Your physician may have suspected that you have diabetes because of a high sugar (glucose) level found in your blood or urine during a routine office visit. At the time you may not have noticed any symptoms. Many diabetics, however, do notice symptoms including excessive urination, unusual thirst, weight loss despite good appetite, or constant fatigue-and seek medical advice because of them.

Detecting High Glucose and Ketones

When adequately distributed throughout your body, glucose gives you energy. If the glucose level in your blood or urine is high, it means that the glucose is not being channeled properly. This happens when too little of the hormone insulin is produced or when the insulin that is produced is not used appropriately by the body.

Insulin is responsible for clearing sugar out of your blood­stream and getting it into cells, where it is used or stored. In a diabetic, because enough insulin isn’t there or isn’t working properly, glucose just accumulates in the blood. After a certain point the blood glucose becomes so high that the kidneys, which filter waste products from the blood, begin to overflow some of the glucose into the urine. Your physician can measure your glucose level through several tests using urine and blood specimens. In addition to measuring the glucose level, urine and blood tests can indicate the presence of ketones. Without insulin, fat stores in the body break down and substances called ketones, ketone bodies or acetone are produced. Because of their acidic nature, ketones can lead to complications when they accumulate in the blood. At high enough levels ketones overflow into the urine. Glucose and ketone levels in the urine and blood may be high because of stress as well as a low insulin level. A finding of high levels of glucose or ketones indicates to your physician that further investigation is necessary.

Urine Tests

Urine testing is part of most physicians’ routines in giving complete physical examinations. Urine tests are basic diagnostic
tools that can give physicians valuable information about how your body is working.

In a form of urine testing known as semiquantitative your doctor may use either a tablet or one of several brands of paper or plastic strips to determine the approximate sugar or ketone level in your urine. Only a small sample of urine is needed, and the test takes only a few seconds. The paper or plastic strips are coated with chemicals that change colors according to sugar and ketone concentration. For example, one type of strip ranges from yellow through green to dark blue. With this test a color closer to dark blue indicates a high concentration of sugar in the urine. However, if you are taking certain medications, aspirin, or vitamin C, these substances may interfere with the dyes on the strips and distort the readings. Your physician will ask you about medications you are taking so that test results can be interpreted properly.

An advantage of semi quantitative urine testing is that it is fast and can be done easily by your doctor. The disadvantage of urine tests, in general, however, is that they are less accurate and harder to interpret than blood tests. Because the point at which your kidneys begin to spill glucose into your urine may differ from the point in other people, urine test readings may not always accurately reflect the level of glucose in your blood.

Another urine test your physician may do is known as a quantitative measurement in a timed sample. This test might be ordered by your physician after a high or low reading has been found with a semi-quantitative test. One advantage of this type of test is that only glucose and ketones are measured, and other chemicals in your blood that might have caused false higher or lower readings with the chemically coated paper strips used in semi-quantitative testing are removed. Another advantage is that the exact concentration, rather than a range, of glucose and ketone in the urine is measured. Because the urine must be collected very accurately in such tests, (whereas only a small sample is necessary for the semi-quantitative tests), it is inconvenient. If the physician orders a 24-hour sample, this means that all urine during that period must be collected and brought to the laboratory. Another disadvantage is that, depending on the point at which the patient’s kidneys actually begin to spill sugar and ketones into the urine, this may or may not be an accurate reflection of glucose levels.

Blood Tests

Blood glucose tests are also used to indicate whether or not you have too much or not enough sugar in your blood and whether or not ketones are present. If you are curious about the numbers you hear or read, ask your doctor to explain your test results to you. Comparing blood test result& with others, however, is not a good idea, because different blood tests yield different results.
The easiest and fastest procedure for measuring glucose and ketones in the blood is to use plastic or paper strips like those
used in urine tests. These strips give a range, not an exact value. Other methods, called reagent kits and rapid analytical systems, are also used by many physicians. These tests use chemicals to test blood samples in a rapid single-step process.

Which is Better? Urine-Sugar or Blood-Sugar Test

• Urine or blood sugar tests are the commonest test performed to know the state of diabetic control.
• Blood contains some amount of sugar (80 to 140 mg%) round the clock, since certain tissues like brain cannot survive without readily available glucose.
• When the blood sugar exceeds, 180 mg% sugar appears in urine. Urine test is only a rough guide, e.g. if there is no sugar in urine it can only mean that blood sugar at that time is less thanl80 mg% (it can be anything 60 to 180 mg%).
• Since urine is secreted drop by drop by the kidney and stored in bladder to be evacuated at longer intervals. if we wish to correlate urine sugar with blood sugar level we must test second sample of urine i.e. evacuate the bladder, dicard it and pass urine after half an hour. test that sample.
• Blood sugar is more accurate parameter for assessing control of diabetes

Blood glucose concentration is one of the best measurements of the presence of diabetes as well as diabetic control. But, because this test measures the blood glucose level at only one instant, it may not represent your usual condition. For example, a trip to your doctor’s office can cause stress that can result in an abnormally high glucose value. Blood sugar is affected by the food eaten, the amount of time after or before eating, and activity and stress. A sample taken within two hours after you have eaten gives the most sensitive results after a measured glucose intake. Evaluating your fasting or before glucose intake level indicates the extent to which carbohydrates from your last meal have been removed from your bloodstream. The fasting glucose concentration is the measure of blood sugar after a lack of intake for more than four hours or overnight. If you have diabetes, your glucose concentration is usually lowest in this state.

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This entry was posted on Tuesday, May 29th, 2007 at 12:00 am and is filed under Diabetes Care. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.