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Diabetes and Urine Tests

Urine Testing For Severe Hyperglycemia

Sometimes, your health care provider may perform a urine test if your blood sugar is dangerously high to see if you are producing substances called ketones. Ketones are the by-product of the fat burning process that occurs in the absence of insulin. When a person with diabetes develops hyperglycemia, or high blood sugar, if there is not enough insulin around (type 1 diabetes) or if their body is unable to utilize the insulin properly (type 2 diabetes) and break down sugar, the body turns to fat stores to create energy for the cells. While ketones can be a source of energy for many cells, they can be toxic in large amounts and cause a life-threatening emergency condition called ketoacidosis.

Ketone levels can be measured in the urine by your doctor or by using an over-the-counter kit at home.

How Do I Test for Ketones?

Testing for ketones involves 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 Ketones?

If you have type 1 diabetes, you may need to check your urine for ketones if:

  • You feel sick (have a cold, the flu, or other illness) and have nausea or vomiting.
  • You are pregnant.
  • Your blood sugar level is high (usually over 300 milligrams per deciliter or mg/dL) or as directed by your doctor.
  • You have symptoms of high blood sugar including extreme thirst or tiredness, a flushed or foggy feeling, or your breath smells fruity.

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.

If you have type 2 diabetes, your doctor may advise you to check 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 sugar level is high (over 300 milligrams per deciliter or mg/dL, or as directed by your doctor) and continues to rise throughout the day.


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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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