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PubMed1984

Renal glycosuria in renal homograft recipients.

Transient renal glycosuria was observed in eight renal transplant patients during the recovery phase from initial tubular necrosis or acute rejection. In these subjects and three homograft recipients without glycosuria we performed glucose titration experiments. Three patients were found to have type A glycosuria, two had type B and three type C. The titration curve was normal in the three patients without glycosuria. In addition, most subjects presented with hypophosphataemia and hyperphosphaturia. Apart from a direct correlation between the point of splay of the glucose titration curves and the fractional clearance of phosphate, there was no clear-cut relationship between the handling of glucose and phosphorus. Mild hyperchloraemic acidosis was observed in six subjects, but this was unrelated to the type and grade of glycosuria. It is concluded that in homograft recipients the tubular alterations have a patchy and unpredictable distribution and may cause a variety of symptoms which do not necessarily occur in close association.

Absorption↗
PubMed1991

Glycosuria and diabetes mellitus in children and adolescents in south India.

In Madras city (India) 10,513 school students between 3 and 20 yr of age were investigated for glycosuria and its causes. While no previously known cases of diabetes mellitus of any type were encountered, four students (0.038%) in the survey population were found to have glycosuria. One (0.009%) had renal glycosuria, two (0.019%) were possibly NIDDY (MODY) and one (0.009%) had transient glycosuria while receiving anti-tuberculous chemotherapy. It is therefore concluded that neither diabetes mellitus nor glycosuria of non-diabetic causes is a crucial health problem in Indian children and adolescents. While the reasons for this are not known, further research in this field could be of global interest.

Adolescent↗
PubMed2004

The usefulness of glycosuria and the influence of maternal blood pressure in screening for gestational diabetes.

OBJECTIVE: Although gestational diabetes is among the most common diseases arising during pregnancy, glucose stix is the only screening test to date in Germany. Our goal was to evaluate the sensitivity of the glucose-stix for diabetes screening and the possible influence of other parameters. METHODS: 1001 patients who underwent the 50 g glucose screening test between June 1, 1997 and January 5, 2000 as part of prenatal care were asked to participate. In accordance with the guidelines of the American Diabetes Association, patients with a screening test result >/= 140 mg/dl underwent a oral glucose tolerance test (Carpenter/Coustan criteria). A urine sample was collected prior to the test. The glucose content of the urine was semiquantitatively analyzed using a test strip (Multistix 10 SG Bayer), Munich, Germany). Blood pressure was measured in 349 consecutive cases according to the criteria of the National Institute of Health. RESULTS: The overall frequency of gestational diabetes was 4.1% (37/912). 8.2% of the women presented with glycosuria (82/1001, 36 before screening, 46 based on the pregnancy medical records booklet). 30/82 (37%) of these patients had a pathological screening test (P = 0.029). 7.1% (52/729) of the healthy patients and 10.8% (4/37) of the gestational diabetics had glycosuria at least once. Therefore, the sensitivity of glycosuria is 10.8%, the positive predictive value is 6.6%. The systolic blood pressure was 116+/- 12 mmHg and the diastolic blood pressure 72 +/- 9 mmHg. Three of 349 (0.9%) patients were documented with preexisting hypertension, 14/349 (4.0%) patients with "pregnancy induced hypertension". Patients with glycosuria were both significantly more advanced in gestational age (34.4 +/- 2.8 versus 33.7 +/- 2.9, P = 0.673) and had higher diastolic blood pressure (79 +/- 9 versus 71 +/- 9, P = 0.005). The 50 g glucose screening test results showed only a tendency to differ (131 +/- 23 versus 127 +/- 24, P = 0.073). A multivariate analysis of these factors showed a significant influence of the diastolic blood pressure (P = 0.016) and the 50 g glucose screening test (P = 0.032), whereas the gestational week had no influence (P = 0.673). CONCLUSIONS: Urine glucose dip stick analysis is not useful in the detection of gestational diabetes because of its low sensitivity and negative predictive value. Our study suggests that glycosuria is not only dependent on the blood glucose level, but highly influenced by diastolic blood pressure. The results clearly underscore the need for standardized, routine testing of every pregnant woman.

Analysis of Variance↗
PubMed2004

Soyfood consumption and risk of glycosuria: a cross-sectional study within the Shanghai Women's Health Study.

