“Sugar in the urine” - so colloquially called glucosuria. This term refers to the appearance of glucose in urine, which is determined in an analysis of urine on an empty stomach. By itself, this condition is not a disease, but only a secondary symptom of a number of diseases and pathological processes that occur in the body. The presence of glucose in the urine is an indication for further examinations in order to identify the causes of impaired kidney function.
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What glucose shows in urine
The main functional purpose of the kidneys is blood filtration. With the help of this organ, various compounds (both beneficial and dangerous) are secreted from the blood, and then they are either excreted in the urine or filtered by the glomeruli of the kidneys and returned to the bloodstream. Glucose is one of those beneficial substances that go through reabsorption in the kidneys and are delivered back to the blood.
The presence of sugar in urine is an alarming signal, indicating either initially high glycemia or kidney pathology.
Urine glucose is the most important diagnostic criterion for determining diabetes.
Normal indicators and deviations
Normally, glucose in the urine is practically absent. Its quantity is so small that it is not detected by a general or biochemical analysis of urine. To accurately determine the presence of sugar in urine in a healthy person, one would have to do a daily urine test, which would show a minimum amount of glucose - not more than a few hundredths of a mmol in a liter of material.Deviation is any amount of sugar in a general or biochemical analysis of urine. If a routine analysis revealed glucosuria, the patient is prescribed several more examinations, including re-delivery of urine.
Types of Glucosuria
Doctors distinguish two main forms of glucosuria - physiological and pathological. Physiological glucosuria refers to the temporary release of glucose by the kidneys, associated with the characteristics of the physiological state of a person.
There are three types of such glucosuria:
- alimentary;
- emotional
- glucosuria of pregnant women.
Alimentary glucosuria refers to the presence of sugar in the urine against a background of high glycemia due to dietary features. The kidney has a so-called "renal threshold" - this is the maximum amount of glucose that can be reabsorbed by the kidneys.
If the amount of sugar in the blood greatly exceeds the metabolic capabilities of the kidneys, the organ ceases to cope with its function, and excess glucose is excreted in the urine.
The value of the "threshold" is individual for each person. Alimentary glucosuria is a temporary disorder associated with a sudden excess of the "renal threshold" due to the large amount of fatty and heavy foods. In case of emotional glucosuria, the presence of sugar in urine is caused by exceeding the “renal threshold” due to severe stress and emotional overstrain. Glucosuria during pregnancy appears due to increased renal blood flow and a decrease in the "renal threshold."
Pathological glucosuria occurs due to various disorders in the body, in particular the kidneys.
Her views:
- extrarenal;
- renal;
- iatrogenic.
Extrarenal glucosuria develops as a result of a significant increase in blood sugar (hyperglycemia). As a result, the kidneys simply can not cope with the reabsorption of glucose, so a significant part is excreted in the urine. Renal renal glucosuria is a rare pathology associated with a decrease in the "renal threshold." Iatrogenic glucosuria develops as a side effect of taking potent drugs.
Reasons for sugar increase
There are several main reasons for the allocation of sugar in the urine:
- high blood glucose;
- congenital decrease in the "renal threshold";
- severe stress, overwork, exhaustion;
- impaired functioning of the renal tubules;
- intestinal malabsorption of glucose and galactose;
- endocrine disorders;
- organic kidney disease.
In general, there are a lot of reasons for this phenomenon and not all of them are pathological. To determine the exact cause of the appearance of sugar in the urine is possible only after a comprehensive examination of the body. In addition, it is important to re-analyze urine to exclude a false-positive result, which is often noted with unbalanced nutrition and non-compliance with the doctor’s recommendation before analysis. So, too tight dinner and night snacks on the eve of the delivery of the material to the laboratory can lead to fluctuations in glucose in the blood, which will distort the results of a urinalysis.
What diseases does it indicate?
The presence of sugar in the urine is not a disease, but a secondary disorder caused by various pathologies and malfunctions of the body. In this regard, glucosuria is divided into primary and secondary.
In the vast majority of cases, doctors and patients are faced with secondary glucosuria, which can be a symptom of the following diseases:
- type 1 and type 2 diabetes;
- renal failure;
- kidney inflammation;
- pancreatitis
- meningitis;
- encephalitis;
- tumor neoplasms of the brain.
Detection of sugar in the urine is an occasion to do a glycemia test and check glucose tolerance, since a similar phenomenon is observed in diabetes mellitus. There are type 1 and type 2 diabetes. In the first case, the pathology is caused by insufficient production of insulin, in the second case, the blood sugar level rises due to metabolic disturbances.
Decompensated type 2 diabetes causes severe dehydration, thirst, dysuria and kidney glucose excretion.
Primary glucosuria is due to impaired renal function or a decrease in the "renal threshold." In the vast majority of cases, this pathology is hereditary and is accompanied by other congenital disorders in the work of the kidneys.
How to normalize glucose in urine?
To confirm glucosuria, you need to take another urine test for sugar. Usually 2-3 consecutive general or biochemical analyzes of urine and a study of the composition of daily urine are prescribed, and only then a diagnosis is made. In general, glucosuria alone does not require treatment. If diabetes mellitus is detected, treatment is carried out with insulin injections (for type 1 diabetes), or with a diet and sugar-lowering drugs (for type 2 diabetes).
Renal glucosuria is usually asymptomatic and does not cause discomfort. This violation does not require treatment, but continuous monitoring to timely detect deterioration of the kidneys. Physiological glucosuria is a temporary disorder that does not require treatment, except for a balanced diet and drinking regimen. In other cases, normal treatment of glucose helps to normalize the underlying disease that caused glucosuria.
Features of the analysis during pregnancy
Glucosuria of pregnant women can be both a consequence of the physiological state of a woman, and a symptom of gestational diabetes. The presence of sugar in the urine requires differential diagnosis with gestosis (late toxicosis of pregnant women) and diabetes mellitus. Therapy is aimed at preventing the leaching of potassium from the body, normalizing kidney function and lowering blood glucose levels through a balanced diet.
