Once upon a time urine testing was the only method available to gauge blood glucose levels for patients with diabetes. Urine tests however do not tell the whole story of glucose levels for diabetes management. For the most part, glucose levels in the urine are undetectable unless they reach high levels. For type 1 diabetics this poses the biggest problem as urine tests won't be able to detect hypoglycemia(low blood sugar). The American Diabetes Association and health care providers recommend the use of glucose meters as the best means to keep tight controls around blood glucose levels rather than urine tests. So what role do urine tests play in diabetes management? 

Urine tests can detect other substances in the urine which are very important for diabetes management. In the absence of insulin the body can start to burn fat for fuel producing poisonous ketones which end up in the urine. Also when high blood glucose levels are sustained in the system of a diabetic, the kidneys' filtering processes can break down allowing microscopic proteins called microalbuminuria to pass into the urine. Their presence in the urine is an early sign of kidney disease, one of the major complications resulting from diabetes. 

Urine tests can show the warning signs of serious complications and are very useful. Three different kinds of urine testing kits are available for testing three different substances in the urine: glucose, ketones and the microscopic protein microalbuminuria. 

Glucose Kits

A home urine glucose test comes in the form of test strips. Since glucose meters have become the standard among health care professionals insurance companies may not cover the cost of the strips and the cost varies. These strips are typically packaged in foil or vials with manufacturers recommendations for storage and are marked with shelf life dates just the milk in your refrigerator. 

If you are collecting a urine sample for a test you must use a clean and dry container or you can simply pass the strip through the urine stream to saturate it. The timing for results will vary depending on the manufacturer. Mishandling of the urine sample or the urine test strips can interfere with an accurate reading. The use of certain medications or vitamins may also skew the results and its best to ask your healthcare team if any medications you are on may interfere. 

The results of the test are indicated by a color change on the strip which is then compared with a scale provided by the manufacturer. If you have trouble with color perception it is best to use another method in checking for high blood sugar. 

Ketone Kits 

Ketones are byproducts of burning fat instead of glucose and are a waste product that can build up and cause diabetic ketoacidosis. Urine tests are useful in testing for ketones because as they build up your body tries to dispose of them as quickly as possible.

Ketone tests are recommended if you are type 1 diabetic when you have high blood sugar or as directed by your doctor. If you are diabetic and sick, stressed, have high blood pressure or are a woman with any type of diabetes (type 1, type 2 or gestational) you should also test for ketones. If you suspect that ketoacidosis is imminent test yourself immediately and contact your healthcare provider. It is important to discuss guidelines for testing with your doctor as well record keeping in order to keep tabs on these dangerous waste products. 

As with the urine glucose test the testing materials are packaged, stored and used similarly. It is important to heed all manufacturers recommendations with regard to testing guidelines and procedures. False positives are also possible due to improper storage and handling of the test strips or because of certain medications and vitamins. And again if color perception is a problem discuss with your doctor how to overcome this by having someone help you decipher results.

Protein (Microalbuminuria) Test 

This test is important for everyone who has diabetes. The presence of proteins known as microalbuminuria in the urine is an early sign of kidney disease, a serious and life threatening complications as a result of diabetes. The American Diabetes Association recommends that you test for proteins annually and in some cases it might be necessary for you to test more frequently. Be sure to discuss recommended frequency of testing with your doctor. 

Up until recently this was a test that could only be administered by a health care professional however now you can order the test through the mail. A specially packaged test kit is provided for you to apply a urine sample and then return it to the company. The results cannot be interpreted by you at home, a physician must do this, but the mail-order format makes it more accessible and eliminates the need to take a trip to an medical facility.