What Do Urine Tests Say About Diabetes?

When you have diabetes, you’re no stranger to tests that keep track of your disease. Most look at your blood, but there are others. Two simple ones that check your urine can help you and your doctor watch for kidney disease and severe high blood sugar.

Tests for Kidney Disease

About one-third of people with diabetes have problems with their kidneys. But early and tight control of your blood sugar and blood pressure, plus help from certain medications, can keep these organs working like they should

To check for problems, your doctor can do a test that measures the amount of protein in your urine, called microalbuminuria. It shows up when small amounts of albumin (the main protein in your blood) seep into your pee. Without treatment to slow the leak, your kidneys could be damaged and eventually fail.

You should get this test every year starting as soon as you’re diagnosed with type 2 diabetes. That’s because high blood sugar is usually present many years before you find out you have the disease.

If you have type 1 diabetes, you probably won’t get the test until you’ve been diagnosed for 5 years.

What Does a Positive Result Mean?

If the test is positive, it means your kidneys can no longer filter the blood as well as they should. It also shows you have blood vessel disease that could lead to heart problems. Your doctor will probably suggest medications or lifestyle changes to help prevent these conditions:

  • Kidney damage. You may start specific medicines to prevent further harm. If your microalbumin level is high, your doctor may suggest another type of test that requires you to collect samples for 24 hours. This can better tell the extent of damage to the organs and see how well they’re working.
  • High blood sugar. Studies show tight control of your blood sugar can lower kidney damage, so your doctor may put you on more aggressive treatments.
  • Blood pressure. Lowering blood pressure reduces your risk of diabetes-related kidney damage. Get it checked each time you have an office visit. The recommended reading for most people with diabetes is less than 140/90.
  • Cholesterol. Since the microalbuminuria test suggests you’re at greater risk of getting heart disease, your doctor may try to get your cholesterol and other fats into a healthier range.

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Tests for High Blood Sugar

Your doctor could ask you to take a test that looks for ketones. Your body makes them when it doesn’t have enough insulin and turns to fat stores to create energy for your cells. Ketones are toxic in large amounts. Too many of them can cause a life-threatening emergency condition called ketoacidosis.

How Do I Test?

Your doctor can check for ketone levels, or you can do it at home with an over-the-counter kit. You simply dip a test strip into your urine. It will change color, and you’ll compare it to a chart to see what your reading means.

When Should I Test?

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’re pregnant.
  • Your blood sugar level is over 300 mg/dL.
  • You have symptoms of high blood sugar including extreme thirst or tiredness, a flushed or foggy feeling, or your breath smells fruity.
  • The doctor tells you to.

If you have type 2 diabetes, there isn’t much chance you’ll have too many ketones, even if you’re taking insulin. But it could happen during a severe illness. Your doctor may tell you to check your urine when:

  • You have a cold, the flu, or other illness or have unexplained nausea or vomiting.
  • Your blood sugar level is over 300 mg/dL and continues to rise throughout the day.

When Should I Call the Doctor?

A urine test for ketones should always be negative. Report a positive result to your doctor immediately. You should also let her know right away if your blood sugar remains high or if you have stomach pain, nausea, vomiting, rapid breathing, sweet-smelling breath, or if you’re peeing a lot.

The doctor may tell you to:

  • Drink plenty of water and fluids to lower the amounts of ketones and stay hydrated.
  • Continue to check your blood sugar. If it’s high, you may need to give yourself a small amount of rapid-acting insulin.
  • Go to the local emergency room so you can get intravenous fluids and insulin.

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How Do I Record My Results?

Keep detailed records of any urine or ketone tests you perform. These can help alert you and your doctor to any problems. Bring them with you on every office visit.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on July 30, 2016

Sources

SOURCES: 

The Department of Endocrinology at The Cleveland Clinic.

American Diabetes Association: "Living With Diabetes: Checking for Ketones."

American Diabetes Association: "Kidney Disease (Nephropathy)."

American Diabetes Association: "Standards of Medical Care in Diabetes -- 2014."

 

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