OBJECTIVE: To assess the association between soyfood intake and risk of glycosuria. DESIGN AND METHODS: A cross-sectional study was conducted among participants of the Shanghai Women's Health Study, a population-based cohort study of women aged 40-70 y. Information on usual intake of soyfoods was obtained at baseline survey through an in-person interview using a validated food-frequency questionnaire. Included in this study were 39,385 cohort members screened for diabetes at the baseline survey and free of previously diagnosed diabetes, cardiovascular diseases, kidney diseases, and cancer. There were 323 women who tested positive for urine glucose. Odds ratios (ORs) and 95% confidence intervals (CIs) were employed to measure the association between soyfood intake and glycosuria using unconditional logistic regression. SETTING: Urban communities of Shanghai, China. RESULTS: Overall, soyfood intake was not related to the risk of glycosuria. Among postmenopausal women, however, intake of tofu and other soy products was inversely associated with risk of glycosuria after adjustment for potential confounders. The ORs across quintiles of intake were 1.0, 0.75 (95% CI=0.47-1.20), 0.79 (95% CI=0.51-1.25), 0.53 (95% CI=0.32-0.88), and 0.51 (95% CI=0.26-0.98; P for trend=0.05). Further analyses showed that the inverse association was primarily confined to postmenopausal women with a body mass index (BMI) of <25 kg/m2. The adjusted OR comparing the extreme quintiles was 0.36 (95% CI=0.13-0.97; P for trend=0.004). CONCLUSIONS: Soyfoods may play a role in the development of glycosuria, an important indicator of diabetes, among postmenopausal women with a low BMI.

Adult↗
PubMed2005

Beta-cell dysfunction, insulin sensitivity, and glycosuria precede diabetes in hepatocyte nuclear factor-1alpha mutation carriers.

OBJECTIVE: Patients with diabetes due to hepatocyte nuclear factor (HNF)-1alpha mutations have beta-cell deficiency, insulin sensitivity, altered proinsulin levels, and a low renal threshold for glucose. It is uncertain how many of these features precede the development of diabetes. The aim of our study was to test for these characteristics in young nondiabetic HNF-1alpha mutation carriers. RESEARCH DESIGN AND METHODS: A total of 47 offspring from 19 extended families underwent genetic testing, a standard oral glucose tolerance test, and urine testing. RESULTS: HNF-1alpha mutations were found in 20 offspring, 7 with diabetes and 13 without diabetes. The 13 nondiabetic mutation carriers were compared with 27 family control subjects, who were matched for age, sex, and BMI. There was marked beta-cell deficiency with reduced insulinogenic index (53.5 [31.5-90.9] vs. 226.0 [126.0-407.1], SD [range], P < 0.001) and area under the curve for insulin (P < 0.001). Insulin sensitivity was increased in mutation carriers (homeostatic model assessment of insulin sensitivity 144.6 [82.7-252.7] vs. 100 [66.9-149.4], P = 0.025). A total of 38% of mutation carriers had glycosuria at 2 h compared with 0% of control subjects (P = 0.0034). Those with glycosuria had peak glucose values that were higher than the mutations carriers without glycosuria (range 8.1-11.8 vs. 6.2-8.4 mmol/l, P = 0.002). The seven subjects with diabetes all showed glycosuria. CONCLUSIONS: We conclude that marked beta-cell deficiency, increased insulin sensitivity, and a low renal threshold are present in young nondiabetic HNF-1alpha mutation carriers. The presence of glycosuria post-glucose load could be used to screen children of mutation carriers as it occurs in all mutation carriers with a peak glucose in the oral glucose tolerance test >8.4 mmol/l.

Adolescent↗
PubMedDate not supplied

The incidence of glycosuria in patients attending the Korle bu and Mamprobi polyclinics.

A survey conducted to search for the incidence of glycosuria among the patients who attended consultation at the Polyclinics at Korle bu and Mamprobi is published. Sample population of 800 patients who came to these clinics for the first time had specimen of their urine collected at random, and tested for glucose. Out of these 800 patients 633 were of general cases while 167 were pregnant women who came to attend pre-natal consultation services. Out of the general cases, there were 33 cases of glycosuria; an incidence of 4.1%. Among the pregnant women, there were 5 cases of glycosuria; an incidence of 0.63%. The highest incidence of glycosuria was observed within the age group of (21-30 years). Glycosuria among the pregnant women is more rampant among women were more than among men. The incidence among the pregnant women was not more than 0.63.0% compared with about an incidence of 3% in nonpregnant women.

Adult↗
PubMed1978

The spontaneously diabetic Wistar rat (the "BB" rat): the significance of transient glycosuria.

