Basal glucosuria is ubiquitous in critically ill patients

Abstract

The 'renal threshold for glucose' has never been evaluated in critically ill patients. Therefore, we aimed to investigate the renal glucose threshold in this patient group using high-sensitivity urine glucose assays. In this retrospective analysis of prospectively collected data, we analysed 100 consecutive critically ill patients from a medical intensive care unit (ICU). Arterial blood glucose and spot urine glucose were simultaneously quantified daily during the first week after ICU admission. Three hundred seventy-three pairs of blood/urine glucose were plotted in five pre-defined categories of blood glucose (<80, 80-109, 110-139, 140-179 and ≥180 mg/dL). Urine glucose values of the five categories were compared using the Kruskal-Wallis test to assess the relation with blood glucose. Urine glucose was detected in virtually all of the urine samples. Urine glucose showed a positive nonlinear correlation with blood glucose and was significantly elevated at blood glucose levels of 140-179 and ≥180 mg/dL compared with lower blood glucose ranges. Basal glucosuria is ubiquitous in critically ill patients. A 'soft' renal threshold for glucose is present at blood glucose levels in the range of 140-179 mg/dL.

Basal glucosuria in cats

“…Data of this study confirm that, as has already been shown in humans (Fine, ; Rave et al, ; Wolf et al, ; Brunner et al, ) and a small cohort of non‐diabetic obese cats (Hoenig, Clark, Schaeffer, & Reiche, ), glucosuria is present in euglycemic cats. With the use of a highly sensitive assay, the mean (± SD ) urinary glucose concentration was 0.46 (±0.32) mmol/L [8.25 (±5.76) mg/dl], which is very close to the 0.7 (±0.3) mmol/L [12.6 (±5.4) mg/dl] reported by Hoenig et al ().…”

“…Data of this study confirm that, as has already been shown in humans (Fine, 1965;Rave et al, 2006;Wolf et al, 2009;Brunner et al, 2015) and a small cohort of non-diabetic obese cats ( Hoenig et al (2018). Accordingly, the presence of small amounts of glucose in feline urine is by no means diagnostic for diabetes mellitus or renal glucosuria.…”

“…The most sensitive test strips currently validated for the use in cats give positive colour reactions at glucose concentrations of about 2.78 mmol/L (50 mg/dl, Defontis, Bauer, Failing, & Moritz, ). Several studies in healthy and sick humans have shown that glucose is virtually present in all urine samples (Apthorp, ; Brunner, Kurz, Adelsmayr, & Holzinger, ; Fine, ; Wolf, Rave, Heinemann, & Roggen, ). In 1965, Fine proposed to replace the term “glucosuria,” by the terms “normoglucuria” and “hyperglucuria.” In modern literature, the excretion of glucose at euglycaemic blood glucose concentrations and a normal tubular function is named basal glucosuria (Rave et al, ; Wolf et al, ).…”

Enzymatic assays for detecting lactose and sucrose in urine to reveal intravenous drug abuse with emphasis on buprenorphine

“…In the normal glycemic state, the amount of glucose in urine is relatively low, as it is mainly reabsorbed by the kidneys. Nevertheless, the renal threshold for glucose may be lowered due to a critical illness in addition to diabetes …”

“…Nevertheless, the renal threshold for glucose may be lowered due to a critical illness in addition to diabetes. [11] Interpretation of the results may also be complicated by diseases like coeliac disease and hypolactasia. [8] During these conditions intestinal damage leads to uncontrolled intestinal permeability which in turn increases the disaccharide concentration in the blood, and eventually in the urine.…”