Urine Glucose Monitoring in Diabetes Mellitus

When compared with blood glucose monitoring, urinalysis for measurement of urinary glucose is a very imprecise method for monitoring glucose control in diabetes mellitus.

• There is only limited evidence that glucose monitoring improves outcomes in patients with type 2 diabetes.¹
• Urine monitoring may be used as an alternative to blood glucose monitoring for some patients with Type 2 diabetes who are managed by either diet alone or with oral hypoglycaemic drugs (e.g. those patients who are unable or unwilling to measure capillary blood glucose levels).
• There is no evidence that blood glucose testing is more effective than urine testing in improving blood glucose control in people with Type 2 diabetes.²
• Urine glucose testing should not be used instead of glucose monitoring for people with Type 1 diabetes.

Advantages

• Urine testing is easy to perform and does not require a meter with associated maintenance and battery replacement needs.
• Urine testing is cheaper.
• It does not require lancets with the associated safety and disposal issues.

Disadvantages of urine glucose monitoring

• Negative test does not distinguish between normoglycaemia and hypoglycaemia.³
• The renal threshold for glucose is approximately 10 mmol/L but varies in individuals between 8 and 12 mmol/L. The threshold is lower in children and pregnant women, who are therefore more likely to have false positive results, and higher in the elderly and those with renal impairment, who are therefore more likely to have false negative results. Fluid intake may also affect glycosuria.
• The level of glycosuria represents an average of blood glucose levels since the patient last passed urine. Collecting a sample soon after emptying the bladder helps to reduce this problem.