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Diabetes Health Center

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What Do Urine Tests Say About Diabetes?

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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. They're 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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