Urine analysis for diabetes mellitus – what are the types, norms and indicators

Diabetic sugar levels rise not only in the blood, but also in the urine. In ancient times, there was even a way to diagnose diabetes – the urine was tested for taste. If it is sweet, then the diagnosis was confirmed. Now medicine offers more humane methods of testing – passing a urine test.

Urinalysis for diabetes

A urine test is prescribed for patients with complaints of diabetes mellitus symptoms:

  • intense, persistent thirst and dry mouth;
  • increased urination or urinary incontinence;
  • dry skin and mucous membranes;
  • fast fatiguability;
  • depressive state;
  • decreased performance.

Urine analysis fails to differentiate diabetes mellitus from other diseases. This is just a part of the comprehensive diagnostics prescribed by endocrinologists and therapists.

If the patient has already been diagnosed with diabetes, then a urine test is taken at a frequency of 1 time in 2-3 months in order to adjust the treatment when necessary. Many are interested in whether glucose in urine always rises and how to remove this pathology. Deviations from the norm always occur if the patient does not take insulin and does not follow a diet. External factors can also provoke an increase in sugar – stress, excessive physical activity, etc.

Analysis types

There are two ways to identify increased sugar by urine analysis:

  • passing analysis in a medical laboratory;
  • test strips at home.

A diabetic should have special test strips for home examination of the state of urine together with a blood glucose meter . It is carried out as follows:

  1. Collect the mid-morning urine portion in a sterile jar.
  2. Dip the test strip into the container with urine.
  3. Interpret the result.

A change in the color of the strip indicates the presence of ketone bodies (acetone) in the urine. The brighter the shade, the higher their level. The norm values ​​are indicated on the packaging or in the enclosed instructions.

Attention! You cannot diagnose diabetes yourself with test strips. This research method is used for preventive purposes. If you change the color of the stripes, you need to see a doctor.

In type 1 diabetes, urinalysis using express strips is recommended in the following cases:

  • if you have nausea, vomiting, or cold symptoms;
  • during pregnancy (at least once every 3 weeks);
  • when the blood sugar level has exceeded 13 mmol / l.

In type 2 diabetes, the study is carried out:

  • in case of malaise, cold symptoms;
  • when the sugar level is above 16 mmol / l.

Urine test method

If you suspect diabetes and in order to monitor the patient’s condition, three types of urine analysis are prescribed:

  1. General analysis . The first morning urine is collected.
  2. Analysis according to Nechiporenko . The middle urine is collected (the first and last portions go down the toilet).
  3. Daily analysis . Urine is collected during the day, mixed and a small amount is separated.

Any analysis is prescribed to detect sugar in urine, study the condition of the kidneys (by the number of leukocytes), determine the amount of protein (for microalbuminuria ), the presence of bilirubin and ketone bodies. For the analysis to show reliable results, careful preparation is required for the collection of urine:

  1. Exclude heavy physical activity the day before the analysis.
  2. The day before the analysis, spicy, salty and sweet foods, alcohol, carrot and beet juice are excluded from the diet. From vegetables in its pure form, it is forbidden to eat carrots and beets. It is recommended to reduce the size of the portions.
  3. For 2-3 days, the intake of diuretics is stopped.
  4. During the day, the intake of antibiotics and anti-inflammatory drugs ends. If this is not possible, then after passing the analysis, you should inform the doctor about the therapy received.
  5. Do not drink a lot of fluids the day before the test.
  6. Before collecting urine, the genitals are washed with warm water without the use of soap and gels.
  7. If it is necessary to collect urine during menstruation in women, the entrance to the vagina is closed with a tampon.
  8. For collection, use a clean, sterile container purchased from a pharmacy. A glass jar (for example, from under baby puree) is also suitable, but first it must be washed with ordinary soap and treated with boiling water.
  9. Urine must be delivered to the laboratory within 2 hours of collection. Store urine in a warm place.

In children, preparation for analyzes is similar. Collecting urine is allowed in a special urine bag, which is glued to the genital area. Do not use diaper, diaper or dirty potty urine. It is important to ensure that no feces get into the test material.

