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Urine glucose and diabetes mellitus
Last reviewed: 04.07.2025
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In patients with diabetes mellitus, glucosuria (glucose in urine) is studied to assess the effectiveness of treatment and as an additional criterion for disease compensation. A decrease in daily glucosuria indicates the effectiveness of treatment. The criterion for compensation of type 2 diabetes mellitus is achieving aglucosuria. In type 1 diabetes mellitus (insulin-dependent), a loss of 20-30 g of glucose in urine per day is allowed.
It should be remembered that in patients with diabetes mellitus, the renal glucose threshold may change significantly, which complicates the use of these criteria. Sometimes glucosuria persists with persistent normoglycemia, which should not be considered an indication for increased hypoglycemic therapy. On the other hand, with the development of diabetic glomerulosclerosis, the renal glucose threshold increases, and glucosuria may be absent even with very pronounced hyperglycemia.
To select the correct regimen for administering antidiabetic drugs, it is advisable to examine glucosuria (glucose in urine) in three urine portions. The first portion is collected from 8 a.m. to 4 p.m., the second from 4 p.m. to midnight, and the third from midnight to 8 a.m. the following day. The amount of glucose (in grams) is determined in each portion. Based on the resulting daily glucosuria profile, the dose of the antidiabetic drug is increased, the maximum effect of which will occur during the period of greatest glucosuria. Insulin is administered to patients with diabetes at a rate of 1 U per 4 g of glucose (22.2 mmol) in urine.
It should be remembered that with age, the renal threshold for glucose increases; in older people, it can be more than 16.6 mmol/l. Therefore, in older people, a urine test for glucose is ineffective for diagnosing diabetes. It is impossible to calculate the required dose of insulin based on the glucose content in the urine.
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