Why does sugar appear in the urine of a child? Glucose in urine: what does it mean and what are the norms for analysis?
In the kidneys, glucose is filtered through the glomeruli. But, despite this, in the renal tubules, it is completely absorbed into the blood if the person is healthy. It follows from this that the healthy people glucose should not be found in urine. It may contain only insignificant remnants of it, which are not even detected during a biochemical or general analysis of urine.
Changes in glucose tolerance are observed in 12% of adult patients and 7% of pregnant women. However, it is estimated that about 50% of people with diabetes are unaware of the diagnosis. According to the international forecast, with the increase in sedentarism, obesity and an aging population, the number of people with diabetes in the world will increase by more than 50%, while 380 million people.
Diabetes mellitus was known before the Christian era. Referring to the sweet taste of urine, it was he who gave it the name diabetes mellitusalthough this fact was already recorded about a thousand years ago in India all year round. Frank, by that time, also classified diabetes in two ways: diabetes mellitus and tasteless, no sweet urine. The first necropsy observation of diabetics was made by Cowley and published in the London Medical Journal at about the same time that Englishman John Rollo, who attributed the illness to stomach ailment, achieved marked improvements with a high-protein, high-fat, carbohydrate-restricted regimen.
The concentration of glucose in the blood may indicate a health condition. The norm, the normal threshold for this indicator are numbers from 8.8 to 9.9 mmol / liter. If the amount of sugar in the blood rises, then the kidney tubules do not cope with their task and cannot return all glucose back to the blood.
As a result, glucose is present in the urine, and this condition is called glucosuria in medicine. With age, there is a gradual decrease in the set blood sugar threshold, and this rate can also decrease with various kidney diseases.
More recently, pancreatic transplantation has become a viable alternative to insulin for the treatment of diabetes. A later line of medical research attempted to transplant only the islets of Langerhans. The procedure is simple, has few complications, and requires a short hospital stay. The main problem is acquiring cells that come from corpses. To achieve a reasonable number of cells, an average of three donors are required.
Diabetes affects about 12% of the Brazilian population and 5% of the Portuguese population. Type 1 diabetes occurs at a lower incidence in black and Asian individuals and is more common in the European population, especially in the population from northern European regions. The incidence among the Japanese is about 20 times lower than among the Scandinavians. In São Paulo, the incidence of type 1 is 7.6 cases per thousand inhabitants.
Based on the above, the presence of sugar in urine is due to its increased content in the blood or a decrease in the renal threshold, in any case, the norm is violated. Doctors divide glucosuria into several forms:
- Alimentary glucosuria - it develops due to the consumption of food containing a lot of carbohydrates, which means that the blood sugar level rises for a short time.
- Emotional glucosuria - sugar can be determined in urine as a result of stressful situations.
- Extrarenal glucosuria is a pathological form in which glucose in the urine appears when its content in the blood rises.
Also, sometimes sugar in the urine can be retained during pregnancy in women.
Diabetes mellitus occurs all over the world, but is more common in more developed countries. Currently, the largest increase is expected in Asia and Africa, where most diabetics will be seen. The rise in the incidence of diabetes in developing countries follows the trend of urbanization and changes in lifestyle.
Diabetes is among the 5 highest deaths in the world, and it is getting closer and closer to the top of the list. For at least 20 years, the number of diabetics in North America has been on the rise. According to the American Diabetes Association, about 2 million people with undiagnosed medical conditions and about 41 million people may be considered pre-diabetic.
The detection of glucose in urine tests can be associated with many reasons. For example, this happens in diabetes mellitus, and here the sugar rate already indicates a disease. In this case, sugar in the urine is determined in patients even with a rather low concentration in the blood.
Most often this can happen with insulin-dependent diabetes mellitus. In the renal tubules, the absorption of sugar into the bloodstream can be carried out only when exposed to a special enzyme called hexokinase (a phosphorylation process occurs).
Depending on the cause, diabetes can be classified as. Increased thirst is one of the symptoms of hyperglycemia. The classic triad of diabetes symptoms. Other important symptoms include. When the concentration of glucose in the blood is high, the reabsorption of glucose in the proximal channel of the kidney is incomplete, and part of the glucose is excreted in the urine. This increases the osmotic pressure of urine and therefore inhibits the reabsorption of water by the kidney, resulting in increased urine production and marked fluid loss.
