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What Causes Glucosuria While Having Diabetes?

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Posted on Thu, 17 Aug 2017
Question: i want to ask a question about diabetes type 1. Why is there glucose in the urine and what cause this to happen and the process?
doctor
Answered by Dr. Mirjeta Guni (38 minutes later)
Brief Answer:
About glucosuria in type 1 Diabetes:

Detailed Answer:
Hello and thank you for asking!
The mechanism causing glucosuria in type 1 Diabetes is relatively easy understandable.
When the serum glucose level rises above approximately 180 mg/dl (10 mmol/L), the kidneys are unable to resorb all the glucose being presented to them.
This results in glucosuria, which stimulates an osmotic diuresis and the symptom of polyuria. Polydipsia is then triggered to maintain euvolemia.
The impaired fluid intake in the presence of the glucosuric osmotic diuresis produces dehydration. The dehydration impairs the ability to excrete glucose and acids, worsening the hyperglycemia and acidemia. The worsening hyperglycemia increases the osmotic diuresis, setting up a cycle of worsening dehydration and worsening hyperglycemia, making it a vicious cycle.
Hope it is understandable.
Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Mirjeta Guni (29 minutes later)
Can you please explain a bit more about the kidney and how is glucose process in the kidney. How hyperglycemia related to glucose in the urine? thank you very much
doctor
Answered by Dr. Mirjeta Guni (25 minutes later)
Brief Answer:
Detailed mechanism of glucosuria:

Detailed Answer:
Hi again,
So you would like to know a detailed mechanism of glucosuria in Diabetes? The physiological explanation would be;
For a healthy adult, approximately 180g of glucose is filtered by the glomerulus every day
under normal circumstances, almost all of this glucose is reabsorbed with less than 1% being excreted in the urine

Glucose reabsorption in the tubules is a multi-step process involving several transport mechanisms,
glucose is filtered through the tubule and then transported via the tubular epithelial cells through the basolateral membrane into the peritubular capillary. Under optimal conditions, when tubular glucose load is approximately 120mg/min or less, there is no glucose loss in urine
however, when the glucose load exceeds approximately 200mg/min (glucose threshold), glucose starts to appear in the urine.
Approximately 90% of filtered glucose is reabsorbed by the high absorption capacity of 2 sodium-glucose cotransporter (SGLT2) and (GLUT 2) transporter in the convoluted segment of the proximal tubule, and the approximately 10% of filtered glucose is reabsorbed by the SGLT1 transporter in the straight segment of the descending proximal tubule
as a result, no glucose appears in the urine.

Patients do not excrete glucose in the urine until the concentration of blood glucose is over 180mg/dl, which does not normally occur in people without diabetes.

Hope this is the information you intended to have.
Best wishes,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Mirjeta Guni (20 minutes later)
so is this for adults only or also for children, im looking after a 7 years old, thank you so much doctor
doctor
Answered by Dr. Mirjeta Guni (42 minutes later)
Brief Answer:
yes, is almost the same:

Detailed Answer:
Hi again,
Yes, it is almost the same mechanism, there may be a difference at the glucose threshold (it varies from 180-220 mg/dl), but glucose appears in urine when it is over 180 mg/dl in blood.
Wish him good health.
Best wishes,
Dr.Mirjeta
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2414 Questions

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What Causes Glucosuria While Having Diabetes?

Brief Answer: About glucosuria in type 1 Diabetes: Detailed Answer: Hello and thank you for asking! The mechanism causing glucosuria in type 1 Diabetes is relatively easy understandable. When the serum glucose level rises above approximately 180 mg/dl (10 mmol/L), the kidneys are unable to resorb all the glucose being presented to them. This results in glucosuria, which stimulates an osmotic diuresis and the symptom of polyuria. Polydipsia is then triggered to maintain euvolemia. The impaired fluid intake in the presence of the glucosuric osmotic diuresis produces dehydration. The dehydration impairs the ability to excrete glucose and acids, worsening the hyperglycemia and acidemia. The worsening hyperglycemia increases the osmotic diuresis, setting up a cycle of worsening dehydration and worsening hyperglycemia, making it a vicious cycle. Hope it is understandable. Kind regards, Dr.Mirjeta