Glycosuria: Symptoms, Causes, Treatment

Glycosuria simply means glucose in the urine. 

However, more correctly, it means a higher than normal glucose level in urine. 

It is worth understanding that some glucose is always present in urine, which is healthy. 

However, if the glucose is above certain limits, it indicates a disease.

Glycosuria is almost synonymous with diabetes, as it is the most common cause of it. 

However, glucosuria may occur due to other reasons, too.

Keep reading to find out more about glycosuria, what causes it, and how you can treat it.

What is glycosuria?

As already mentioned, glycosuria means glucose in urine. Since some glucose in the urine is normally present, doctors would only use the term glucosuria for abnormally high glucose in urine. 

However, these days accepted normal limit of glucose in the urine is up to 25 mg/dl. Therefore, the term glucosuria should be used if glucose is above this limit.

Human urine, ideally, should not contain glucose more than 25 mg/dl under any conditions. If it is above this level, then it is an elevated level of glucose in urine – glycosuria medical definition. There could be many reasons why urine might have high levels of glucose. 

High glucose in the urine may happen due to abnormally high plasma glucose or renal diseases and thus impaired glucose absorptive capacity. In many cases, both the conditions may be present.

Is glycosuria the same as diabetes?

The answer is both “yes” and “no.” Though glycosuria is almost synonymous with diabetes, it may occur due to other conditions. 

Thus, in most cases, glucosuria would indicate diabetes. Nonetheless, glucosuria alone is not enough to say that a person has diabetes. 

Glucosuria occurs due to the failure of the kidneys to reabsorb glucose during the filtration process. It does not essentially mean that kidneys are damaged, but they have a limit of reabsorbing the glucose. 

This limit or threshold is 180 mg/dl on average. However, there are massive individual differences. Therefore, this threshold may be much lower for some individuals and, for others, almost twice higher.

Studies show that for those living with diabetes, the threshold may range from anywhere between 54 to 300 mg/dl. That is quite a big difference. It means that glucosuria is not the best way to diagnose diabetes.

Just take an example of a person with a 300 mg/dl threshold level. If such a person has a plasma glucose level of 280 mg/dl, there won’t be any glucosuria in such an individual. 

Unfortunately, though, the person is living with severe diabetes. This is just an extreme example of why glucosuria is not the same as diabetes and why it is not the best way to diagnose diabetes.

Nevertheless, there are very few extreme cases in practice, and detectable glucosuria is present in most people living with diabetes. Therefore, it is a reliable way to diagnose diabetes in most but not in all cases.

Can you have glycosuria without diabetes?

Yes, you can have glycosuria even without diabetes. A completely healthy person may have glucosuria for short intervals. 

For example, if a person consumes too much sugar, sugary drinks, and high-carb foods, they may exceed the so-called kidney threshold level, and glycosuria may occur. However, such glycosuria would be short-lived and not most of the time as in diabetes.

Just consider that if a person has a fasting blood sugar test value of 126 mg/ml or more, the person is said to be living with diabetes. However, this value is 200 mg/dl or glucose tolerance test, a test in which doctors test blood glucose two hours after drinking a sugary drink. 

Short-term glycosuria may occur in completely healthy adults if the body is overloaded with glucose due to a high intake of carbs. Therefore, glucose in urine often indicates a health issue, though not necessarily. There could be many glucosuria causes.

However, glycosuria may also indicate various kidney disorders. For example, studies show that glucosuria is one of the signs of acute tubulointerstitial nephritis (ATIN). In addition, glycosuria may occur in many other kidney disorders like benign glycosuria, familial renal glycosuria, and more.

Additionally, it is worth knowing that some anti-diabetic drugs like dapagliflozin and empagliflozin may also cause glycosuria. This is because these drugs work by reducing the renal reabsorption of glucose.

Symptoms of glycosuria

Glycosuria or high glucose levels in urine causes many symptoms. However, many urine sugar symptoms are a reminder of diabetes, but not necessarily. Thus, glycosuria may cause extreme thirst and hunger in most cases.

Glycosuria is quite likely to cause frequent urination. Additionally, a person living with urine glucose levels may experience increased nighttime urination or nocturia.

In the case of urine glucose levels, there would be additional symptoms like fatigue, unexplained weight loss, and changes in the skin.

There could be other urine sugar symptoms like high urine glucose levels may significantly increase the risk of urinary infection. Moreover, urinary infections tend to be recurrent in those living with glycosuria. Older adults are more likely to develop severe urinary infections.

What causes glycosuria?

Whether in healthy adults or those living with diabetes, the cause of glycosuria is the same. It occurs when the reabsorption threshold of the kidneys is exceeded. 

This means that during blood filtration or detoxification, the kidney removes toxins and reabsorbs essential nutrients. However, if something is too much in the blood, the kidneys might not be able to reabsorb all of them.

