Glycosuria and Diabetes Mellitus


Glycosuria and Diabetes Mellitus:

In addition to diabetes, many kidney diseases, endocrine and metabolic diseases and other stress factors can also cause diabetes

  1. Renal glycosuria: congenital anomalies or acquired diseases of the kidney can reduce the renal glucose threshold. Even if the blood glucose is not high, glycosuria can also occur.
  2. Hepatogenic glycosuria: various serious liver diseases, with obvious impairment of liver function, can not convert glucose into liver glycogen for storage, and appear postprandial glycosuria and abnormal glucose tolerance.
  3. Endocrine and metabolic diseases can cause abnormal glucose tolerance and glycosuria: the common ones are hyperthyroidism, hypercortisolism, gigantism and acromegaly, pheochromocytoma, glucagon tumor, etc., and the serious ones can have secondary diabetes.
  4. Nourishing glycosuria: some factors lead to rapid absorption of glucose in food after eating, and blood glucose rises significantly. When it exceeds the renal glucose threshold, glycosuria can occur. For example, dumping syndrome after gastroduodenojejunostomy, etc., but some nourishing glycosuria may be the manifestation of early diabetes, which should be paid attention to by patients and their families.
  5. Stress glycosuria: under certain stress conditions, such as cerebrovascular disease, trauma, surgery, etc., a large amount of adrenal glucocorticoid secretion can increase by more than 10 times, and antagonize the normal physiological function of insulin, so that blood glucose increases, and urine glucose occurs. Some patients have no obvious symptoms in the early stage of diabetes, and can become typical clinical diabetes under stress.
  6. Gestational diabetes mellitus: some women have reduced renal glucose threshold during pregnancy, may have a small amount of diabetes mellitus, which can return to normal after delivery, and should be differentiated from gestational diabetes mellitus.
  7. Non glucose glycosuria: most of them are congenital genetic diseases, such as galactonuria, fructonuria, pentosuria, etc. generally, the existing urine glucose determination methods are not easy to detect these substances, so the urine glucose qualitative is mostly negative, while ban reagent can detect some of the above substances, showing a positive response, also known as pseudoglycosuria.
  8. Pseudoglycosuria: in addition to the above factors, vitamin C, salicylic acid, etc. can cause false positive reaction in urine.

Because urine sugar test paper is often used to detect urine sugar, the method used is glucose oxidase method. Generally, false positive reaction can be avoided.

Primary and secondary diabetes

  1. Primary diabetes mellitus. Generally speaking, the commonly referred to diabetes mellitus is primary diabetes mellitus. The etiology and mechanism of this group of diabetes mellitus are not completely clear, so the word “primary” is used in medicine, including type 1, type 2 and gestational diabetes mellitus.
  2. Secondary diabetes. According to the latest etiological classification principle recommended by who, this type of diabetes is specific, which means that there are specific causes of disease, including 8 factors: pancreatic islets β Cell function gene deletion; Gene deletion of insulin action; Pancreatic diseases (pancreatitis, tumor, cystic fibrosis, trauma or surgery, etc.); Endocrine disease, similar to the factors causing the above-mentioned diabetes; Drugs or chemical poisons; Infection; Uncommon immunomodulatory diabetes; Other genetic diseases are accompanied by diabetes. This group of diabetes is caused by a specific primary disease, which is a secondary manifestation of the primary disease, so the word “secondary” was usually used in the past.

At present, the concepts of “primary diabetes mellitus” and “secondary glycogen disease” have rarely been applied in the etiological classification of diabetes.

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