Sugar Matters
September 16, 2014
The pee test

The first time your diabetes doctor says: “I will need a urine sample,” you may accidentally give him/her a shocked look. What on earth could your doctor need your pee sample for anyway? There are actually a few especially important reasons in diabetes.{{more}}

The big one that everyone knows about is testing for sugar in the urine. You ask: shouldn’t everyone with diabetes have sugar in the urine since they have blood sugars that are high? Not really. The kidneys do not leak any sugar into the urine unless something is wrong – there is some damage or there is MUCH too much sugar in the blood. People with well-controlled diabetes often have very little or no sugar in the urine at all. But if your sugars are running super-high, then you will leak a lot of sugar into the urine.

Many of you probably also know about ketones in the urine. It is a bit complicated to explain in detail, but the gist is that ketones come from parts of your body (like muscles) that are broken down because you are not using the sugar in your blood properly. Your body uses sugar as fuel, but needs insulin to work for this to happen. If for some reason your own insulin is not working or is not enough, then you start breaking down other parts of your body for fuel and ketones start showing up. Ever hear about people with diabetes smelling sweet? That smell is from ketones, and it means you are very sick and need to get to a doctor right away. A few ketones in the urine may not mean too much, but many ketones are a serious warning sign.

Infections are also easily picked up when testing urine. Some folks do not have the usual symptoms of a urine infection (burning when you pee, having to go to the bathroom a lot, smelly urine, pain in the belly or back, fever, sweats etc). Sometimes all you have are hard-to-control sugars or just feeling tired, but when your doctor sends out your urine, then he/she will note the infection. In diabetes it is VERY important to treat urine infections (and any infections for that matter) as soon as possible, because you can become VERY sick very fast. Germs LOVE sugar, and the sweeter you are, the more they will want to stay with you…

The last reason I want to mention may be the most important in regard to your future health. Your urine may have some protein, which can be a sign of early kidney damage in diabetes. The urine microalbumin (long word, just means mini-proteins) is a measure of early protein loss through the kidney. Why should you even care about this? Turns out that this urine microalbumin is linked to ongoing kidney damage as well as future heart problems. Your doctor will be checking for this every few months to see if you have any protein leakage, and if it is decreasing or increasing. Your blood sugars and blood pressure are CRITICALLY important in keeping this under control, so be sure to keep an eye on both.

Now, do you feel better about peeing into that little cup? Thought so.

Until next week, Vincies. Stay healthy and safe.

Anita Ramsetty, MD

Medical Director Endocrine Care Group

Tel: 843-798-4227