Diabetes: Choosing and Using Your Glucose Meter (cont.)

If you have any other disease that can change your serum proteins or if you have large amounts of Vitamin C (ascorbic acid) in your diet, these tests may give wrong values.

Urine Glucose

Only patients who are unable to use blood glucose meters should use urine glucose tests. Testing urine for glucose, which was once the best way for patients to manage their diabetes, has mostly now been replaced by self-monitoring of blood glucose. There are three major drawbacks of urine glucose testing compared to blood testing. First, urine glucose testing will not tell you about low (below 180 mg/dl) glucose levels, since at lower levels glucose does not enter your urine. Second, urine glucose readings change when the volume of your urine changes. Third, your urine glucose level is more of an average value than your blood glucose level. There are several dipstick tests available on the market.

Urine and Blood Ketones

When the body does not have enough insulin, fats are used for fuel instead of glucose. A by-product of burning fats is the production of ketones. Ketones are passed in the urine and can be detected with a urine test.

If you do not have diabetes, you usually have only small amounts of ketones in your blood and urine. If you have diabetes, however, you may have high amounts of ketones and acid, a condition known as ketoacidosis. This condition can cause nausea, vomiting, or abdominal pain and can be life threatening.

You may use urine dipsticks to rapidly and easily measure the ketones in your urine. You dip a dipstick in your urine and follow the instruction on the package to see if you have a high amount of ketones.

If you have type 1 diabetes, are pregnant with preexisting diabetes, or who have diabetes caused by pregnancy (gestational diabetes), you should check your urine for ketones. If you have diabetes and are ill, under stress, or have any symptoms of high ketones, you should also test your urine for ketones.

Results of ketone testing should be interpreted with care. High ketone levels are found when patients are pregnant (in the first morning urine sample), starving, or recovering from a hypoglycemic episode.

There are now tests for measuring ketones in blood that your doctor may use or you can use at home. Some measure a specific ketone (beta-hydroxybuyric acid) that patients with diabetic ketoacidosis may have.

It is still not known which type of ketone test -blood or urine-- offers more aid to people with diabetes.

Microalbumin

One common and extremely serious result of diabetes is kidney failure. Under normal conditions, the kidneys filter toxins from the blood. When the kidney's filtering processes begin to become impaired, protein (microalbumin) begins to spill into the urine. Testing urine for small, yet abnormal amounts of albumin (microabluminuria) is a common way to detect this condition early, before it can damage your kidneys.

Many urine dipsticks are used to test for large amounts of albumin. To measure a small amount of albumin, which may show an early stage of kidney disease, your health care provider may use specific tests for low levels of albumin (microalbumin tests). To do this test, you may have to collect your urine for several 24-hour periods.

The ADA recommends that adults with diabetes be tested for microalbumin every 3- to 6-months. The ADA recommends testing in children with type 1 diabetes at puberty or after having diabetes for 5 years.

Early detection of microalbumin is important because it indicates increased risk for both renal and vascular disease. Fortunately, early detection allows for treatments that may delay the beginning of a more serious disease.

Cholesterol

If you have diabetes, you have a higher risk of heart and blood vessel disease (cardiovascular disease). One way to limit this risk is to measure your cholesterol routinely and control it by changing your lifestyle or taking prescription drugs. A cholesterol test usually shows your total cholesterol, total triglycerides, and high-density lipoproteins (HDLs). The Centers for Disease Prevention and Control (CDC) has set up a National Reference System for Cholesterol Testing and many manufacturers verify their test through certification with this method.


For additional information, please visit Diabetes Channel.

The above information has been provided with the kind permission of the Food and Drug Administration.


Last Editorial Review: 1/4/2005



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