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What About Urine Tests?
October 7, 2009
Since I was diagnosed with multiple sclerosis (MS) over 20 years ago, I’ve been a self-care maniac. I think about it, write about it, and talk about it all the time. So when I started having to urinate every 90 minutes or so, I decided to investigate for myself.
Frequent urination is an MS symptom, but it can also be a sign of a urinary tract infection (UTI). Diabetes Self-Management readers can probably relate. If your blood glucose is high enough, some glucose will spill into your urine. High blood glucose can make you urinate more often (“urinary frequency”). Glucose in the urine can also put you at risk for a UTI, because the bacteria feed on the sugar.
With MS, it’s nerve damage, not sugar, that causes the urinary frequency. The nerve damage can also predispose you to infection, because the bladder doesn’t empty very well. It’s best to check it out, because in both MS and diabetes, those infections can spread to your kidneys and cause serious damage.
I could have gone to my doctor, but I figured, why waste the time and money? I can check this myself. I’m a nurse, so I knew about the dipsticks they use in doctor’s offices to check urine. I went online to see about buying some. Meanwhile, I started drinking lots of cranberry juice, in case there was an infection.
It turns out there are dozens of different strips. Some check for glucose and some for ketones (to check for diabetic ketoacidosis). Glucose strips are how we used to check the glucose levels of people with diabetes before they invented the finger-stick glucose meters. Glucose starts to spill into the urine when your blood glucose level goes over roughly 160–180 mg/dl. (If there are kidney problems, the spilling can start at lower levels.)
So if you only want to keep your glucose below 180 mg/dl, you could theoretically just check your urine and not stick yourself for blood. If you did that, you would have no idea what your actual glucose number was, just whether it had been above or below 160–180 mg/dl (there is a lag time associated with urine glucose testing). But it’s worth noting that an A1C of 7%, which is the American Diabetes Association’s (ADA) recommendation for most adults, translates to an average blood glucose level of 170. So if you do urine tests and never show positive for sugar, your A1C is almost certainly in the target range.
Other sticks check the urine for protein and creatinine (to check for kidney problems), bilirubin (to check for liver or gallbladder issues), drugs, and many other things. What I was interested in were the tests for nitrites, blood, and leukocytes (white blood cells). The presence of any of those substances in the urine would be a sign of infection.
When the sticks come in contact with the substance they’re testing (glucose for example,) they will change color. There’s a chart on the side of the bottle that you can use to determine what the color on the stick means.
I’m cheap, so I was shopping for price. The range for 100 sticks was from $22.00 to $49.00. I didn’t need 100, because I probably wouldn’t use more than one or two a month, and they’re only good for a year. You can get 100 urine sticks for glucose, ketones, and albumin for about $17.00. But according to the ADA, insurance may not pay for them.
Amazon.com has a customer review function. People write in what they thought of a book or a product. Some of these reviews are helpful and some are hilarious. A few reviewers of the cheap urine sticks advised that customers should “spend a few more bucks and get the real thing,” because the colors on the cheap one ran and were hard to distinguish.
So I bought 25 of the more expensive ones that checked for 10 different things and waited three days for delivery. When they finally came, I tested and thought I saw a color change that indicated blood. So I made an appointment. When I got to the doctor’s office, their test (using the same stick) was completely negative. It turned out that I had probably used a contaminated urine container. I learned that I need to use a very clean container.
It wasn’t a complete waste of time, though. I found out my blood pressure was also up a bit. The physicians assistant (PA), a real sweetheart named Greg, said maybe the blood pressure and the urinary frequency had the same cause. Maybe I was stressing too much.
He could probably tell because I was talking fast and all my muscles were tensed up. He said, “Anything you can do to reduce stress will help.” So I came home after doing about four errands and took a nice nap. I tried to spend the afternoon thinking pleasant thoughts. And that night (last night), I only had to get up once to the bathroom. So maybe Greg is right. I hope so. And I’ve still got the sticks for next time I need to check.
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