Interpretation of glycosuria in the teenage diabetic patient

More than 700 insulin-dependent diabetic patients of both sexes and all ages have attended an education and stabilization course. Twelve adult females and four adult males were subsequently issued the means to monitor their blood glucose in their homes. Two of the adult females were pregnant, while the other 14 patients had one or more of the following: renal failure, an abnormal renal threshold, diabetic retinopathy, or continued and unexplained instability. A number of children were also issued Ames reflectometers. Eleven out of 13 male patients between the ages of 12 and 18 yr had no special difficulties except for a poor correlation between minor degrees of glycosuria and blood glucose estimations. One youth had a renal threshold of 17 mmol/L, while a recently diagnosed youth had a varying renal threshold. Eleven out of 17 teenage female diabetic patients had no correlation between urinary and blood glucose estimations with an apparant varying renal threshold being common. Four of these patients had a reflectometer on loan for 6--8 wk, but in three there was continued instability. Two others, who had continued use of home monitoring of blood glucose, had normoglycemia upon review. One of these patients had what appeared to be a varying renal threshold while unstable but a normal threshold with diabetic stability. Regardless of the cause of the disparity between blood and uninary glucose estimations, it appears that the unstable teenage female diabetic patient cannot rely upon urinalysis as a guide to insulin dosage.