Why does sugar appear in a child's urine? 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 kidney tubules it is completely absorbed into the blood if the person is healthy. From this it follows that healthy people glucose should not be found in the urine. It may contain only minor traces of it, which are not even detectable during biochemical or general analysis 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 an international forecast, with increasing sedentarism, obesity and an aging population, the number of people with diabetes in the world will increase by more than 50%, to 380 million.
Diabetes mellitus was known before the Christian era. Referring to the sweet taste of urine, he gave it its name diabetes mellitus, although 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, not representing sweet urine. The first observation made using autopsies of diabetics was made by Cowley and published in the London Medical Journal almost simultaneously with the Englishman John Rollo, who attributed the disease to gastric disease, achieving marked improvements with a regimen rich in protein and fat, limited in carbohydrates.
The concentration of glucose in the blood may indicate health conditions. 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 cannot cope with their task and cannot return all the glucose back into the blood.
As a result, glucose is present in the urine, and this condition is medically called glucosuria. With age, there is a gradual decrease in the established blood sugar threshold, and this norm can also decrease with various kidney diseases.
Later, pancreas transplantation became a viable alternative to insulin for the treatment of diabetes mellitus. 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. An average of three donors is required to achieve a reasonable number of cells.
Diabetes affects about 12% of the Brazilian population and 5% of the Portuguese population. Type 1 diabetes occurs at a lower frequency in black and Asian individuals and is more common in European populations, especially those from northern European regions. The frequency among Japanese is approximately 20 times lower than among 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 the 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:
- Nutritional glycosuria - it develops due to the consumption of food containing a lot of carbohydrates, which means that the blood sugar level increases for a short time.
- Emotional glycosuria - sugar can be detected in the urine as a result of stressful situations.
- Extrarenal glycosuria is a pathological form in which glucose appears in the urine when its content in the blood increases.
Also, sometimes sugar in the urine can be retained during pregnancy in women.
Diabetes mellitus occurs throughout the world, but is more common in more developed countries. Currently, the largest increase is expected in Asia and Africa, where the majority of diabetics will be seen. The rising incidence of diabetes in developing countries follows the trend of urbanization and changing lifestyles.
Diabetes is in the list of the 5 highest deaths in the world and it is getting closer and closer to the top of the list. The number of diabetics in North America has been rising sharply for at least 20 years. About 2 million people with undiagnosed conditions and about 41 million people may be considered prediabetic, according to the American Diabetes Association.
The detection of glucose in urine tests can be due to many reasons. For example, this happens in diabetes mellitus, and here the sugar level already indicates the disease. In this case, sugar in the urine is detected in patients even with a fairly 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 only occur when it is exposed to a special enzyme called hexokinase (a process of phosphorylation 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 blood glucose concentration is high, glucose reabsorption in the proximal kidney is incomplete, and some 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 volume of lost blood will be osmotically replaced from water stored in the body's cells, causing dehydration and increased thirst. When high levels glucose remains for a long period of time, glucose causes damage to the retinal circulatory system, leading to vision difficulties known as diabetic retinopathy. Blurred vision is the most common complaint that leads to a diagnosis of diabetes; type 1 should be suspicious in cases of rapid changes in vision, while type 2 usually causes a more gradual change.
But in diabetes, this enzyme can only be activated by insulin. This is why the renal threshold is usually lower in patients with type 1 diabetes. If sclerotic processes develop 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 on the patient's breath, Kusmaul breathing, polyuria, nausea, vomiting and abdominal pain and changes in any state of consciousness. In severe diabetic ketoacidosis, coma may occur, progressing to the pillow. In any case, diabetic ketoacidosis is a medical emergency and requires special attention. Rare, but the same serious condition- This is a non-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 origin can occur as a result of tumor processes in the brain, meningitis, hemorrhagic stroke, encephalitis, and traumatic brain injury.
Endocrine glucosuria is a consequence of increased production of thyroxine, somatotropin, glucocorticosteroids and adrenaline. Febrile glucosuria is caused by diseases accompanied by fever.
Often the patient would swallow large quantities of sugar-sweetened drinks, resulting in dehydration due to fluid loss. The predominant symptoms are mental confusion, restlessness or lethargy, sweating and loss of consciousness. You should try first oral administration sweet solution, but not be possible, should be considered as an emergency medical care and receiving glucagon medication or intravenous administration glucose.