Thus, glycosuria primarily occurs due to glucose overload. This means that a person has too much glucose in the blood, like in those living with diabetes. It is the leading cause of sugar in the urine.

In kidney diseases, glycosuria occurs due to a reduced kidney threshold or reduced ability to absorb glucose back into the blood.

Similarly, glycosuria may occur in healthy adults after consuming too many carbs and sugary drinks, though such glycosuria would be short-lived. Moreover, due to the lower threshold value, some might be prone to the condition.

Risk factors

Though there might be multiple risk factors for the condition, diabetes mellitus remains the primary cause of glycosuria. In the condition, glucose remains above the kidney threshold most of the time.

Nonetheless, there could be other risk factors like severe kidney disease. Additionally, some people are born with a lower kidney threshold, and they often experience the so-called primary glycosuria.

Further, older adults or those taking multiple medications are also more likely to develop the condition. Such a risk is higher in those taking medications that interfere with glucose reabsorption or are toxic to the kidneys.

How is glycosuria diagnosed?

Generally, a person living with diabetes may need to check for glycosuria. Additionally, individuals prone to recurrent urinary tract infections may also check their glucose level in urine.

Till the 1980s, checking glycosuria was the main way to monitor diabetes, as in those days, home blood glucose testing devices were unavailable. Nowadays, glycosuria has lesser value in monitoring diabetes, as home blood glucose monitoring devices are a much more accurate way to assess the severity of the condition.

Nevertheless, monitoring glycosuria may have some benefits, like it not only suggests the severity of the underlying disease condition and indicates ongoing renal damage. In addition, it clearly shows that person is not controlling diabetes sufficiently.

There are many ways of checking glycosuria. For example, hospitals or labs may even use the so-called “24-hour collection” or “fractional collection” by collecting urine for 4-6 hours. 

However, at home, people are more likely to use urinary testing strips that change color depending on the glucose content of the urine. There are many sticks or strips available like Clinistix, Diastix, and Uristix. 

However, when using these strips, one must let go of some of the urine and then test. It is because the first few milliliters of urine may have unusually high glucose, which may result in the wrong findings.

All these testing strips are coated with a special chemical that reacts with glucose and changes color. Therefore, a color scale or indicator printed on the packing of these testing strips would help understand the severity of the condition. 

Here it is vital to understand that generally, urine tests are not very accurate. Most tests can detect glucose above 50 mg/dl. However, due to different kidney thresholds, and varying hydration levels of individuals, they only provide rough information.

Treating glycosuria

Glycosuria is a disease symptom, and thus you manage the symptom by treating the underlying cause – in the case of glycosuria, it mainly means managing diabetes.

If you have a detectable level of glycosuria, you are quite likely living with mild to severe and poorly controlled diabetes. Additionally, there could be many lifestyle factors causing glycosuria.

Poorly controlled glycosuria means higher stress on the kidneys and their blood vessels. 

There are many ways of reducing glycosuria, like limiting the intake of processed foods, sugars, and fast-absorbing carbs. Eating food in smaller portions may also help. Additionally, one should limit their daily intake of carbs to below 180 grams a day.

Improving hydration level is another good way to reduce glycosuria. This can boost metabolism levels and also improve kidney function. Additionally, drinking an ample amount of water can help dilute urine and thus reduce glucose concentration. 

Other ways to reduce glycosuria are weight loss and increasing physical activity levels. A higher physical activity level may be particularly good at lowering glucotoxicity and glycosuria. 

Exercise helps burn glucose in skeletal muscles, reduces insulin resistance, and improves glucose storage by the liver and skeletal muscles.

Additionally, strict diabetes control could also help manage glycosuria. Diabetes is best managed through lifestyle interventions and medications. 

Can you prevent glycosuria?

The primary way of preventing glycosuria is by lowering the blood sugar level. It means preventing diabetes or managing diabetes effectively. 

Apart from treatment, one should pay particular focus on lifestyle interventions as these conditions have lots to do with wrong lifestyle choices. For example, high-calorie intake and a sedentary lifestyle are the leading causes of diabetes and glycosuria.

Additionally, one can also make significant dietary changes like reducing total carb intake. Switching to a low-carb diet or even a keto diet may help significantly.

Additionally, one should also take care of renal health. Some of the things one can do are drink more water and increase physical activity levels.

Conclusion

So, if you have glycosuria or you are spilling sugar in your urine, that most likely indicates that you have a high blood sugar level. 

Trace glucose in the urine is normal, but anything above 25 mg/dl is not good. Glucose in urine means diabetes for most. 

Urine sugar symptoms may be few initially, but they increase as the illness progresses. As the presence of glucose in urine mostly indicates diabetes, one should pay particular focus on managing diabetes when urine tests show high urine sugar levels.

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