When a person with diabetes develops hyperglycaemia (high blood sugar), if there is not enough insulin around - or if their body is unable to utilise the insulin properly and break down sugar - the body turns to fat stores to create energy for the cells. As part of this process ketones are formed. Whilst ketones can be a source of energy for many cells they can be toxic in large amounts and cause a life-threatening emergency condition called ketoacidosis.
Ketone levels can be measured in the urine by your doctor or by using an over-the-counter kit at home.
Urine tests for diabetic kidney disease
Diabetic kidney problems can occur in people with diabetes. However, with early and intensive control of blood sugar, blood pressure and the use of certain medications, the development and the progression of kidney problems can be slowed.
To check for kidney problems, your doctor can arrange a urine test that measures the amount of protein in your urine, called microalbuminuria. Microalbuminuria occurs when small amounts of albumin (the main protein in your blood) leak into your urine. Without treatment to slow the leakage of protein, the kidneys may continue to be damaged and eventually fail.
This test should be performed at least every year, or as often as advised by your doctor.
What happens if the microalbuminuria test is positive?
If the microalbuminuria test is positive, it indicates the blood vessels to your kidneys are damaged. It also reflects more widespread blood vessel disease that can increase your risk of heart problems. Therefore your doctor may take the following steps:
Recommend medication to slow kidney damage. Your doctor may recommend starting specific drugs to prevent further damage to your blood vessels and kidneys. If the microalbumin level is very high, your doctor may recommend you have another type of urine test that involves you collecting your urine for 24 hours to more accurately determine the extent of damage to your kidneys and see how well they are working.
Offer more intensive diabetes treatment . In addition, studies show that tight control of your blood sugar can significantly decrease kidney damage, so your doctor may recommend more intensive treatment of your diabetes.
Better blood pressure control. Controlling your blood pressure has also been shown to reduce the risk of kidney damage related to diabetes. It is important your blood pressure is checked each time you go to the doctor. The recommended goal for blood pressure control in people with diabetes is less than 130/80.
Better cholesterol control. Since the microalbuminuria suggests you are at greater risk of heart disease, your doctor will try to get your cholesterol and other fats into a healthier blood level range.
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