Glycosuria in organophosphate and carbamate poisoning

Puzzled by the observation of occurrence of transient glycosuria in several patients admitted with organophosphate and carbamate compound poisoning, we undertook a critical analysis of this observation.

Of the fifty-one consecutive patients admitted to the intensive care unit with organophosphate and carbamate compound poisoning, in 23 subjects the nature of the compound consumed was known; these were studied. The occurrence and duration of glycosuria, its magnitude, associated hyperglycemia if any, and correlation thereof were recorded.

Sixteen out of the 23 subjects (69%) demonstrated transient glycosuria. There were 13 men and 10 women. 10 subjects had euglycemia associated with glycosuria; 6 subjects had transient glycosuria with hyperglycemia (defined as random glucose over 160 mg%). None of the subjects had diabetes mellitus and the pre-hospital-discharge blood sugars were in the normal range.

Glycosuria (renal), albeit transient, was noted in a proportion of subjects admitted with organophosphate and carbamate poisoning. The exact etiology of this is unclear but in the light of recent literature, it is likely that oxidative stress at the renal tubular level leading to renal tubular damage may be the most likely explanation. Further, larger studies are needed to elucidate this is detail.