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[Urine glucose testing in children with diabetes mellitus--obsolete as a daily control measure?]
1Abteilung Allgemeine Pädiatrie der Universitäts-Kinderklinik Tübingen.
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Home urine sugar testing for children with type 1 diabetes is inadequate for monitoring treatment. Results from home urine glucose tests showed poor correlation with blood glucose levels, making them unreliable for therapeutic decisions.
Area of Science:
- Pediatrics
- Endocrinology
- Clinical Chemistry
Background:
- Type 1 diabetes management in children requires accurate glucose monitoring.
- Home-based testing methods are convenient but require validation.
Purpose of the Study:
- To evaluate the accuracy of home urine glucose monitoring in children with type 1 diabetes.
- To compare home urine glucose results with laboratory blood glucose assays.
Main Methods:
- Sixty-four children with type 1 diabetes performed home urine glucose testing.
- Home test results were compared with laboratory glucose dehydrogenase assays.
- Urine glucose levels were correlated with simultaneous blood glucose measurements.
Main Results:
- Home urine glucose testing showed significant disagreement with laboratory results.
- Correlation between urine and blood glucose levels was poor (0.3-0.64).
- Urine sugar testing was deemed unsatisfactory for home monitoring.
Conclusions:
- Urine sugar testing is not a reliable method for home monitoring of type 1 diabetes in children.
- Current home urine testing methods provide inadequate data for diagnostic or therapeutic purposes.
Abstract:
Sixty-four children with type 1 diabetes (33 girls and 31 boys with a mean age of 11 1/4 years) were studied in order to ascertain whether urine sugar measurements performed by the patients or their parents can provide adequate monitoring of treatment. The results of two home-testing methods for urine glucose were compared with subsequent glucose dehydrogenase assays in the laboratory. Over the range from 0 to 5 g/dl the results of home testing disagreed with the laboratory checks by an average of one concentration grade, and displayed wide scatter. Only in the concentration range of 0.5 g/dl were there differences between the nonspecific reduction test (Clinitest) and the specific enzymatic assay. Glucose concentrations in urine specimens passed at 7 am, 12 noon and 6 pm (home testing) were compared with blood glucose concentrations checked at the same times. Correlation was not very close (correlation coefficients between 0.3 and 0.64). Correlation between pooled urine collections and 24 hour blood sugar profiles was equally poor (0.5-0.6). The author concludes that urine sugar testing is unsatisfactory for home monitoring of children with diabetes and the results are inadequate for diagnostic or therapeutic purposes.