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Wednesday, October 1, 2014
Sugar in Urine
What is the difference in sugar in the urine and keytones? My daughter is 12 and tested negative for keytones but her sugar in the urine was 1100. She is a type 1 diabetic.
When the blood glucose rises above a certain point (different in each person, approximately 160 - 180 mg/dl), the extra glucose from the blood above that level spills over in the kidneys into the urine. So glucose in the urine is a sign of higher than normal blood glucose levels.
Monitoring glucose in urine is not helpful to a person with Type 1 diabetes. Instead, people with Type 1 diabetes should test blood glucose frequently and regularly each day to control blood glucose levels effectively.
In contrast, monitoring ketones in urine is VERY important for people with Type 1 diabetes. Insulin is like a key that allows sugar to enter cells in the body for energy. When insulin levels are too low, the cells can't use sugar for energy in a normal way. Therefore the body starts burning fat for energy, and ketones are produced. Ketones can cause problems if they build up - so our body wants to get rid of them as quickly as possible. The ketones travel from the tissues to the blood to the urine, and leave our body through the urine.
In people with Type 1 diabetes, ketones can be the beginning of a process called Diabetic Ketoacidosis (also known as DKA). It is a potentially life-threatening condition started by insulin deficiency, and eventually complicated by dehydration, electrolyte imbalance, and acidosis.
Please note: people without Type 1 diabetes can also develop ketones in the urine. For example, you may have heard of people on weight-loss diets who develop ketones. Ketones can be present in the urine from starvation (fat is burned for energy because the dietary intake of calories is very low). Or ketones can be present in the urine if natural insulin levels are very low because the person is eating very low amounts of carbohydrates or calories.
The risks and concerns about ketones are very different for people with Type 1 diabetes. Talk to your diabetes care provider about a plan for checking urine ketones and responding quickly if urine ketones are present. In general, people with Type 1 diabetes should check urine ketones when blood glucose levels are high, and when they are ill. Extra insulin is needed when ketones are present, and you need to search for the cause of the ketones. Your diabetes care provider will give you specific instructions about what to do when ketones are present. Responding to ketones quickly can make all the difference in preventing diabetic ketoacidosis., and keeping people with Type 1 diabetes safe.
Nancy J Morwessel, CNP, MSN, CDE
Pediatric Nurse Practitioner
College of Medicine
University of Cincinnati