Urine Glucose Concentrations Research Articles

Rapid, automated measurements of urinary protein and glucose concentrations

Procedures are described for the quantitative determination of urinary protein and glucose concentrations using assay methodologies that are readily automated. Glucose was measured by the hexokinase method and protein by interaction with the dye Coomassie Brilliant Blue C-250. Both assays can be performed with a centrifugal analyzer. The linear range for the glucose assay was 10–500 mg dl , encompassing the normal range of 10–30 mg dl for glucose in rat urine. The linear range for the protein assay was 5–45 mg dl , necessitating dilution of the urine (normal range for rats of 100–400 mg dl ) by a factor of 10. As with many other protein assay methodologies, response to gamma globulins was less than that to albumin. The procedures described herein require only minute quantities (5–10 μl) of sample and are sufficiently simple and rapid to be used as screening procedures. Moreover, they provide quantitative results and are more sensitive than many of the more commonly used diagnostic tests for urine protein and glucose.

Pathophysiologic evidence of gentamicin nephrotoxicity in neonatal puppies.

Newborn puppies were paired (n = 21 pairs) at birth, given gentamicin (5 mg/kg/day for 7 days and the 7.5 mg/kg/day) or saline intramuscularly (IM) and studied at 10, 20, or 30 days of age. Peak gentamicin concentrations correlated neither with total body water nor extracellular fluid volume. The ratio of outer/inner cortical gentamicin concentrations increased with therapy (n = 0.579; P < 0.01). Pathologic changes in proximal tubular cells of superficial and juxtamedullary cortices corresponded to tissue accumulation of gentamicin. Inulin clearance was lower but not statistically different in gentamicin puppies at 20 and 30 days, but tubular reabsorption of phosphate was lower at 30 days (P < 0.02). Plasma creatinine decreased during the first month of life in both control and gentamicin puppies (n = -0.370; P < 0.02) and was not different between puppies even at 20 and 30 days when tubular damage was marked. No differences in urine sediment, osmolarity, glucose, and protein concentrations were noted between paired animals. Mean values of gentamicin half-life in gentamicin (control) puppies decreased from 80.3 (84.0) min at 10 days to 45.3 (50.3) min at 20 days, but increased to 61.0 (40.0; P < 0.05) min at 30 days. Similar studies in older puppies and adult animals given gentamicin resulted in an increase in plasma creatinine and gentamicin half-life within 10 days. Results of these studies confirmed that gentamicin nephrotoxicity occurred within 10 days in puppies treated from birth. The relative tolerance of the neonatal puppy to the toxic effects of gentamicin was attributed to the distribution of renal blood flow predominantly to juxtamedullar nephrons at birth which spared superficial nephrons from gentamicin accumulation and toxicity until renal blood flow was redistributed to the outer cortex and filtration in superficial nephrons began after the first wk of life.

Use of Clinitest Urine test for Indirect Estimation of Blood Glucose Levels in the Critically III

The use of the Clinitest urine glucose test as an indirect way to monitor and control blood glucose levels in critically ill patients was studied. Part 1 of the study was a review of 16 patients records to determine the correlation between 348 paired Clinitest readings and blood glucose levels. Part 2 was a study of six patients from whom a total of 83 arterial blood samples were obtained, each followed 15 minutes later by a urine sample that was tested quantitatively by autoanalyzer and qualitatively by Clinitest. In Part 1, only 43% of the paired readings were within clinically acceptable levels. In Part 2, there was an 11% error rate between quantitative urine glucose values and the corresponding Clinitest results, and the relationship between arterial and urine glucose concentrations was unpredictably variable. The study indicates that both Clinitest error and a variable relationship between arterial and urine glucose concentrations make the use of Clinitest as the sole monitor and basis for controlling blood glucose levels in critically ill patients as unsatisfactory and potentially dangerous procedure.

24-hour metabolic profiles in diabetic children.

15 metabolic profiles were performed on 10 diabetic children who were on once-daily injections of insulin. Blood and urine glucose concentrations were high throughout much of the day and night, and were associated with abnormal levels of blood ketones, lactate, and pyruvate. The plasma free-insulin profiles gave a characteristic pattern for each type of insulin. The investigation gives valuable information for the clinical management of such children.

