Urine Tests for Diabetes: Purpose, Preparation, Procedure and Normal Range

A urine glucose test is done to check for abnormally high levels of glucose and ketone in the urine.

Updated: June 16, 2022

A urine glucose test is done to check for abnormally high levels of glucose and ketone in the urine. Normally glucose is not found in urine of a healthy person. The most common cause of elevated glucose levels is diabetes, a condition in which the ability of body to manage glucose levels is affected.
In case of type 1 and type 2 diabetes, the kidneys often release some of the excess sugar from the blood into the urine when blood sugar levels rise above a target range. As sugar does not show up in urine until it is higher than 180 mg/dL in the bloodstream, urine test cannot be used to check for slightly high or low blood sugar levels. Therefore this test is not an accurate way to measure how much sugar is in your blood. The kidneys sometimes release sugar into the urine even when blood sugar levels are within the range. This happens in case of pregnant women.

Purpose of Urine Tests:

Usually a urine glucose test is performed to check for diabetes. Urine glucose test is also used to monitor the degree of sugar control, or efficacy of treatments in case of diabetic people. A urine glucose test may also be done to check for kidney problems or a urinary tract infection.
Urine tests are not used to diagnose diabetes, but they may be used to monitor the levels of urine ketones and urine glucose in a person having diabetes. Sometimes it is done to make sure the diabetes is being managed well.

Who Should Have a Urine Test for Diabetes?

A urine test is done to find out the presence of glucose and ketones in the urine. If either are present in the urine, it is an indication that you are not producing enough insulin. Urine ketone testing is necessary in people with type 1 diabetes who have blood sugar levels over 300 mg/dl or who have symptoms of diabetic ketoacidosis which is an acute complication of diabetes.
In type 1 diabetes, as the body does not have enough glucose for the cells it may begin to burn fat for energy resulting in producing chemicals called ketones. When ketones build up in the blood, they make the blood more acidic which can be poisonous and may lead to coma or even death. A urine test for ketones should be used if:

  • your blood glucose is more than 300 mg/dl
  • your blood glucose level is high and you are planning to exercise
  • you are vomiting or feel nauseous
  • your breath smells fruity
  • you are sick
  • you are pregnant and have gestational diabetes
  • you feel exhausted or tired all the time
  • you are thirsty or have a very dry mouth
  • you are confused

Preparation for a Urine Test:

Speak to your doctor about any prescription drugs, over-the-counter medicines, or supplements you are taking before the test as certain medications can affect your test results.
Make sure to drink enough water before the test to provide an adequate sample of urine.

Procedure for a Urine Test:

A urine test can be done at home or lab. If it has to be done at a lab, you will be given a plastic cup labeled with your name and other information.Then you should take the cup into a private bathroom and urinate into the cup. To avoid contamination with bacteria or cells on your skin, you should only collect the middle part of the urine that comes out which is also called a clean catch. The first and last part of the urine can go into the toilet. Place the lid on the cup and wash your hands once you are done and leave the cup in the place you are asked to keep it. The sample will then be analyzed for the presence of glucose and ketones and the results will be available with in a day.
In case of home urine test you can use the test strips available in the market. Before using the test strip, check the expiry date. To start the procedure urinate into a clean container. Dip the strip in the urine and shake the excess urine off the strip. As the strips are coated with chemicals that react with ketones, the strip pad will change color. You should wait for few minutes as instructed in the testing kit to see the change in color. By comparing the strip color to the color chart on the packaging, you will be able to know a range which indicates the amount of ketones in your urine.

Glucose and Ketone Levels in Urine Test:

The normal amount of glucose in urine is 0 to 0.8 mmol/L. A value higher then this could be a sign of a health issue. Diabetes is the most common cause of elevated glucose levels. A blood test can be performed to confirm the diagnosis. 
A high amount of glucose in urine can also be due to pregnancy. Pregnant women will have a higher urine glucose levels than women who are not pregnant. Women who already have increased levels of glucose in their urine should be screened for gestational diabetes if they become pregnant.
Renal glycosuria is a rare condition in which the kidneys release glucose into the urine. This can be another cause of elevated levels of glucose in urine even if blood glucose levels are normal.
Further testing will be done to find out the underlying cause if the results of your urine glucose test are abnormal. Certain medications can interfere with glucose levels in the blood and urine. Speak to your doctor about prescription or over-the-counter medication you are taking before the tests.
As ketones are more commonly seen in the urine of people with type 1 diabetes, ketone levels in urine should be monitored frequently if you have type 1 diabetes. Normal levels of ketones in urine are less than 0.6 mmol/L. If you have more then this in your urine it can be classified as  small, moderate, or large.

  • If the level is 0.6 to 1.5 mmol/L or about 10 to 30 mg/dL, it is small to moderate and ketone buildup is starting. Drink plenty of water and test again in a few hours. Do not exercise if your blood glucose levels are also high.
  • If the level is 1.6 to 3.0 mmol/L or about 30 to 50 mg/dL in the urine, it is considered as moderate to large amounts and this can be a indication that your diabetes is not being managed well. You need medical attention in this case.
  • If the level is higher than 3.0 mmol/L or more than 50 mg/dL, it is very large and you will be diagnosed with ketoacidosis. This is a life-threatening condition and requires immediate medical treatment.


 


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