A simple home urine test can determine if patients with type 1 or 2 diabetes are producing their own insulin. 

The urine test can replace multiple blood tests and can be sent through the mail as it is stable for up to three days at room temperature, British researchers reported in Diabetes Care (2011; 34:286-291).

Rachel Besser, MD, of the Peninsula Medical School at the University of Exeter in Exeter, U.K., and her colleagues found that the test can measure endogenous insulin production even if patients receive daily insulin injections. In addition, the test can be used to differentiate type 1 from type 2 diabetes, as well as rare genetic forms of diabetes. Making this type of differential diagnosis can result in important changes in treatment and the discontinuation of insulin in some patients.

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“The urine test offers a practical alternative to blood testing,” Dr. Besser said. “As the urine test can be done in the patient’s own home we hope that it will be taken up more readily, and more patients can be correctly diagnosed and be offered the correct treatment.” 

Hepatocyte nuclear factor 1-a (HNF1A)/hepatocyte nuclear factor 4-a (HNF4A) maturity-onset diabetes of the young (MODY) is commonly misdiagnosed as type 1 diabetes, resulting in the inappropriate treatment with insulin. Serum C-peptide can be beneficial in the diagnosis of MODY, but practical reasons limit its widespread use. Dr. Besser and her team have found that the urinary C-peptide creatinine ratio (UCPCR) is a stable measure of endogenous insulin secretion and a non-invasive alternative.