Interet Du Dosage Des Hemoglobines Glycosylees Dans Le Diabete Sucre

SummaryHaemoglobin A1 (HbA1) consists of 4 minor components (HbA1a1 HbA.a2, HbA1b and HbA1c), called the glycosylated haemoglobins. It results from the posttranslational transformation of HbA by the binding of a sugar (or a sugar derivative) moiety, and in particular glucose, to some amino acids of the polypeptidic chains of haemoglobin. Previous reports have shown that the level of HbA, essentially reflected the average glycaemia to which the red blood cells have been exposed throughout their life.In the present study, the level of HbA, was measured on one or several occasions in 122 patients presenting various degrees of glucose intolerance. The results demonstrate that the level of HbA, was normal in subjects with chemical diabetes but was elevated in 70–80 % of patients with clinical diabetes (of either adultonset or juvenile-onset type). A significant correlation was found between the level of HbA, and the mean of urine glucose concentrations measured in 3 samples collected during the 24 hours just preceding the determination or one month before. Our data further indicate that an hospitalisation in a specialized unit significantly diminished the level of HbA, measured 1 to 6 months later in the majority of patients studied, and especially in juvenile-onset diabetics.In conclusion, our study confirms the usefulness of the measurement of HbA, in assessing the degree of diabetic control during the proceeding weeks.

Investigations on spontaneous and glucocorticoid induced glucosuria in the bovine animal

The pathologic excretion of glucose in urine is encountered in a number of diseases in which either the glucose concentration in primary urine, due to an elevated blood glucose level, exceeds the reabsorption capacity of the kidney (e.g. diabetes mellitus and in other conditions where the so-called anit-insular hormones predominate), or the renal threshold is pathologically lowered (e.g. mercury and chromate intoxication) - so-called renal glucosuria. Some of these cases have already been described in the ruminant. Central nervous disorders (e.g. rabies) can also lead to glucosuria - presumably due to stimulation of the cerebral glucose regulatory center. Transient glucosurias were observed following therapeutic glucose infusions, glucocorticoid therapy, and after transport.In 1977, during routine examination of bovine patients upon admission to the II. Medizinische Tierklinik at the University of Munich Veterinary School, it was discovered, using quick-test-sticks, that 9% of the animals had glucosuria. Similar observations were made by MEHLS in the Klinik fur Rinderkrankheiten at the Veterinary College Hannover. In both clinics it was observed that tests for glucosuria had become negative after two days.Since the test sticks were originally intended for monitoring human diabetics, they have a lower limit of detection of around 50 mg/dl (2.78 mmol/1) urine glucose, as higher concentrations are considered pathologic in humans. These observations led the present investigation to ask whether a physiologic glucosuria can be expected in adult bovines, and whether application of trade name glucocorticoids in recommended dosages can lead to significant loss of glucose via the kidneys.

Glucosuria in children with diabetes: advantages of the 2-drop Clinitest method.

In order to assess the actual and theoretical limitations of using the traditional urinary glucose determinations as an indicator of plasma glucose concentration, we have measured plasma and urine glucose concentrations in 37 children with diabetes mellitus. A constant blood withdrawal system enabled an accurate estimate of the glucose concentration presented to the renal glomerulus over the 30-min period of blood collection and urine formation. The theoretical range of plasma glucose over which the 5-Drop and 2-Drop Clinitest methods are sensitive is 32 mg/dl and 81 mg/dl, respectively. This suggests that the 2-Drop method is the procedure of chioce for most insulin-dependent diabetic patients. Nevertheless, the extremely wide range of plasma glucose corresponding to a given urinary glucose measurement limits the precision with which any single urine test can be interpreted.

Glucosuria: accuracy and precision of laboratory diagnosis by dip stick analysis.

We studied and compared results of two urine dip-stick procedures for protein with those of quantitative measurements of total protein and albumin in urine. Sensitivity, specificity, and predictive value of "normal" and "abnormal" dip-stick results, assay efficiency, technologist precision, and method association were determined. Precision was poor, attributable largely to variation within each technologist. Relative to a defined measure of precision, technologist performance appears to be uniform within each product. Patients' urinary protein concentrations of less than 200 mg/liter can be distinguished from concentrations greater than 3000 mg/liter with confidence by dip-stick procedures. Urin samples with low albumin/total protein ratios were frequently falsely negative by dip-stick assays.

Relationship between urinary and blood glucose in diabetic children.

The relationship of urine glucose concentration with 'average' blood glucose concentration for the corresponding period was investigated in 10 juvenile diabetics during the performance of 15 inpatient metabolic profiles. 0% glucosuria was associated with 'average' blood glucose concentrations less than 6.4 mmol/l (less than 115 mg/100ml), 2% glycosuria with concentrations greater than 8.6 mmol/l (greater than 154 mg/100ml), and over 5% glycosuria with concentrations greater than 11.3 mmol/l (greater than 204 mg/100ml). Urinary glucose loss was large (greater than 278 mmol; greater than 5g) when the 'average' blood glucose was greater than 11.1 mmol/l (greater than 200 mg/100ml). Because many diabetics have blood glucose concentrations up to 11.1 mmol/l, it is advantageous if glucosuria up to 5% is detectable by routine home urine tests. The 2-drop Clinitest method detects glycosuria up to 5% without significant loss of accuracy and is recommended in preference to the 5-drop method.