How to decipher the results

The interpretation of the results is the responsibility of the doctor. He studies the following indicators:

  • the specific gravity of urine relative to its density – shows the presence of various substances in the material (the norm is 1012-1022 g / l). In diabetes mellitus, it is always elevated;
  • acidity – the pH of urine, normally from 4 to 7. Diabetics have low acidity;
  • microalbumin (protein) – in a healthy person, this indicator does not exceed 0.033 g / l. With diabetes, the indicator is higher;
  • sugar – normally does not exceed 1.7 mmol / l;
  • ketone bodies (acetone) – normally absent, in diabetes, acetone is detected in the amount of 3 and 4, possibly more;
  • leukocytes – normally present in a healthy person in small quantities. With diabetes mellitus, this figure is higher than 6 pieces ;
  • bacteria – their presence in the test material indicates nephropathy (kidney pathology).

Important! With diabetes insipidus, the absence of ketone bodies and glucose in the urine is noted, but the density decreases (below 1005 g / l) and the osmolarity increases (up to 250 and above mosm / kg).

Sugar in urine in type 1 diabetes

In men and women with type 1 diabetes, sugar in urine tests is observed, provided that the patient is not taking insulin. Thanks to the study of the material, it is possible to diagnose the disease by glucose indicators – they exceed 1.7 mmol / l. An increase in sugar in urine is due to the fact that the body produces an insufficient amount of insulin, which is necessary for the breakdown of glucose. As a result, the body is forced to excrete sugar through the kidneys, which is determined by laboratory tests.

Sugar in urine in type 2 diabetes

In type 2 diabetes, urinary glucose levels are more likely to remain normal. If there is a sharp rise in sugar levels, then patients are prescribed insulin therapy. Typically, in type 2 diabetes, deviations from the norm are minor and dietary adjustments can help correct the situation. If the body cannot cope with the breakdown of glucose in the blood, then the reason is an error in nutrition, the use of prohibited foods.

If you do not follow the diet prescribed by your doctor, you will face serious kidney damage.

Acetone in urine for diabetes

An increase in ketones (acetone) in the urine indicates ketoacidosis , a dangerous condition that requires immediate medical attention. This pathology occurs when carbohydrate metabolism is disturbed, which is typical for type 1 and type 2 diabetes. The normal value of ketones is up to 0.5 mmol / L. When there is an increase in acetones, the patient is worried about the following symptoms:

  • intense thirst;
  • dry mucous membranes;
  • prostration.

If ketoacidosis is not identified and eliminated at the initial stage, then the disease progresses, which is manifested by concomitant symptoms:

  • the smell of acetone from the mouth and from the body;
  • low blood pressure;
  • pallor of the skin;
  • disorders of the nervous system;
  • rare urination;
  • pain in the abdomen.

The severe form of ketoacidosis is accompanied by muscle weakness, slow breathing, fainting, and vision complaints.

Ketoacidosis is dangerous for diabetic coma and death.

However, an increase in ketone bodies does not always indicate diabetes. In a child, acetone in the urine indicates an improper diet, an excess of simple carbohydrates in the diet. To reduce the amount of ketones, you need to undergo inpatient treatment. If the indicators are not too high, then outpatient treatment is indicated.

The color and smell of urine in diabetes

When examining urine, color and odor are of differential diagnostic value. Normal urine should be light yellow to dark yellow (amber). The change in this indicator is influenced by the use of certain foods and medicines. A characteristic feature of diabetes mellitus is colorless urine. This condition is due to the rapid elimination of fluid from the body. If ketoacidosis develops with rare urination, then the urine becomes cloudy, dark. The color of urine in diabetes changes simultaneously with a decrease in glucose levels. Therefore, this indicator is not constant. The odor of urine in diabetes is influenced by the level of ketone bodies. The higher this indicator, the more pronounced the smell of acetone. Also, urine can smell like rotten apples, which is also not the norm.

What additional research is needed?

A general urine test is one of the types of examination of a patient with suspected diabetes mellitus. If deviations from the norm are detected, the doctor prescribes additional studies:

  • urine analysis according to Nechiporenko , which studies the level of leukocytes, erythrocytes and cylinders;
  • monitoring of daily urine to determine the amount of excreted urine. 

The doctor must clarify what the urine smells like, what color it is, whether there are any blood impurities in it. It is recommended to keep a special diary in which to indicate the amount of urination and the characteristics of urine during the day. If the sugar in the urine is high, the doctor will tell you what to do in this case. In the absence of a large number of ketone bodies, dietary adjustments and moderate physical activity are sufficient. Which treatment method will be chosen depends on the patient’s condition, blood glucose level and physiological characteristics.

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