Diabetes Urine Tests

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

Urine tests for diabetes facts

What are urine tests for diabetes?

Urine tests are tests performed in a clinical laboratory or at home using self-test kits and a sample of the patient's urine. Urine tests can be performed for a variety of reasons, but in people with diabetes, they are most commonly used to look for ketones or microalbumin (see below). Urine glucose (sugar) can also be measured, but this is less valuable than blood glucose levels for diagnosis and monitoring of diabetes, so this is not commonly done as a way to monitor blood glucose status.

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Diabetic Ketoacidosis Signs and Symptoms

High blood glucose levels, or hyperglycemia, cause a cascade of effects that are damaging to the body in the short and long-term. In the long-term, abnormally high blood sugar causes damage to blood vessels leading to a variety of potential catastrophes; including but not limited to any system that has a blood supply, potentially leading to heart attack, stroke, kidney failure, blindness, and amputations. Add the increased risk of infection associated with hyperglycemia and there is great incentive to keep blood sugars tightly under control....

Ketone test

This test detects the presence of ketones, which are byproducts of metabolism that form in the presence of severe hyperglycemia (elevated blood sugar). Ketones are formed from fat that is burned by the body when there is insufficient insulin to allow glucose to be used for fuel. When ketones build up to high levels, ketoacidosis (a serious and life-threatening condition) may occur.

Ketone testing can be performed both at home and in the clinical laboratory. Ketones can be detected by dipping a test strip into a sample of urine. A color change on the test strip signals the presence of ketones in the urine. Ketones occur most commonly in people with type 1 diabetes, but uncommonly, people with type 2 diabetes may test positive for ketones.

Microalbumin test

The microalbumin test detects microalbumin, a type of protein, in the urine. Protein is present in the urine when there is damage to the kidneys. Since the damage to blood vessels that occurs as a complication of diabetes can lead to kidney problems, the microalbumin test is done to check for damage to the kidneys over time.

Can urine tests be used to diagnose diabetes?

While urine tests can show signs that may signal diabetes, such as elevated sugar or ketones, the diagnosis of diabetes is made on the basis of blood tests. Urine tests may be done in some cases as back-up testing or for screening to see if blood tests should be done, but the diagnosis of diabetes is made after blood glucose testing.

When are urine tests used in people with diabetes?

The ketone test is generally recommended for people with type 1 diabetes. Those with type 1 diabetes should test their urine for ketones when they are ill, especially if they have vomiting and nausea. Pregnant women with type 1 diabetes may also be advised to test their urine for ketones. Ketone testing is also done when the blood sugar is noted to be very high (over about 240 mg/dL). Your doctor can advise you specifically about recommended testing practices for your individual situation. Sometimes, people with type 2 diabetes may be advised to check their urine for ketones. Those with type 2 diabetes should discuss with their doctor whether ketone testing is necessary and under what circumstances.

The microalbumin test is done once per year starting at the time of diagnosis in people with type 2 diabetes. Even though protein in the urine is a sign of long-term damage to the kidneys, many people have type 2 diabetes without knowing it, so it is unclear how long they have had the condition. In people with type 1 diabetes, the micoalbumin test may not be performed until the condition has been present for up to 5 years.

Medically reviewed by John A. Seibel, MD; Board Certified Internal Medicine with a subspecialty in Endocrinology & Metabolism

REFERENCES:

Medscape. Type 2 Diabetes.

Medscape. Type 1 Diabetes.

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Reviewed on 3/15/2016
References
Medically reviewed by John A. Seibel, MD; Board Certified Internal Medicine with a subspecialty in Endocrinology & Metabolism

REFERENCES:

Medscape. Type 2 Diabetes.

Medscape. Type 1 Diabetes.

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