Investigations on Spontaneous and Glucocorticoid Induced Glucosuria in the Bovine Animal

The pathologic excretion of glucose in urine is encountered in a number of diseases in which either the glucose concentration in primary urine, due to an elevated blood glucose level, exceeds the reabsorption capacity of the kidney (e.g. diabetes mellitus and in other conditions where the so-called anit-insular hormones predominate), or the renal threshold is pathologically lowered (e.g. mercury and chromate intoxication) - so-called renal glucosuria. Some of these cases have already been described in the ruminant. Central nervous disorders (e.g. rabies) can also lead to glucosuria - presumably due to stimulation of the cerebral glucose regulatory center. Transient glucosurias were observed following therapeutic glucose infusions, glucocorticoid therapy, and after transport.In 1977, during routine examination of bovine patients upon admission to the II. Medizinische Tierklinik at the University of Munich Veterinary School, it was discovered, using quick-test-sticks, that 9% of the animals had glucosuria. Similar observations were made by MEHLS in the Klinik fur Rinderkrankheiten at the Veterinary College Hannover. In both clinics it was observed that tests for glucosuria had become negative after two days.Since the test sticks were originally intended for monitoring human diabetics, they have a lower limit of detection of around 50 mg/dl (2.78 mmol/1) urine glucose, as higher concentrations are considered pathologic in humans. These observations led the present investigation to ask whether a physiologic glucosuria can be expected in adult bovines, and whether application of trade name glucocorticoids in recommended dosages can lead to significant loss of glucose via the kidneys.

Effects of xylazine hydrochloride on urine in cattle.

Urine volume, urine pH, and urine glucose concentration were monitored for up to 24 hours after physiological saline or one of two dosage levels (0.22 mg/kg or 0.44 mg/kg) of xylazine was administered to cows. During the first 2 hours after xylazine was given, urine output was greatly increased (relative to the control animals), with the high dosage group having more output than the low dosage group. The influence of the drug on urine volume had ended by 5 hours after injection when urine output in both dosage groups had returned to that of the control group. Glucose was detected in the urine of xylazine treated animals, beginning at 15 to 30 minutes after injection, reached a maximum at 2 hours, and was undetectable at 5 to 6 hours. Urine pH decreased in control and treated animals, but in treated animals the pH began to increase 2 hr after treatment.

Evaluation of a dipstick test for glucose in urine.

As an example of qualitative tests, a dipstick analysis for glucose in urine has been tested for the influence of modifying factors on the test result. Two different types of dipsticks were examined, "Clinistix" and "S-Gluko-test." Used according to manufacturer's instructions, the latter is more sensitive and selective. By multivariance analysis the following variables were examined: urine samples, inter- and intra-analyst, exposure to light, and dipstick batch. The first three contributed significantly to the total variation in results, inter-specimen variation being the most important. With knowledge of the frequency of testing urines with a given glucose concentration and the probability of the result at that concentration, an expression of the probability of the glucose content of a urine sample can be obtained. Even with the tests of the type examined having a sensitivity and specificity exceeding 95%, 14 of 100 patients suspected of having diabetes mellitus on the basis of a dipstick examination will be found to have a urinary glucose concentration of less than 2 mmol/liter. These figures were found when the prevalence of urines with a glucose concentration exceeding 2 mmol/liter was 17.5%.

An antomated method for the quantitative assessment of low concentrations of glucose in urine.

In view of the recent work by Schersten and Fritz (1967), which indicates that the utilization of small amounts of glucose in urine by actively respiring bacteria can be used as an index of urinary tract infection, there is a need for a simple, sensitive test which detects very low concentration of urine glucose and can be applied in the analysis of large numbers of specimens. This paper describes the adaptation of a routine blood glucose autoanalyser method to the measurement of glucose in urine.

Tests for glucosuria. An analysis of factors that cause misleading results.

The incidence of potentially erroneous tests for urinary glucose was studied. Each urine specimen collected was tested with Clinitest, Clinistix, Diastix, and Tes-Tape before and after addition of glucose to produce a urine glucose concentration of 1/2 per cent. There was a 23 per cent incidence of falsely high (&amp;gt;1/ 2 per cent) and a 33 per cent incidence of falsely low (&amp;lt;1/2 per cent) results in the 513 specimens examined. Underreading, frequently caused by urinary metabolites of common medications, was seen only with Clinistix and Diastix. Overreading had a distinct relationship to dilute urine and was most frequent with Clinitest (65 per cent). The patient's habits (medications taken and water ingestion) should be considered carefully when a urine testing method is selected. Periodic plasma glucose measurements are recommended to confirm impressions obtained from urine tests for glucose.

