Efficacy of urinary glucose for diabetes screening: a reconsideration

Previous studies indicated that urinary glucose (UG) had a limited efficacy in diabetes screening. This study was designed to have a re-evaluation of its efficacy, taking into consideration the collection method of urine and the measurement approach for UG among Chinese adults.

This cross-sectional study enrolled a total of 7689 participants without known diabetes, who were fasted and asked to empty bladders before a 75 g glucose loading. Urine was collected 2 h post glucose loading, and UG was measured using quantitative and qualitative approaches. The efficacy of UG in detecting diabetes was assessed by the receiver operating characteristic (ROC) curve.

The area under the ROC curve was 0.89 for quantitative UG and 0.87 for qualitative UG. Quantitative UG was positively correlated with fasting plasma glucose (FPG) and 2 h plasma glucose (2 h PG) (r = 0.55 and 0.56, respectively, both P < 0.001). Quantitative UG displayed a sensitivity of 82.9% and a specificity of 84.7% in detecting diabetes at the corresponding optimal cutoff of 130 mg. Qualitative UG exhibited a sensitivity of 80.2% and a specificity of 85.6% at the optimal cutoff of glycosuria + 1. In addition, the sensitivity of both quantitative and qualitative UG was significantly higher than that of HbA1c (≥ 6.5%) (P < 0.001) and had a comparable sensitivity to 2 h PG (≥ 11.1 mmol/L) (P = 0.493).

UG, either quantitatively or qualitatively measured at 2 h post glucose loading, was effective in diabetes screening. This indicates that UG is a feasible approach for diabetes screening.