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Automatic analysis of urine test strips using automated urine test strip analysers is a well-established practice in modern-day urinalysis. They can measure calcium , blood, glucose, bilirubin, urobilinogen, ketones, leukocytes, creatinine , microalbumin , pH, ascorbic acid and protein.
Test for ketonuria using Bayer Ketostix reagent strips. Urine testing is the most common method of testing for ketones. Urine test strips utilize a nitroprusside reaction with acetoacetate to give a semi-quantitative measure based on color change of the strip. Although beta-hydroxybutyrate is the predominant circulating ketone, urine test ...
The same principle is used in test strips that have been commercialized for the detection of diabetic ketoacidosis (DKA). These test strips use a beta-hydroxybutyrate-dehydrogenase enzyme instead of a glucose oxidizing enzyme and have been used to detect and help treat some of the complications that can result from prolonged hyperglycemia. [34]
Diabetic ketoacidosis may be diagnosed when the combination of hyperglycemia (high blood sugars), ketones in the blood or on urinalysis and acidosis are demonstrated. [6] In about 10% of cases the blood sugar is not significantly elevated ("euglycemic diabetic ketoacidosis"). [3] A pH measurement is performed to detect acidosis.
Test strips use sodium nitroprusside to detect acetoacetate, and those with a glycine additive can detect acetone; however, none detect BHB. The reaction of ketones with sodium nitroprusside in an alkaline medium turns the test pad purple. [76] Ketonuria occurs in uncontrolled type 1 diabetes and in diabetic ketoacidosis. [77]
The most common cause of ketoacidosis is a deficiency of insulin in type 1 diabetes or late-stage type 2 diabetes. This is called diabetic ketoacidosis and is characterized by hyperglycemia, dehydration and metabolic acidosis. Other electrolyte disturbances such as hyperkalemia and hyponatremia may also be present.
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