Why glycosuria during pregnancy

Reabsorption, which is normally complete, is thus compromised. There is a diurnal variation in glycosuria: being least evident in the morning and most evident after meals. Women who develop diabetes during pregnancy are said to have gestational diabetes. Some will remain diabetic after delivery of the foetus while others will revert to apparent normality.

The detection of gestational diabetes is described 1 :. This results from increased renal blood flow so that the tubules are presented with a greater volume each minute. Glycosuria in pregnancy, however, must not be dismissed, as it may be the first sign of gestational diabetes. Urine glucose dipstick analysis is not useful in the detection of gestational diabetes because of its low sensitivity and negative predictive value.

NB : fasting plasma glucose, random blood glucose, HbA1c, glucose challenge test or urinalysis for glucose should not be used to assess risk of developing GDM. Inadequate proximal renal tubular resorption of glucose occurs in Fanconi's syndrome.

There may be a history of growth failure, rickets, polyuria, polydipsia or dehydration. This may be idiopathic, inherited or acquired. This is also known as benign glycosuria, familial renal glycosuria, primary renal glycosuria and nondiabetic glycosuria. Renal glycosuria is a rare inherited disorder resulting in glucose excretion in the urine despite normal blood glucose concentrations. It occurs in males and females. Renal glycosuria is diagnosed based upon laboratory tests that confirm the presence of glucose in the urine in association with normal or low blood glucose levels.

It is usually asymptomatic. In most affected individuals, no treatment is required. However, some individuals with renal glycosuria may develop diabetes mellitus. Exclusion of these by appropriate testing should only be carried out if otherwise clinically indicated. Testing sticks using glucose oxidase are specific for glucose.

Other substances do not cause it to change. The small amounts of glucose normally excreted by the kidneys are usually below the sensitivity range of this test but on occasions may produce a colour between the negative and the lowest positive and may be interpreted by the observer as positive.

Three of the 4 most likely overestimate the sensitivity of glycosuria for predicting gestational diabetes. Conclusions: Routine dipstick screening for protein and glucose at each prenatal visit should be abandoned.

Women who are known or perceived to be at high risk for gestational diabetes or preeclampsia should continue to be monitored closely at the discretion of their clinician. Abstract Objective: More than 22 million prenatal visits occur in the US each year. Publication types Review.