Sugar in the urine (glucosuria) is closely related to elevated blood glucose levels. Depending on the cause, individually effective therapeutic measures differ.
What is glucosuria?
Physicians speak of sugar in the urine (also referred to as urinary sugar, urine sugar, or glucosuria) when there is an increased amount of glucose in the urine. Physicians speak of sugar in the urine (also referred to as urine sugar, urine sugar or glucosuria) when there is an increased amount of glucose in the urine. In humans, glucose enters the urine via the kidneys: kidney corpuscles draw sugar from the blood. The portion of glucose that is not absorbed by the kidney cells for recycling then enters the urine. In the urine of a healthy person, there are usually only very low concentrations of glucose. Glucosuria often occurs when a person’s blood glucose concentration is higher than 180 mg/dl. Because glucosuria itself is often symptomless, its presence is often discovered by chance.
Causes
An increased concentration of glucose in the urine results from elevated blood glucose levels: when blood glucose levels are too high, the kidney can no longer adequately pull the sugar out of the blood (when the kidney’s capacity with regard to glucose utilization is exhausted, this is also known as the renal threshold). As a result, excess glucose is excreted through the urine and urinary glucosuria occurs. Causes of glucosuria can be both renal (affecting the kidney) and non-renal. Possible renal causes of glucose in the urine include, for example, kidney tumors or poisoning of the kidney by heavy metals. As a result, kidney function is impaired, which can affect glucose utilization. The most common non-renal cause of urinary glucose is the presence of diabetes mellitus disease (diabetes). Diabetes leads to a greatly increased blood glucose concentration, which eventually results in glucosuria or glucose in the urine.
Diseases with this symptom
- Diabetes mellitus
- Heavy metal poisoning
Diagnosis and course
The presence of glucosuria can be diagnosed with the help of urine test strips. If glucose was detected in the urine, the next step is usually to investigate the causes of glucosuria. This usually involves a patient consultation with the attending physician. A patient’s individual medical history can often already provide initial indications of possible causes of urinary glucose. On the basis of a tentative diagnosis, the physician can then carry out various further diagnostic examinations, including, for example, a blood sample. The course of glucose in the urine depends above all on the extent to which it is possible to control corresponding causes. If, for example, renal causes such as functional impairment or kidney disease can be treated or heal on their own, this usually has a positive effect on the course of glucosuria. The same is true for nonrenal causes of glucosuria.
Complications
Sugar in the urine is indicative of elevated blood sugar, which can occur primarily in the setting of diabetes, which has numerous complications. The sugar in the blood chemically combines with proteins in the blood, which can then be deposited in the smaller vessel walls. This can lead to an occlusion and thus to a disturbance in the supply of blood to the corresponding organ. Predisposed sites are the eye in the area of the retina, the kidney and nerves. In the eye, it can lead to visual impairment and even blindness (diabetic retinopathy). In the kidney, it initially leads to increased excretion of urine because the sugar osmotically attracts the water and the kidney cannot sufficiently reabsorb the sugar. Thereupon, the excretion becomes less and less, ending in kidney failure (diabetic nephropathy). Diabetes also leads to wound healing problems because blood flow is reduced. This leads to problems, especially on the foot. In addition, there is damage to nerves (diabetic neuropathy), resulting in sensory disturbances. Smaller wounds on the foot can go unnoticed and become larger and infected. Not infrequently, this leads to tissue death and the foot must be amputated (diabetic foot).
When should you go to the doctor?
Increased sugar in the urine is always a reason to see a doctor. Whether it is glucosuria can be determined by some warning signs. For example, an increased excretion of urine in particular indicates an elevated level of sugar in the urine. If there is concomitant visual impairment or wound healing disorders, it is most likely a glucosuria. Other alarm signs are sensory disturbances and signs of paralysis in the feet, which increase rapidly. In most cases, the breath also smells of acetone and there is fatigue and strong feelings of thirst. As the disease progresses, there are increased symptoms of fatigue and severe weight loss. A visit to the doctor is recommended if one or more of the above symptoms can be observed. If the symptoms persist for more than a few days, a physician must clarify the cause and initiate appropriate treatment. Diabetes patients and other high-risk groups such as pregnant women and the elderly should talk to their doctor immediately if there are any changes in urinary behavior or unusual physical symptoms. If sugar in the urine is treated early, further complications can be reliably avoided.