The term diabetes usually refers to diabetes mellitus, but there are many other, rarer conditions also called "diabetes." This diabetes may be caused by damage to the kidneys or pituitary gland. Complications caused by diabetes are mainly caused by excess glucose in the blood, so there is the possibility of glycosylation of proteins in addition to water retention in the bloodstream and removal from the intercellular space.
In addition, when poisoning with certain substances (morphine, chloroform, phosphorus or strychnine), toxic glucosuria develops, and when the renal threshold decreases, renal glucosuria develops.
Primary and secondary glucosuria are also distinguished. The first type develops when the glucose level in the blood or lack thereof drops. Secondary can be caused by nephrosis, pyelonephritis, acute renal failure, and therefore 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 to maintain adequate and long-term glucose levels. Careful monitoring is necessary to reduce the risk of long-term complications.
This can be achieved through a combination of diets, physical exercise and weight loss, various oral diabetic drugs and insulin use. Moreover, due to the high associated risk cardiovascular diseases It is necessary to make lifestyle changes to control blood pressure and cholesterol, exercise more, smoke less and consume diabetic foods, and take medications to lower blood pressure if necessary.
The amount of glucose in the urine is very important, as is its norm, because it can indicate the presence of enough serious illnesses both men and women. Therefore, if sugar is found in a person’s urine, he needs to urgently seek medical help.
Reasons for detecting glucose in urine
Sugar in the urine may appear due to the most various diseases. The main reasons for this phenomenon are an increased concentration of glucose in the blood, a disrupted filtration mechanism by the kidneys, or a delay in the reabsorption of glucose in the tubules.
Diabetes bill in Brazil
Treatment of type 2 diabetes mellitus with surgery. People with diabetes are entitled to a number of benefits already provided by law for other diseases. The proposal also entitles diabetics to free use of public transport. The Brazilian government has invested $200 million to create 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 per week, and use medication when necessary and approved to avoid complications. Physical activity, crash diets and weight loss among at-risk groups cut the risk of developing type 2 diabetes in half.
To more accurately determine the most common reasons for the presence of glucose in the urine, it is necessary to identify 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 when the sensitive endings of the central nervous system due to cerebral hemorrhages, traumatic brain injuries, epileptic seizures or acute encephalitis.
The practice of exercise brings benefits such as better use of oxygen by the body, increased glucose uptake into muscles, and increased cellular sensitivity to insulin from the first weeks and lasts as long as they are performed regularly. With more effective use A person with diabetes will need smaller doses of insulin to burn the extra glucose.
In people with pre-existing type 2 diabetes, low doses reduce the risk of developing diabetes by approximately 66% and cause 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 immunosuppressants such as azathioprine, corticosteroids and cyclosporine can reduce the required dose of insulin replacement, but they have little effect in the long term and when they stop the use of immunosuppressants, in addition to causing side effects.
Among the main reasons, pathological processes in the renal tubules or glomeruli that occur during acute infectious diseases, glomerulonephritis, interstitial nephritis both among the stronger sex and among women.
Glucose in urine in children
If sugar is detected in a child’s urine, this should be regarded as a very alarming symptom, since it is more dangerous than when the blood glucose level 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 that destroy beta cells. Researchers tested a substance in rats that inhibits the action of zonulin, preventing the progression of damage to pancreatic beta cells.
The better the control, the lower the risk of complications. Therefore, patient education, understanding and participation are vital. Health care professionals who treat diabetes also try to educate the patient about breaking certain habits that are harmful to diabetes. These include snoring, sleep apnea, smoking, high cholesterol, obesity, high blood pressure and a sedentary lifestyle.
High concentrations of glucose in the urine in children have their own reasons and may indicate pathological conditions endocrine system Therefore, in such a situation, you should definitely consult a doctor (endocrinologist).
Also, childhood glucosuria can occur with diseases of the kidneys or pancreas, and in some cases this can be very pronounced.
It is recommended to maintain a healthy weight and get at least 3 hours of exercise per week, not consume too much fat, and eat a good amount of fiber and grains. Although doctors do not recommend drinking alcohol, research suggests that moderate alcohol consumption may reduce the risk.
This is the most common questioning of owners of dogs affected by this disease at the time of diagnosis. The stories they tell when they arrive at the veterinarian's office are very similar: the animal is very hungry, eating well but losing weight, drinking a lot of water and urine. Some reports of ants collecting urine are made outside or in the yard. In more complex cases, the animal exhibits weakness, apathy and vomiting.
