Can we trust the positivity of semi-quantitative glucose measurement in the urine?

Year 2017, Volume: 34 Issue: 3, 161 - 164, 10.07.2018

Rukiye Nar , Bahattin Avci

Abstract

Objective: As known, when the blood glucose level exceeds the renal threshold value of 180-200 mg/dL begins to be excreted with urine. Spot urine analysis is easy to perform and an important test, with false positive or negative test results incompatible with the clinic. Our aim in this study is to investigate the relationship between glucose levels in different sample types with simultaneous measurements.

Material and Method: Simultaneous fasting serum glucose, HbA1c levels and urine glucose of 2375 patients were screened retrospectively from the hospital information system between June 1, 2015 and November 30, 2015. Fasting serum glucose was measured by enzymatic hexokinase method in biochemical autoanalyzer, HbA1c was measured by chromatographic method on HPLC and urine glucose was measured semi-quantitatively by urine autoanalyzer by strip glucose oxidase method.

Results: It was found that there was a medium-strong relationship between all three results. There was significant correlation between fasting serum glucose and HbA1c (r: 0.787, p <0.001) and the correlation between urinary glucose and fasting serum glucose and HbA1c were (r: 635, p <0.001) and (r: 533, p <0.001), respectively.

Conclusion: In our study, we indicated that there is a strong correlation between the glucose results of different types of samples that we use in our laboratory. The patient's concurrently measured HbA1c and fasting serum glucose results may be helpful to the laboratory specialist to avoid both false positives and false negatives.

Keywords

glucose, HbA1c, fasting serum glucose

References

• Altınısık M. 2010. Biochemical Approach to Carbohydrate Metabolism Disorders. ADÜ Tıp Fakültesi Dergisi. 11, 51–59
• American Diabetes Association. 2016. Classification and diagnosis of diabetes. In: 2016 Standards of Medical Care in Diabetes. Diabetes Care. 39, 13-22.
• Cersosimo E, Solis-Herrera C, Triplitt C. 2014. Inhibition of Renal Glucose Reabsorption as a Novel Treatment for Diabetes Patients. J Bras Nefrol. 36(1), 80–92
• Davies MJ, Williams DRR, Metcalf J, Day DL. 1993. Community screening for non-insulin-dependent diabetes mellitus: self testing for post-prandial glycosuria. Q J Med. 86, 677-684
• Englelgau MM, Narayan VKM, Herman WH. 2000. Screening for Type 2 diabetes. Diabetes Care. 23, 1563-1580.
• Friderichsen B, Maunsbach M. 1997. Glycosuric tests should not be employed in population screening. Journal of Public Health Medicine.19, 55-60.
• Herman WH, Fajans SS. 2010. Hemoglobin A1c for the diagnosis of diabetes: practical considerations. Pol Arch Med Wewn. 120, 37-40.
• Hillman N, Herranz L, Grande C, Vaquero PM, Pallardo LF. 2004. What is the relative contribution of blood glucose levels at different time points of the day to HbA1c in Type 1 diabetes? Diabet Med. 21, 468-470.
• Hu Y, Liu W, Chen Y, Zhang M, Wang L, Zhou H, Wu P, Teng X, Dong Y, Zhou Jw, Xu H, Zheng J, Li S, Tao T, Hu Y, Jia Y. 2010. Combined use of fasting plasma glucose and glycated hemoglobin A1c in the screening of diabetes and impaired glucose tolerance. Acta Diabetol. 47(3), 231-236.
• Karatoprak K, Uysal S, Akkılık ZS, Ercan M, Yılmaz FM. 2012. The Relationship Between Serum Biochemical Parameters And Glycaemic Control In Diabetes. Abant Med J. 1, 51-4
• Koenig RJ, Peterson CM, Kilo C, Cerami A, Williamson JR. 1976. Hemoglobin A1c as an indicator of the degree of glucose intolerance in diabetes. Diabetes. 25, 230-232.
• Lacher DA, Hughes JP, Carroll MD. 2005. Estimate of biological variation of laboratory analytes based on the Third National Health and Nutrition Examination Survey. Clin Chem. 51,450–452
• Mitchell R, Thomas SD, Langlois NE. 2013. How sensitive and specific is urinalysis ‘dipstick’ testing for detection of hyperglycaemia and ketosis? An audit of findings from coronial autopsies. Pathology. 45, 587-90
• Motor S, R Dokuyucu, F Sefil, MM Rifaioglu, Yengil E, Ulutas KT, Ahmet Taner Sümbül AT, Rızaoglu H, Ustun I, Gokce C. 2013. Relationship between Hba1c and blood glucose level in hemodialysis patients with diabetes mellitus. Dicle Medical Journal. 40 (4), 616-620
• Mundt L, Shanahan K. 2010. Chemical Analysis of Urine. Graff’s textbook of routine urinalysis and body fluids. 2nd ed. Goucher C, ed. Lippincott Williams & Wilkins 2010. Philadelphia, pp. 35-53
• Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ. 2008. Translating the A1C assay into estimated average glucose values. Diabetes Care. 31, 1–6
• Ogawa E, Urakami T, Suzuki J, Yoshida A, Takahashi S, Mugishima H. 2012. Usefulness of HbA1c to diagnose diabetes among Japanese children detected by a urine glucose screening program in the Tokyo Metropolitan Area. Endocr J. 59(6), 465-71.
• Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS, Lernmark A, Metzger BE, Nathan DM. 2011. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 57(6), 1–47
• Sacks DB. 2011. A1C Versus Glucose Testing: A Comparison A1C versus glucose testing: a comparison. Diabetes Care. 34, 518–523
• Shinozaki T1, Yamaoka K, Yano E. 1999. Validity of urinary glucose test for diabetes screening in workplace regular medical checkups. Nihon Koshu Eisei Zasshi. 46(9), 790-8
• Simerville JA, Maxted WC, Pahira JJ. 2005. Urinalysis: a comprehensive review. Am Fam Physician; 71, 1153–1162
• Urakami T, Kubota S, Nitadori Y, Harada K, Owada M, Kitagawa T. 2005. Annual incidence and clinical characteristics of type 2 diabetes in children as detected by urine glucose screening in the Tokyo metropolitan area. Diabetes Care. 28(8),1876-81.
• Wei OY, Teece S. 2006. Best evidence topic report. Urine dipsticks in screening for diabetes mellitus. Emerg Med J. 23(2), 138.
• World Health Organization. 2003. Screening for Type 2 Diabetes: Report of a WHO/IDF Meeting. WHO/NMH/MNC/03.1. Geneva
• Yokota Y, Kikuchi N, Matsuura N. 2004. Screening for diabetes by urine glucose testing at school in Japan. Pediatric Diabetes. 5, 212-218
• Young DS, Bermes EW. 2006. Preanalytical variables and biological variations. In Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis CA, Ashwood ER, Bruns DE, Eds. St. Louis, Elsevier Saunders, pp. 449–473