Treatment and therapy
Therapy for glucose in the urine usually starts with treatment of corresponding causes. If glucosuria is due to diabetes, for example, an elevated blood glucose level can be countered by measures such as a consistent diet or the administration of medication (such as insulin). Which therapy concept is individually suitable here depends, among other things, on the form of diabetes present. In some cases, glucosuria is only temporary and does not always require medical treatment. This can be the case, for example, in the context of pregnancy: In pregnant women, the renal threshold often drops, so that the kidney’s capacity to utilize glucose from the blood is lower. As a result, glucose appears more quickly in the urine. After pregnancy, however, the renal threshold rises again and glucosuria often resolves on its own. Depending on the form of renal causes of urinary glucosuria, these can be countered therapeutically, for example, by medicinal or even surgical procedures; successful therapy usually has a positive effect on glucosuria.
Outlook and prognosis
Depending on the underlying disease, elevated blood glucose levels are treated with different therapeutic approaches, and the prognosis is positive in most cases. Depending on whether or not the kidneys are involved, various complications may develop that affect the individual’s chances of recovery. If the course of the disease is mild, most patients do not notice any symptoms at all. In some cases, urinary sugar only appears temporarily, for example during pregnancy, and subsequently regresses. This form of sugar in the urine does not always need to be treated. Successful therapies for kidney dysfunction and disease also have a positive effect on the course of glucosuria. Individual therapy approaches exist for diabetes mellitus, with which patients can lead a largely symptom-free life. The diabetes itself remains for life, but the symptoms are treated to such an extent that the prognosis is favorable for patients. Complications can include wound healing disorders, impaired vision, and sugar deposits on the vessel walls. This can lead to a reduced supply of blood to the affected organs and to occlusion. In the worst case, kidney failure occurs. However, these serious health disorders usually only occur if no treatment has been initiated. Measures such as a change in diet as well as sufficient exercise also have a positive effect.
Prevention
Urine sugar can be prevented, for example, by regular check-ups with a doctor. In this way, possible diseases or functional impairments that may result in glucose in the urine can often be diagnosed and treated at an early stage. If underlying diseases are already present, consistent therapeutic measures can prevent the development/worsening of glucosuria.
Here’s what you can do yourself
An increased amount of sugar in the urine mostly occurs as a concomitant of renal insufficiency or diabetes mellitus. Both conditions require medical treatment.Nevertheless, those affected can do a lot themselves to support their bodies. If diabetes is present, the blood glucose level must be lowered and excessive fluctuations avoided. A change in diet is essential for this. Sugar should be avoided. The use of xylitol is recommended. With identical sweetening power, birch sugar causes only a minimal increase in blood sugar. The consumption of fruit should also be kept in moderation due to the fructose it contains. The proportion of fresh vegetables, on the other hand, should be increased. When taking carbohydrates, whole grain products should be preferred. The multiple sugars they contain are broken down more slowly, so blood sugar levels rise only slowly. Regular exercise and sufficient sleep also have a blood sugar-lowering effect. In the case of gestational diabetes, stabilization of blood sugar levels is also strongly recommended and can easily be achieved through a conscious diet. Kidney insufficiency caused by heavy metal contamination can be counteracted with the help of cleansing cures. An important part of this is intestinal cleansing and rehabilitation as well as subsequent elimination, for example by taking pressed algae (chlorella). Attention should also be paid to the daily drinking quantity. A sufficient amount of still water or unsweetened herbal teas flushes the urinary tract and stimulates the metabolism. Caution is advised in case of existing kidney disease and coordination with the attending physician is advised.