A longitudinal study of thirteen rats with transient and intermittent episodes of glycosuria was undertaken, to further characterize the "BB" diabetic syndrome. "Chemical diabetes" (normal fasting glycemia, abnormal GTT) was observed in five rats, accompanied by the same dramatic insulitis previously reported in this syndrome, in two of the three pancreases examined. Progression from "chemical" to overt diabetes occurred in one of these rats. Two other patterns of presentation were observed. Periods of complete remission occurred in four rats with diabetes considered sufficiently severe to warrant previous treatment with insulin. Four additional rats with previous glycosuria (untreated) showed no abnormalities on followup. It is not known whether hyperglycemia accompanied the glycosuria in these rats, and renal glycosuria has not been excluded. Thus, the "BB" diabetic syndrome exists in not only the overt and "chemical" forms, but may also present with transient glycosuria, followed by a variety of subsequent progressions.

Animals↗
PubMed1987

Hyperglycemia with and without glycosuria: effect on inulin and para-amino hippurate clearance.

The response of the clearance of inulin (Cin) and para-amino hippurate (CPAH) to acute hyperglycemia with and without glycosuria was investigated in ten, healthy non-diabetic subjects. Standard methodology (UV/P) was used, with a mean clearance calculated from three, 15-minute urine collection periods. Each subject was studied at three levels of blood glucose (mmol/liter) concentration, mean (SE): Level 1, fasting, 4.5 (0.1); Level 2, hyperglycemia below renal threshold for glucose, 7.2 (0.1); Level 3, hyperglycemia with glycosuria, 12.6 (0.5). There was a significant rise in mean Cin (ml/min/1.73 m2) when changing from Level 1 (112[3]) to Level 2 (121[5]), with no further increase on changing to Level 3 (122[4]). With glycosuria Cin fell in some subjects. Mean CPAH (ml/min/1.73 m2) increased through Level 1 (560[27]) to Level 3 (603[34]), with consequently no change in mean filtration fraction at the three levels of glycemia. Our observations show a rise in glomerular filtration rate with mild hyperglycemia below renal threshold, with no further increase during hyperglycemia sufficient to produce glycosuria.

Adult↗
PubMed1983

Mechanism of glycosuria during volume expansion superimposed on subthreshold glucose loading.

In order to elucidate the mechanism of glycosuria, clearance and micropuncture studies were performed in 19 dogs before and after subthreshold glucose loading and again after superimposition of extracellular volume expansion. Subthreshold glucose loading inhibited proximal sodium reabsorption and increased proximal glucose reabsorption, demonstrating dissociation between net sodium and glucose transport. Glucose delivery out of the proximal convoluted tubule was greatly increased by the combined effect of increased filtered load of glucose and reduced fractional proximal fluid reabsorption. There was a remarkable compensatory increase in glucose reabsorption in the segment between late proximal tubule and distal tubule (intermediate segment) and glycosuria did not occur. When 10% extracellular volume expansion was superimposed on the ongoing subthreshold glucose loading, absolute proximal glucose reabsorption was inhibited. This led to an additional increase in glucose delivery to the intermediate segment, but glucose reabsorption in this segment failed to increase further and overt glycosuria eventually developed. Thus the intermediate segment possesses some capacity to reabsorb glucose when glucose load is increased, and glycosuria develops only when the glucose reabsorptive capacity of this segment is exceeded. We conclude that the intermediate segment serves as the "buffer zone" of renal glucose transport and plays an important role in the regulation of urinary glucose excretion.

Absorption↗
PubMed1993

Serum trehalase activities in controlled and uncontrolled diabetes and the impact of oral glucose, high carbohydrate and glycosuria on serum levels.

Nineteen healthy volunteers, made up of two groups were subjected to an extended oral glucose tolerance study. In one group, each had 50g glucose and in the other a high carbohydrate meal. Blood glucose and serum trehalase activities were determined on fasting blood samples and specimens collected half-hourly for 4 hours. The values obtained for both at each stage of the investigations were compared with one another. Correlation coefficient (r) between blood glucose and serum trehalase were 0.4923 for the fasting samples and 0.4762 at 1 hr. The impact of diabetes and glycosuria on serum trehalase activities in 50 diabetics consisting of treated (controlled) and untreated (uncontrolled) cases was also studied. Our study reveals a slight fall in serum trehalase values from the initial fasting level, but thereafter a gradual and progressive rise during the course of the glucose tolerance investigations. Serum trehalase values were higher in diabetics compared to normal subjects (t = 7.0168, P = 0.005). Diabetics with glycosuria had a significantly higher mean serum trehalase compared to the controlled group (t = 5.233, P = 0.005). High serum trehalase values were seen in diabetics with renal glycosuria at comparatively low levels of blood glucose. The significance of these findings is discussed in relation to the possible place of serum trehalase assay in the management of diabetes, especially when this is made difficult by renal glycosuria.

