Self-monitoring Guidelines for Patients with Hyperglycemia: Methods for Recording Urine Output and Blood Glucose Testing

Medication Adjustment and Contraindications for Hyperglycemia Patients

It is advisable to carefully record daily urine output: Generally speaking, the higher the blood sugar, the more urine is excreted, and the more sugar is excreted. Diabetic patients should not only record the sugar in each urine segment and each time, but also the urine volume. During holidays, patients have time and resources to record both the sugar in each urine segment and the volume. During weekdays, record the number of urinations (four segments) to roughly estimate the amount of urine excreted. The insulin dosage before breakfast can be adjusted based on the urine volume and sugar in the first urine segment and the urine sugar before lunch (or before the midday insulin injection), and so on. If the patient's urine volume and sugar are both high, insulin therapy should be initiated, with a decrease in urine volume followed by a decrease in the plus sign of sugar in urine. This is because a urine sugar level of 10x10x10 may indicate a sugar content of 2%, but it could also be much higher than 2%. If urine volume decreases significantly but the plus sign does not decrease, do not rush to increase insulin, at least not in large quantities. Special cases exist, such as when severe dehydration leads to decreased kidney function. Due to reduced renal blood flow and difficulty in glucose excretion, blood glucose levels are high, but the number of positive urine glucose tests (e.g., +10) is relatively low. However, as the condition improves and blood glucose levels decrease, the number of positive urine glucose tests increases.

It is advisable to know self-monitoring methods for blood glucose:

Since most people's urine glucose and blood glucose levels are generally consistent, blood glucose testing methods include urine glucose test strips and blood glucose monitors.

(1) Colorimetric Test Strip Method
First, immerse the urine glucose test strip in urine for about 1 second, then remove it. Observe the color of the test strip within 1 minute and compare it with a standard color chart to obtain the test result.

Depending on the amount of sugar in the urine, the test strip will show different shades of color change. If the colorimetric result is blue, it indicates no sugar in the urine, meaning the urine glucose test is negative (symbol: -); green indicates one plus sign (+), indicating 0.3%–0.5% sugar in the urine; yellow-green indicates two plus signs (++), indicating 0.5%–1.0% sugar in the urine; orange-yellow indicates three plus signs (+++), indicating 1%–2% sugar in the urine; brick red indicates four plus signs (++++) or more, indicating more than 2% sugar in the urine.

When using the colorimetric test strip method to test for urine glucose, patients should remove all the test strips needed for one test, then tighten the stopper and store the test strips in a cool, dry place.

(2) Blood Glucose Monitor Method
The testing procedure is as follows:
Adjust the code on the blood glucose meter to match the code on the test strips you are currently using.
Wash your hands and disinfect the finger used for blood collection with alcohol.
Hold your arm down for 30 seconds to allow sufficient blood flow to the finger. Insert the lancet into the finger-prick pen, select the puncture depth according to the thickness of your finger skin, and prick your finger to collect an appropriate amount of blood.

After the blood glucose meter indicates that blood has been collected, drop the blood onto the indicator hole of the blood glucose test strip.

Insert the blood glucose test strip into the blood glucose meter (some blood glucose meters require the test strip to be inserted into the meter first, then the blood to be dropped onto the test strip).

After a few seconds or tens of seconds, read the blood glucose value from the blood glucose meter.

Record the blood glucose value and monitoring time in a logbook.