In some situations, a urine test in children may 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 the day before the test, 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 occurs when a dog's body does not produce enough insulin or does not process it properly. Without enough insulin, glucose cannot enter cells and accumulate in the blood. The diagnosis can be confirmed by a blood test that detects high levels of glucose in the blood and a urine test that shows the presence of glucose. In more severe or decompensated cases, ketone bodies are present, which are toxic compounds formed after the body tries to provide for the lack of energy caused by the disease.
Symptoms of the disease
For both men and women, the norm, as well as glucose levels, may vary depending on age, diet, lifestyle and many other factors. If an increase in sugar is observed once, then there is no need to worry, but you need to retake the test.
When there is a high sugar content in the urine, the following symptoms occur:
- - strong feeling of thirst;
- - constant desire to sleep;
- - unexpected weight loss;
- - frequent urge to urination;
- - irritation and itching in the genital area;
- - feeling tired;
- - dry skin.
If at least one of these signs occurs, then you need to go to the hospital, undergo an examination and identify a diagnosis, clarify what the sugar norm is for men and women.
How to determine the presence of sugar in urine
For the study, you will need to collect morning urine in a clean, dry glass jar. The volume of material must be at least 150 milliliters.
This container must be closed with a lid and delivered to the laboratory in this form. Before collecting urine, the perineum must be washed with warm water and neutral soap. This must be done so that microorganisms that very quickly decompose glucose do not get in with the urine. That is why it is important to ensure that there are no foreign impurities in the urine delivered to the laboratory.
You should also try to bring the material for analysis no later than six hours from the moment of collection.
Sometimes it is necessary to conduct a 24-hour urine test. This means that throughout 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 the urine. But in the laboratory, out of the total amount of material, only 150 milliliters are taken for research, 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 wet. After two minutes the result appears. It is assessed by the degree of color on indicator paper. If glucosuria exceeds 2%, then the color intensity remains unchanged.
Gaines test;
A complex process that uses copper sulfate, sodium hydroxide and glycerin. Carrying out the analysis: urine is added to the finished reactive composition, the color changes to bluish. The top of the test tube is placed over the burner until the liquid boils. If there is sugar in the urine secretions, the color turns yellowish.
The test may give false readings if protein and glucose are present in the urine. Protein compounds are first removed by acidifying the secretions with acetic acid. Then, after bringing to a boil, the protein precipitate is filtered off.
Althausen colorimetric method;
When a sweet substance is heated together with an alkali, a color reaction is also formed. The urine is boiled with caustic soda for a minute. After 10 minutes, you can compare the indicators with a color scale that determines the percentage of sugar substance.
There is also a modified method. It does not require scarce reagents. It happens very quickly. Before analysis, urine with high concentration sugar (more than 4%) is diluted.
Reaction with orthotoluidine;
When the temperature rises, the sugar substance, together with the reagent, becomes colored in proportion to its concentration in the urinary secretions. 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 colorimeterized with an orange filter (FEK 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 indicators are negatively affected by tetracyclines and protein. If the urine discharge is cloudy, use an adsorbent. The deflection angle of the polarized beam corresponds to the percentage of glucosuria in the urine.
Test strips for express diagnostics of sugar in urine
Disposable strips for determining glucosuria can be used for both home and inpatient urine testing. They are well suited for patients with diabetes and people with impaired fatty acid metabolism.
Touch test strips that have a backing chemical reagent, give indicative results. They are not unconditional diagnostic methods. But they are suitable for patients to quickly detect increased sugar concentrations. Thus, a person understands whether he needs to change his diet or take medications. Indicator strips do not depend on the presence of ketones or acetone in urine.
There are many manufacturers that produce indicator plastic strips. They are sold in special containers. The composition of the reactive layer varies:
- Peroxidase;
- Tetramethylbenzidine;
- Glucose oxidase.
If sugar is detected in the urine, the test strip will be colored. If not, its original color will remain. With a positive reaction, the hue changes to dark blue or dark green. It takes one minute to determine the results.
The following factors negatively affect the indicators:
- Medicines;
- High concentrations of ascorbic acid;
- Gentisin acid;
- Residues of detergents in the urine collection container.
A rapid test for glucosuria is carried out at a temperature of 15 to 30 0 C. You cannot touch the sensor strip with your fingers or any other objects; it must remain sterile until immersed in the secretions. A strip removed from a jar does not have an unlimited validity period. It must be used within an hour. For some manufacturers, the time period has been increased to a day.
To carry out the analysis, take morning mixed urine in such a quantity that the indicator is completely immersed in the liquid. The minimum height is 5 mm.
