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Question:

From Phoenix, Arizona, USA:

I am a 34 year old female and about a year ago, I was seen in an emergency room for recurrent urinary tract infections. At that time, my urinalysis showed 2+ glucose. I had had 60 ounces of juice, so the doctor attributed the urine glucose to that. Two hours later, another dipstick was negative for glucose entirely. My blood glucose has never been elevated, but I do have a family history of diabetes. I also had an hemoglobin A1c done a few days after the ER visit and the result was well within the normal range.

Last week as part of a yearly "well woman" exam, I had a fasting glucose well within the normal range, but a few days later, I thought I was having symptoms of a UTI again and went in. At that time, I also had had about 20 ounces of regular lemonade and had eaten less than an hour before. The dipstick result again showed 2+ glucose and a trace of ketones.

My doctor has my family history, and she didn't think it was anything to be concerned about, given I had just had a meal. Do I need to be concerned about the repeat positive glycosuria, given that my blood work is normal? Should I have a two-hour glucose tolerance test done? I don't have other symptoms of diabetes (excess thirst or urination, no fatigue, or irritability). I am on quite a few medications, and I have put on some weight in the last three or four years, since I have been on these medications, but I lift weights for an hour every day and have since I was 11 years old.

Answer:

The gold standard test is the oral glucose tolerance test. If I were you, I would go ahead and have this to remove any doubt. You can argue that with all the other testing, even if you had diabetes on the OGTT, you should apply lifestyle changes with diet and exercise. I don't believe you are in immediate trouble. However, I think it is important to make an early diagnosis of diabetes so that aggressive therapy can be initiated from the start.

JTL

DTQ-20020127064902
Original posting 18 Feb 2002
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:30
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