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Question:

From Greensboro, North Carolina, USA:

We have healthy 4 year old identical twin sons, and a 6 year old daughter. At our sons' 3 year check-up, the nurse found a significant amount of sugar in the younger twin's urine. He had a fasting blood sugar test that was normal. At their 4 year check-up, sugar was found in both of their urine samples. A fasting and feasting blood test was done on both. Results were normal. I keep urine strips at home and check them from time to time. Sometimes there is sugar, and sometimes the sample is normal. The doctor says they have renal glycosuria. If they have this disorder, why don't they spill sugar all the time? Why does one twin spill when the other does not? Is this disorder a prelude to diabetes? Why is there so little information? If the gene for the disorder is inherited and recessive, why doesn't our daughter spill sugar? Please help. Our pediatrician has been less than informative. He would not even give me a name for the disorder until I asked if it were renal glycosuria. I guess he figured I wouldn't research.

Answer:

Renal glucosuria is indeed a possibility for your twins, and it is an autosomally recessive inherited disorder which would explain why your daughter does not have it. It is possible to test for this definitively by doing a test for the renal 'tubular rebsorption fraction' for glucose.

However this really requires admission to a clinical research center so I can quite understand why your pediatrician has not encouraged it. The reason that the glucosuria is only occasional is that it only occurs when the blood sugar exceeds the renal threshold (which is normally about 180mg/dl). This is a benign condition although there are some very rare kidney problems that will also cause glucosuria; but which are not associated with otherwise normal health. I expect, though, that what you are really anxious about is whether this might represent the very earliest preclinical stage of Type 1 diabetes. For this reason you might consider talking to their doctor about getting an antibody test for Type 1A or autoimmune diabetes. A negative test would exclude >90% of the possibility of being diabetic in a Caucasian child. The number to call for more informtion is 1-800-425-8361.

DOB

Original posting 21 Jan 1999
Posted to Other Illnesses

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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