 300 mg/dl
- You feel sick (have a
cold, the flu or other illness) and have nausea or vomiting
If you have type 2
diabetes, you have a very low chance of developing ketoacidosis,
even if you are on insulin therapy. However, during severe
illnesses, it is possible that ketoacidosis may develop. You
should test your urine for ketones when:
- You feel severely sick
(have a cold, the flu or other illness) and/or have
unexplained nausea or vomiting
- Your blood glucose level
is high (> 300 mg/dl) and continuing to rise throughout the
When should I call my
The result of your urine
test for ketones should always be negative. Any positive results
should be reported to your doctor immediately. You should also
call your doctor right away if your blood glucose remains elevated
or if you have stomach pain, nausea, vomiting, rapid breathing or
Although high levels of
sugar in your urine can indicate a potential problem, urine tests
are not considered an accurate or reliable way to diagnose
diabetes, according to the American Diabetes Association. Your
blood sugar level could be high without high levels of glucose
showing up in your urine.
How do I record my test
Keep good records of any
urine or ketone tests you do. Your records can help alert you to
any problems. Also, these test records help your doctor make any
needed changes in your meal plan, medication or exercise program.
Bring these records with you every time you visit your doctor.
Hemoglobin A1c >
by the Department of Endocrinology and Department of Patient
Education and Health Information at The Cleveland Clinic.