ABSTRACT
The present study was undertaken to evaluate the validity of glucosuria measurements by double voided technique to monitor plasma glucose level, and use of plasma/urine glucose ratio [P/U-GR] changes as a sign of development of diabetic nephropathy. The study was conducted at AI-Azher University Hospitals between March to November 2002 on 200 diabetic patients [72 type 1 and 128 type 2] who had inadequate glucose control. It has been found that urine glucose levels was correlated significantly with blood sugar levels in uncontrolled diabetic patients. Sensitivity, specificity and negative prediction value were 96.5%, 89.5% and 79% respectively. Glucosuria was significantly higher in diabetic hypertensive patients than diabetic alone and in diabetic hypertensive patients treated by ACE inhibitors than those treated by other lines of antihypertensives. On other hand, glucosuria was significantly lower in patients with proteinuria than the rest of patients and in macroalbuminuria than those with microalbuminuria. P/U-GR which was found to be fixed and individualized for each patient, correlated with age, duration of disease, hypertension, serum creatinine, creatinine clearance, HbA1c and proteinuria but not correlated with blood urea and type of diabetes. P/U-GR was significantly lower in diabetic patients with hypertension than those without hypertension and in patients treated by ACE inhibitors than those treated by other lines of antihypertensive agents. On the other hand, P/U-GR was significantly higher in diabetic patients with proteinuria than the rest of diabetic patients and in diabetic patients with macroalbuminuria than those with microalbumrnuna. Our results recommend that the use of urine testing by double voided technique is reliable and accurate method in more than 79% of diabetic patients and could be used as a guide for detection of plasma glucose level in non emergency conditions