4. urine examination 1. urine routine positive urine sugar is an important clue to the diagnosis of diabetes, but is not the basis for a definitive diagnosis. Normal renal sugar threshold 8.9 ~ 10.0 mmol/L, some patients due to renal lesions resulting in lower renal sugar threshold, although the normal blood glucose concentration may also appear urinary sugar, seen in renal diabetes. In addition, a large intake of sugary foods with elevated blood glucose concentration temporarily exceeding the renal glucose threshold can also occur glycosuria. In addition to urine sugar, urine ketones, urine protein and many other indicators are helpful in diagnosing and identifying other diseases. 2, urinary albumin to creatinine ratio (ACR) diabetic patients in 20% to 40% of diabetic nephropathy occurs, is the main cause of renal failure in diabetic patients. Early diabetic nephropathy is characterized by a mild increase in urinary albumin excretion (microalbuminuria), which gradually progresses to massive albuminuria and rising serum creatinine levels, and eventually renal failure occurs, requiring dialysis or kidney transplantation. The easiest way to detect microalbumin in urine is to measure the ACR in morning urine or random urine, and if the result is abnormal, the test should be repeated within 3 months to clarify the diagnosis. If two out of three ACRs are elevated, microalbuminuria can be diagnosed when other factors such as infection are excluded. exercise, infection, heart failure, significant hyperglycemia and significant hypertension within 24 h can all increase urinary albumin excretion. Microalbuminuria may occur intermittently in stage II diabetic nephropathy, where the patient’s morning urine at rest or random urine albumin to creatinine ratio (ACR) is normal (<2.5mg/mmol in men and <3.5mg/mmol in women); by stage III diabetic nephropathy, the early diabetic nephropathy stage, marked by persistent microalbuminuria, the ACR is 2.5 to 30.0mg/mmol (men) and 3.5~30.0mg/mmol (female); when diabetic nephropathy develops to stage IV, i.e. clinical diabetic nephropathy, ACR>30.0mg/mmol, at this time, urine protein is already positive in urine routine. V. Other blood tests Patients with diabetes should have their blood lipids (including triglycerides, total cholesterol, HDL-C and LDL-C) and blood creatinine checked at least once a year. Blood creatinine is used to estimate the glomerular filtration rate (eGFR) and to evaluate the stage of chronic kidney disease. Patients taking lipid-regulating drugs should also be evaluated for efficacy and side effects periodically after administration.