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Glucose in the urine and diabetes mellitus
Last reviewed: 23.04.2024
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In patients with diabetes, a study of glucosuria (glucose in urine) is conducted to assess the effectiveness of treatment and as an additional criterion for compensation of the disease. The decrease in daily glucosuria indicates the effectiveness of therapeutic measures. The criterion for the compensation of type 2 diabetes is the achievement of aglucosuria. In type 1 diabetes mellitus (insulin-dependent), a loss of 20-30 g glucose per day is permissible in the urine.
It should be remembered that in patients with diabetes mellitus the renal glucose threshold can significantly change, which makes it difficult to use these criteria. Sometimes, glucosuria persists with persistent normoglycemia, which should not be considered an indication of 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 mode of administration of antidiabetic drugs, it is expedient to examine glucosuria (glucose in urine) in three portions of urine. The first portion is collected from 8 to 16 hours, the second from 16 to 24 hours and the third from 0 to 8 hours the following day. Each portion is determined by the amount of glucose (in grams). Based on the daily profile obtained, glucosuria increases the dose of antidiabetic drug, the maximum of which will occur during the period of the greatest glucosuria. Insulin patients with diabetes mellitus are administered from the calculation of 1 ED 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 elderly people, a urine test for glucose to diagnose diabetes is ineffective. Calculate the necessary dose of insulin for glucose in the urine can not.
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