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Glucose, Urine


Definition


  • Detection of glucose on a semiquantitative urine dipstick or Clinitest tablets is an insensitive means of screening for type 2 diabetes. The high rate of false-negative results suggests that the urine dipstick is not adequate as a screening test. In addition, not all patients with glucosuria have diabetes. Glucosuria can occur with defects in renal tubular function, as seen in type 2 (proximal) renal tubular acidosis and in familial renal glucosuria, a genetic disorder associated with salt-wasting, polyuria, and volume depletion.
  • Normal range: see Table 16.37.

‚  
TABLE 16 " “37Normal Values for Urine GlucoseView LargeTABLE 16 " “37Normal Values for Urine Glucose Specimen Type Value 24-h urine 0.04 " “0.21 g/d Random urine In mg/g creatinine Male <40 y 3 " “181 >40 y 19 " “339 Female <40 y 5 " “203 >40 y 8 " “331

Use


  • Aiding the evaluation of glucosuria and renal tubular defects
  • Management of DM

Interpretation


Increased In


  • Any cause of increased blood glucose
  • Endocrine disorders (DM, thyrotoxicosis, gigantism, acromegaly, Cushing syndrome)
  • Major trauma
  • Stroke
  • Myocardial infarction
  • Oral steroid therapy
  • Burns, infections
  • Pheochromocytoma

Decreased In


  • Treatment with ascorbic acid, levodopa, or mercurial diuretics

Limitations


  • Prolonged exposure of urine sample to room temperature lower glucose results due to microbial contamination and glycolysis.
  • Specific gravity >1.020 and increased pH cause reduced sensitivity and falsely low glucose levels.
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