The amount of lost blood will be osmotically recovered from the water stored in the cells of the body, causing dehydration and increased thirst. When high levels glucose remains for a long period of time, glucose causes damage to the retinal circulatory system, resulting in visual difficulties known as diabetic retinopathy. Blurred vision is the most common complaint that leads to the diagnosis of diabetes; type 1 should be suspicious in cases of rapid vision changes, while type 2 usually causes more gradual changes.
But in diabetes, this enzyme can only be activated with the help of insulin. This is why the kidney threshold is usually lowered in type 1 diabetics. If sclerotic processes are developing in the kidney tissues, then even with a high level of glucose in the blood, it will not be detected in the urine.
Sugar in the urine can also appear as a result of acute pancreatitis. Also, a number of other diseases can lead to the appearance of glucose in the urine.
Patients may also develop diabetic ketoacidosis, an extreme state of metabolic dysregulation characterized by the smell of acetone in the patient's breath, Kusmaul breathing, polyuria, nausea, vomiting and abdominal pain, and alteration of any state of consciousness. In severe diabetic ketoacidosis, a coma may occur that progresses to the pillow. In any case, diabetic ketoacidosis is a medical emergency and requires special attention. Rare but the same serious condition - This is not a ketotic hyperosmolar coma, which is more common in type 2 diabetes and is mainly the result of dehydration due to loss of body fluids.
Glucosuria of central genesis can occur as a result of tumor processes in the brain, meningitis, hemorrhagic stroke, encephalitis, traumatic brain injury.
Endocrine glucosuria is a consequence of increased production of thyroxine, growth hormone, glucocorticosteroids and adrenaline. Febrile glucosuria is caused by diseases accompanied by fever.
Often the patient swallowed large quantities of sugar-sweetened beverages, leading to dehydration due to fluid loss. The predominant symptoms are mental confusion, anxiety or lethargy, sweating, and loss of consciousness. You should try first oral administration sweet solution, but not possible, should be treated as an emergency medical assistance and get glucagon medication, or intravenous administration glucose.
The term diabetes usually refers to diabetes mellitus, but there are many other more rare conditions also called "diabetes". This diabetes can be caused by damage to the kidneys or pituitary gland. Complications caused by diabetes are mainly due to excess glucose in the blood, so there is the possibility of glycosylating proteins in addition to retaining water in the bloodstream and removing it from the extracellular space.
In addition, poisoning with certain substances (morphine, chloroform, phosphorus or strychnine) develops toxic glucosuria, and with a decrease in the renal threshold, renal.
Also distinguish between primary and secondary glucosuria. The first type develops when the rate of glucose falls in the blood or its absence. Secondary can be caused by nephrosis, pyelonephritis, acute renal failure, and hence, Gierke's disease.
Treatment is based on five concepts. It is extremely important to educate the patient, monitor their diet, exercise, and monitor their glucose levels in order to maintain adequate and long-term glucose levels. Careful monitoring is essential to reduce the risks of long-term complications.
This can be achieved through a combination of diet, exercise and weight loss, various oral diabetic drugs and insulin use. In addition, due to the high associated risk of cardiovascular disease, lifestyle changes are necessary to control blood pressure and cholesterol, exercise more, smoke less and consume diabetic foods, and, if necessary, take blood pressure medications.
The indicator of the amount of glucose in the urine is very important, as well as its rate, because it can indicate the presence of enough serious illnesses in both men and women. Therefore, if sugar was found in a person's urine, he urgently needs to seek medical help.
Reasons for detecting glucose in urine
Sugar in urine can appear due to a variety of diseases. The main reasons for this phenomenon are an increased concentration of glucose in the blood, a disturbed filtration mechanism by the kidneys, or a delay in the reabsorption of glucose in the tubules.
Brazilian Diabetes Bill
Treatment of type 2 diabetes mellitus with surgery. People with diabetes are eligible for a range of benefits already provided by law for other conditions. This offer also entitles diabetics to free use of public transport. The Brazilian government has invested $ 200 million in an industrial unit in Brasilia to produce insulin crystals, the only one in Latin America.
Patients with impaired glucose tolerance and impaired fasting blood glucose should be on a strict diet without physical activity at least 3 times a week, and if necessary and approved, use medication to avoid complications. Physical activity, strict diets and weight loss among at-risk groups reduce the risk of developing type 2 diabetes in half.