Administration, Oral↗
PubMedDate not supplied

[Importance of glycosuria in pregnant women as a risk factor in relation to diabetes mellitus].

The diabetic type of glucose tolerance tests was revealed in 16% of the women with glycosuria during pregnancy and in 8% of the women of control group without any other risk factors in respect to diabetes mellitus. The results of remote follow up over the women of the both groups are presented. Glycosuria during pregnancy should not be considered prognostically unfavourable in case of normal glucose tolerance test results; pathogenesis of such glycosuria during pregnancy was not associated with insulin insufficiency. Glycosuria during pregnancy served as an indication of the glucose tolerance test for the purpose of timely detection of latent diabetes.

Adult↗
PubMed1997

Renal glycosuria treated as diabetes mellitus: case report.

A case of renal glycosuria is reported. A 55 year old female was diagnosed and treated in an upcountry hospital for diabetes mellitus. She developed symptoms of hypoglycaemia while on an oral hypoglycaemic agent, leading to her admission in Mulago Hospital. Persistent glycosuria was noted despite treatment and normal serum glucose. Oral glucose tolerance test and timed urine glucose showed a normal curve but high urine sugar. A diagnosis of renal glycosuria was made, oral hypoglycaemic therapy was stopped, patient improved and was discharged. Though renal glycosuria is a benign condition, mistaken diagnosis for diabetes mellitus puts patients at risk of hypoglycaemia due to treatment. Diagnosis of the condition requires physicians' awareness of its existence in our community and the use of Marbles' criteria obviates confusion with diabetes mellitus though it does not absolutely exclude Fanconi syndrome.

Blood Glucose↗
PubMed1984

Close genetic linkage between HLA and renal glycosuria.

Renal glycosuria is an inherited disorder of renal tubule function in which significant amounts of glucose are excreted in the urine in the simultaneous presence of normal blood glucose levels. Renal glucose titration analyses and HLA genotypes were performed in 5 unrelated affected families with a total of 25 patients and 40 healthy relatives. In each family the gene responsible for renal glycosuria segregates with the HLA complex suggesting a close genetic linkage. 2 cases carry intra-HLA recombinant haplotypes; in these subjects our findings indicate that the abnormal gene is closer to the HLA-A locus than the HLA-B locus. No HLA-A, HLA-B or HLA-C specific antigen is selectively increased among the 5 unrelated families affected with renal glycosuria.

Adolescent↗
PubMed2004

Peripheral vascular disease is associated with reduced glycosuria in newly diagnosed type 2 diabetic patients.

OBJECTIVES: We examined whether the finding of glycosuria and its level in themselves give information of clinical relevance, apart from being an unreliable indicator of glycemic control. METHODS: Subjects were a population-based sample of 1,284 newly diagnosed type 2 diabetic patients. Median age was 65.2 years. Urinary glucose concentration (UGC) was determined quantitatively in a freshly voided morning urine specimen. RESULTS: The over-all prevalence of peripheral vascular disease (PVD) was 16.5%. Bivariately, high values of UGC were associated with low prevalence of PVD (p<0.001, chi2-test). The predictive value of PVD--together with HbA1c, glomerular filtration rate (GFR) and 10 other possible predictors--was confirmed in a logistic regression analysis with glycosuria (Y/N) as outcome variable (p=0.0004). CONCLUSION: Surprisingly, type 2 diabetic patients with PVD tend not to have glycosuria as compared to patients without PVD. PVD may be indicative of generalized atherosclerotic lesions in the major vessels, including the renal arteries. This could lead to a lowering of GFR and thereby of the amount of glucose filtered. Assuming no, or only a minor direct effect of PVD on tubular function, this would lead to an increased renal threshold for glucose in patients with PVD.

Aged↗
PubMed1989

Phlorizin-induced glycosuria does not prevent gentamicin nephrotoxicity in rats.