DIASTIX AND KETODIASTIX A NEW SEMIQUANTITATIVE TEST FOR GLUCOSE IN URINE

Trials have been made with Ketodiastix, testing the Diastix component, which is a new semiquantitative test for glucose in urine, by comparing it with Clinitest and Testape. The subjects who carried out the tests were diabetic children and their parents, and urine samples containing a range of concentrations of glucose were presented as unknown specimens for testing. The subjects found that Ketodiastix was simple and acceptable. It was as sensitive as Tes-Tape and at least as reliable as Clinitest in registering nil and low concentrations of glucose in urine. Difficulty was experienced by some subjects In matching colour blocks corresponding to 1% and 2% glucose concentrations, and this led to mistakes in making the correct reading for urine samples containing 1% and 4% of glucose. Limited practice led to improvement In correctly reading urine samples containing 1% of glucose, but not In reading those containing 4% of glucose. Clinitest was the most reliable semiquantitative test, particularly at high urine concentrations of glucose. Tes-Tape appeared unreliable as a semiquantitative test, failing to distinguish mild from heavy glycosuria (0.5% from 4%).

Low urinary glucose concentration: A reliable index of urinary tract infection

Urinary glucose concentration was measured in 96 patients aged 2 months to 12 years, with urinary tract infections, in 78 control subjects, and in 548 apparently healthy girls, aged 5 to 14 years, who were screened for asymptomatic bacteriuria. A spectophotometric method and a paper strip test were comparatively evaluated. The results obtained by the strip paper test closely agreed with those obtained spectrophotometric method and a paper strip test were comparatively evaluated. urinary glucose concentration to subnormal levels in specimens obtained under standardized conditions and in random specimens incubated for 8 hours at 37°C. before testing.

Simple and accurate determination of urinary glucose excretion with anthrone reagent.

The use of anthrone reagent for the quantitative determination of glucose in urine is described. Glucose added to urine was completely recovered on sufficient dilution (1 to 500) of the urine samples, whereas the normal constituents of urine did not interfere with the recovery of glucose. The method allows a rapid and accurate determination of glucose in large numbers of samples with widely diverging glucose concentrations (0.1% –12.5%). In alloxan-diabetic rats the urinary glucose concentration appeared to be remarkably constant (104±0.13 mg/ml) irrespective of the severity of their diabetes. In these animals the urine volume per 24 h was practically linearly proportional to the glucose excretion.

Effect of cortisol on the metabolism of glucose in eviscerated adrenalectomized-diabetic rats.

The effects of adrenalectomy and of cortisol on the utilization of glucose by the extrahepatic tissues were studied using eviscerated alloxan-diabetic rats. Changes in total body content of glucose were calculated from glucose concentrations in blood and urine at hourly intervals up to 6 hr after evisceration. Cortisol was given either at the time of evisceration or at various times (1–12 hr) beforehand. The results showed: 1) The decrease in total body glucose which follows evisceration of diabetic rats was considerably greater if the adrenals were removed. 2) Cortisol, given adrenalectomizeddiabetic animals immediately after evisceration, decreased this loss. Treatment for longer periods of time before evisceration resulted in progressively smaller falls in body glucose after evisceration. During the course of these studies it was also found unexpectedly that renal gluconeogenesis makes a significant contribution to the body glucose in diabetic rats after evisceration. Conclusions regarding possible eff...

Semiautomated Assay of Normal Concentrations of Urinary Glucose by an Enzymatic Fluorometric Technic

Abstract A semiautomated, enzymatic, fluorometric method for the determination of the low glucose concentrations normally present in urine from subjects in the fasting state is described. The method is developed from a manual, enzymatic, fluorometric technic for the determination of urinary glucose using hexokinase (HK) and glucose-6-phosphate dehydrogenase (G-6-PDH). The procedure is based on measurements of the fluorescence of reduced nicotine amide adenine dinucleotide-phosphate (NADPH2) which is formed in proportion to the glucose content of the sample. The unspecific fluorescence of urine is almost completely removed by treating the urine with a mixed ion-exchange resin prior to applying the automated procedure. The chief advantage of the method is that it may afford an opportunity for low-cost screening for detection of bacteriuria.

A fluorometric method for the enzymatic determination of normal concentrations of urinary glucose

An enzymatic fluorometric method is described for the determination of the low glucose concentrations normally present in the urine from subjects in the fasting state. The method is an adaptation of existing spectrophotometric procedures using hexokinase (HK) and glucose-6-phosphate dehydrogenase (G-6-PDH). The non-specific fluorescence of urine is almost completely removed by treating the urine with a mixed ion exchange resin. The chief advantage of this method over the spectro-photometric procedure is its low cost.