Home Urine Test

Testing a urine sample for the presence or level of glucose is a far more crude method of assessing glycaemic control. It has the advantage of being simple to perform and is non-invasive and so there is no discomfort involved. This makes it a more acceptable test than HBGM and hence one which is more likely to be carried out. Unfortunately, there are several disadvantages. The presence of glucose in urine is dependent upon the person's renal threshold. As mentioned previously, this is the level or concentration above which glucose ceases to be 'recycled' by the kidneys back into the bloodstream so that it passes into the urine. The normal level at which this occurs in adults is 10 mmol/1 but it varies a great deal, not only between individuals but at different stages in one person's life. Children tend to have a low renal threshold and may have glycosuria (sugar in the urine) in the absence of diabetes. Elderly people are far more likely to have a high renal threshold. Glycosuria may be absent in the presence of hyperglycaemia and elevated HBAlc. The concentration of the urine and the quantity of fluid that has been drunk can affect the HUT reading, and, particularly important, a urine test cannot detect hypoglycaemia. In spite of its limitations, HUT can provide useful information and reassurance, especially for people with Type 2 diabetes. It is inadequate as a testing method for tightly controlled diabetes or where there is a risk of hypoglycaemia.

How to Carry Out a Urine Test

In order to test for sugar in the urine, special strips are used which are coated with a reagent that changes colour according to the amount of glucose present. Testing is simply a matter of collecting a urine sample and dipping the strip into it or alternatively, holding the strip in the urine stream. The test is timed and the colour compared with colours on a chart, indicating the amount of sugar present. Urine test strips are available free on prescription and there are various types, including some which are specially designed for people who are colour-blind. The timing and frequency of testing will depend upon individual advice given by diabetes clinical staff. Results of the tests should be noted in a diary or on a chart so that a record is kept which can be analysed when necessary.

Testing Urine for Ketones

Although this test is carried out in a similar way to that described above, that is, by dipping a specially prepared stick or strip into a urine sample and noting a colour change, the reasons for testing are quite different. In this case, it is not glucose that is being looked for but ketones to detect ketonuria. Ketonuria is a feature of Type 1 diabetes and is a warning sign of the risk of diabetic ketoacidosis (DKA). People with newly diagnosed Type 1 diabetes often test positive for ketones in their urine, but these usually disappear quickly with the initiation of insulin treatment. In fact, ketonuria usually improves even before hyperglycaemia. Hence testing urine for ketones may well be suggested for people in this position and carrying it out provides early positive proof of the efficacy of insulin therapy. The other main circumstance in which the test is useful is during periods of occasional illness. Urine testing for ketones is carried out using test strips or sticks (called ketosticks) which can detect acetoacetate. A colour change occurs which is then compared with colours on a chart supplied by the diabetes clinic. The colour indicates whether there are no ketones, a minute amount, or small, medium or large quantities present. The person will receive advice on whether action needs to be taken and what form this should take: if the results indicate a potential risk, hospital admission may be necessary to stabilize the diabetes.

Get information about home blood glucose monitoring.