For a more accurate determination of the most common reasons for the presence of glucose in urine, it is necessary to highlight the diseases that affect its appearance.
First of all, these include:
- diabetes mellitus, sometimes,
- severe liver pathologies,
- hyperthyroidism,
- as well as acute poisoning with chloroform, carbon monoxide, phosphorus or morphine.
In addition, glucosuria develops with irritation of the sensitive endings of the central nervous system due to hemorrhages in the brain, traumatic brain injury, seizures of epilepsy or acute encephalitis.
Practicing exercise brings benefits such as better oxygen utilization by the body, increased glucose uptake by the muscles, and increased sensitivity of cells to insulin from the first weeks and lasts as long as they are regular. With more effective use a person with diabetes will need smaller doses of insulin to burn extra glucose.
In people with prior type 2 diabetes, using low doses and an approximately 66% reduction in the risk of developing diabetes and causing little side effects... Risk factors for type 1 diabetes can be identified using autoantibodies against multiple pancreatic antigens. There is a significant correlation between the presence of two or more autoantibodies and the development of diabetes, even in individuals without diabetic relatives. Treatment with immunosuppressive drugs such as azathioprine, corticosteroids, and cyclosporine can reduce the required insulin replacement dose, but they are not effective in the long term and when they stop using immunosuppressants, in addition to causing side effects.
Among the main reasons should also be called pathological processes in the renal tubules or glomeruli that occur during acute infectious diseases, glomerulonephritis, interstitial nephritis both in the stronger sex and in women.
Glucose in urine in children
If sugar is detected in the child's urine, then this should be regarded as a very alarming symptom, since it is more dangerous than when the rate of blood glucose rises.
Scientists at the University of Maryland have discovered a protein called zonulin, which is produced in large quantities in people with autoimmune diseases... This overproduction leads to a chain of reactions to destroy beta cells. The researchers tested a substance in rats that inhibits the action of zonulin, preventing the progression of damage to the beta cells of the pancreas.
The better the control, the lower the risk of complications. Thus, patient education, understanding and participation is vital. Health care professionals who treat diabetes also try to educate the patient to get rid of certain habits that are harmful to diabetes. These include snoring, sleep apnea, smoking, high cholesterol, obesity, high blood pressure, and a sedentary lifestyle.
A high concentration of glucose in urine in children has its own reasons and may indicate pathological conditions. endocrine system, therefore, in such a situation, it is imperative to consult a doctor (endocrinologist).
Also, childhood glucosuria can occur with diseases of the kidneys or pancreas, and in some cases it can be and which will manifest itself very clearly.
It is recommended that you maintain a healthy weight and do at least 3 hours of exercise per week, not eating too much fat, and eating a good amount of fiber and grains. Although doctors do not recommend drinking alcohol, research shows that moderate alcohol consumption can reduce your risk.
This is the most frequent questioning of owners of dogs affected by the condition at the time of diagnosis. The stories they tell when they arrive at the veterinary office are very similar: the animal is very hungry, eats well, but loses weight, drinks a lot of water and urine. Some reports of ants collecting in urine have been made outside or in the yard. In more difficult cases, the animal shows weakness, apathy and vomiting.
In some situations, a urine test in children can give false results, for example, the reasons are that the child had previously undergone a long course of antibiotic treatment, ate a lot of sweets on the eve of the tests, or took a large amount of vitamin C. Therefore, with such results, the doctor must first exclude all possible errors and, if necessary, send for a retake of the analysis.
Diabetes mellitus occurs when a dog's body produces insufficient insulin or doesn't process it properly. Without enough insulin, glucose cannot enter cells and build up in the blood. The diagnosis can be confirmed by a blood test that detects high blood glucose levels and urine tests with the presence of glucose. In more severe or decompensated cases, ketone bodies are present, which are toxic compounds formed after the body tries to supply the energy deficit caused by illness.
Symptoms of the disease
In both men and women, the norm, as well as glucose values, can be different depending on age, diet, lifestyle and many other factors. If an increase in sugar is observed once, then you should not worry, but you need to retake the analysis.
With a high sugar content in urine, the following symptoms occur:
- - a strong feeling of thirst;
- - constant desire to sleep;
- - unexpected weight loss;
- - frequent urge to urinate;
- - irritation and itching in the genital area;
- - feeling tired;
- - dry skin.