Because rats with streptozotocin-induced diabetes mellitus (DM) have a high solute diuresis (glycosuria of 10 to 12 g/day), we have suggested that this may in part be responsible for their resistance to gentamicin-induced acute renal failure (ARF). The protection from gentamicin nephrotoxicity was studied in non-diabetic rats with chronic solute diuresis induced by blockage of tubular glucose reabsorption with phlorizin (P). DM rats with mild glycosuria (similar in degree to that of the P treated animals) were also studied. Unanesthetized adult female, Sprague-Dawley rats were divided in four groups and studied for 15 days. Group 1 (P alone) received P, 360 mg/day, for 15 days; Group II (P + gentamicin); Group III (gentamicin alone) and Group IV (mild DM + gentamicin). Nephrotoxic doses (40 mg/kg body wt/day) of gentamicin were injected during the last nine days of study to the animals of groups II to IV. In Group I, P induced a moderate and stable glycosuria (3.9 +/- 0.1 g/day, SE), and no functional or morphologic evidence of renal dysfunction (baseline CCr 2.1 +/- 0.1 ml/min, undetectable lysozymuria) or damage (tubular necrosis score [maximum 4], zero). In Group II, P did not prevent gentamicin-ARF (maximal decrease in CCr at day 9.89%, P less than 0.001; peak lysozymuria, 1863 +/- 321 micrograms/day; and tubular necrosis score, 3.9 +/- 0.1). These values were not different from those of Group III: maximal decrease in CCr 73% (P less than 0.001); lysozymuria, 2147 +/- 701 micrograms/day; tubular necrosis score, 3.8 +/- 0.1.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1993

Community screening for non-insulin-dependent diabetes mellitus: self-testing for post-prandial glycosuria.

Recent requirements of the GP contract have included the testing of random urine samples from all patients aged 16-75 years for glycosuria. As a means of detecting diabetes this will be both inefficient and wasteful of resources, because of the method employed and age group screened. We examined a simple method for screening large populations for non-insulin-dependent diabetes mellitus using self-testing for post-prandial glycosuria, and compared its performance to that using fasting plasma glucose and haemoglobin A1. The study involved five general practices, screening over 13,000 subjects aged between 45 and 70 years. Of the 13,795 subjects screened, 10,348 responded (75%). Glycosuria was detected in 343 subjects (3.3%), of whom 330 (95.9%) attended for oral glucose tolerance testing. Of these 99 (30%) had newly diagnosed diabetes, 56 (17%) had impaired glucose tolerance. A further 65 subjects were identified as having diabetes but were not on a register of cases. Prevalence of diabetes in this age group rose from 2.26% to 4.1%. In a normal population control group (442 subjects from Ely), this system gave a sensitivity of 43%, specificity of 98% and positive predictive value of 53%, and compared favourably to the use of a fasting plasma glucose of 6 mmol/l, which gave a sensitivity of 65%, but only a specificity of 64% and positive predictive value of 9%. These results support the use of this simple system in large population screening for diabetes.

Aged↗
PubMed2001

Transient renal glycosuria in a patient with acute pyelonephritis.

Glycosuria was detected in a 37-year-old Chinese woman by a urinary examination in a local clinic with clinical evidence of acute pyelonephritis (APN). Transient glycosuria is an unusual complication of acute pyelonephritis in non-diabetic patients. As there is growing prevalence of type 2 diabetes in the population worldwide, it must be recognized that mistaken diagnosis of diabetes mellitus by glycosuria may predispose patients to an unfavorable hypoglycemic episode. Thus definite diagnosis of diabetes mellitus should be made only after recovery of APN by means of urinalysis or by simultaneous blood glucose concentration analysis.

Acute Disease↗
PubMed1991

[Glycemia and glycosuria in the search for new energy sources for calves].

Monosaccharide (glucose), disaccharide (saccharose hydrolysate) and polysaccharide (maltodextrin KMS-X 70) were administered perorally to the calves of three age categories (pre-rumination, transition, rumination period) after 12-hour fasting. The following characteristics were investigated: glycaemia, glycosuria, lactic acid concentration, plasma osmolality, hematocrit value, net acid-base secretion and excrement dry matter. The degree of saccharide utilization was evaluated from glycaemia, glycosuria and clinical condition. The administration of maltodextrins to calves at the age of two to three weeks was not found convenient. The absorption of saccharose (hydrolyzate depended strongly on age. The saccharose hydrolyzate dose of 2.5 g per kg l. w. was calculated with respect to glycaemia and glycosuria, but not to the excrement dry matter content. In comparison with glucose absorption, saccharose hydrolyzate seems to be a convenient energy source for calves of different age categories.

Animal Feed↗