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Question:

From New York City, USA:

During a recent pediatrician visit due to a virus with high fever, my son's urine had some glucose in his urine. The doctor sent him for a which was normal, so the pediatrician told me I shouldn't worry about it. However, have read elsewhere that glucose in the urine is a sure sign of diabetes (Parents Magazine, July 2002.)

Previously, my son had blood in his urine, but after an ultrasound and a dye test, I was told not to worry about it. Are these signs of serious problems? Should I truly forget about it?

Answer:

What you ask is sometimes a real clinical problem, i.e., the correct interpretation of a positive test for urinary glucose in an apparent healthy subject. For clinical purposes, a massive glycosuria means diabetes while a trace of glucose on routine urinalysis may or may not be significant.

If fasting and postprandial blood sugar level were confirmed to be fine and a repeated routine urinalysis has given a negative result for glucose in the urine, I think you shouldn't to wrack your brain any longer.

MS

[Editor's comment: Testing for diabetes should include blood sugar levels performed by a medical laboratory. The timing of the sample (fasting, random, or postprandial) would influence how high a level is considered abnormal. See Classification and Diagnosis of Diabetes Guidelines for further information.

Occasionally, lab blood sugar testing might be normal in an early case of diabetes, repeat blood sugar testing at the same or a different time, or performing a glucose tolerance test, might be appropriate if there is a high suspicion of diabetes despite normal initial testing. Another test, the glycosylated hemoglobin, might be used to help confirm a suspected diagnosis of diabetes, but the GHB (also called HbA1c or A1c) is not usually considered as appropriate to make an initial diagnosis. Antibody testing is occasionally done as a screening test in high-risk situations, or as confirmatory of type type 1A (autoimmune) diabetes, but is not part of routine testing.

Urine sugar tests or home glucose testing, if done, might be positive, which would make the situation more urgent to get lab testing done to confirm the abnormal results (as Dr. Songini hopes has already been done for your son). However, urine or home glucose testing, if negative, would not exclude diabetes. SS]

DTQ-20020719134600
Original posting 26 Aug 2002
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:38
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