If at least one of these signs occurs, then it is necessary to go to the hospital, undergo an examination and identify a diagnosis, to clarify what is the norm of sugar in men and women.
How is the presence of sugar in urine determined?
For the study, you will need to collect morning urine in a clean, dry glass jar. The volume of the material must be at least 150 milliliters.
This container must be closed with a lid and delivered in this form to the laboratory. Before collecting urine, the perineum must be rinsed with warm water and neutral soap. This must be done so that microorganisms that very quickly decompose glucose do not get into the urine. That is why it is important to make sure that there are no foreign impurities in the urine delivered to the laboratory.
And you also need to try to bring the material for analysis no later than six hours after collection.
Sometimes it is required to conduct a study of daily urine. This means that during the day, urine is collected in a dry dark glass container. This analysis allows you to obtain expanded and more accurate information about the concentration of glucose in urine. But in the laboratory, out of the total amount of material for research, only 150 milliliters are taken, with which further actions are carried out.
The analysis is carried out by oxidation with glucose oxidase. For research, take a paper strip of Glucotest and immerse it in urinary fluid for 2 seconds. The yellow strip should be completely wetted. After two minutes, the result appears. It is assessed by the degree of coloration on indicator paper. If glucosuria exceeds 2%, then the color intensity remains unchanged.
Guinness test;
A complex process that uses copper sulfate, sodium hydroxide and glycerin. Analysis: urine is added to the ready-made reactive composition, the color changes to bluish. The top of the tube is placed over the burner until the liquid boils. If there is sugar in the urinary secretions, the tint turns yellowish.
The sample can give false readings if protein and glucose are present in the urine. Protein compounds are preliminarily removed by acidifying the secretions with acetic acid. Then, after bringing to a boil, the protein precipitate is filtered off.
Althausen colorimetric method;
When the sweet substance is heated together with the alkali, a color reaction is also formed. The urine is boiled with caustic soda for a minute. After 10 minutes, you can compare the values \u200b\u200bwith a color scale that determines the percentage of sugar substance.
There is also a modified method. He does not need scarce reagents. It is carried out very quickly. Before analysis, urine with a high sugar concentration (more than 4%) is diluted.
Reaction with orthotoluidine;
When the temperature rises, the sugar substance, together with the reagent, is colored in proportion to its concentration in urinary secretions. The urine is diluted and mixed with orthotoludine in a test tube. Then it is placed in a water bath and held for eight minutes. After cooling, the liquid is colorimetric with an orange light filter (FEC wavelength 600 nm). If the collected material contains protein, it does not affect the performance.
Polarimetric method;
A saccharimeter is used, which, using polarized light and a special solution with immersed glucose, provides reliable data for the diagnostic procedure. It is important to note that the performance is negatively affected by tetracyclines and protein. If the urinary discharge is cloudy, an adsorbent is used. The angle of deflection of the polarized beam corresponds to the percentage of glucosuria in the urine.
Test strips for express diagnostics of sugar in urine
Disposable glucosuria strips can be used for both home and stationary urine tests. They are well suited for diabetic patients and people with impaired fatty acid metabolism.
Sensor test strips that have a backing chemical reagent, give indicative results. They are not definitive diagnostic methods. But they are suitable for patients to quickly identify an increased sugar concentration. Thus, a person understands whether he needs to change his diet or take medication. The test strips are independent of the presence of ketones or acetone in urine.
There are many manufacturers who make plastic test strips. They are sold in special containers. The composition of the reactive layer is different:
- Peroxidase;
- Tetramethylbenzidine;
- Glucose oxidase.
If sugar is found in the urine, the test strip is colored. If not, its original color will remain. The hue, with a positive reaction, changes to dark blue or dark green. It takes one minute to determine the results.
The indicators are negatively affected by the following factors:
- Medicines;
- High concentrations of ascorbic acid;
- Gentisinic acid;
- Remaining detergent in the urine collection container.
The rapid test for glucosuria is carried out at a temperature of 15 to 30 0 C. Do not touch the sensor strip with your fingers or any other objects, it must remain sterile until immersed in the discharge. The strip removed from the jar does not have an unlimited period of validity. It should be used within an hour. For some manufacturers, the time period has been extended to a day.
For the analysis, take the morning mixed urine in such an amount that the indicator is completely immersed in the liquid. The minimum height is 5 mm.
