糖尿

WordNet

the presence of abnormally high levels of sugar in the urine
the presence of abnormally high levels of glucose in the urine

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/06/04 23:37:08」(JST)

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Glycosuria or glucosuria is the excretion of glucose into the urine. Ordinarily, urine contains no glucose because the kidneys are able to reclaim all of the filtered glucose back into the bloodstream. Glycosuria is nearly always caused by elevated blood glucose levels, most commonly due to untreated diabetes mellitus. Rarely, glycosuria is due to an intrinsic problem with glucose reabsorption within the kidneys themselves, a condition termed renal glycosuria.^[1] Glycosuria leads to excessive water loss into the urine with resultant dehydration, a process called osmotic diuresis.

Pathophysiology

Blood is filtered by millions of nephrons, the functional units that comprise the kidneys. In each nephron, blood flows from the arteriole into the glomerulus, a tuft of leaky capillaries. The Bowman's capsule surrounds each glomerulus, and collects the filtrate that the glomerulus forms. The filtrate contains waste products (e.g. urea), electrolytes (e.g. sodium, potassium, chloride), amino acids, and glucose. The filtrate passes into the renal tubules of the kidney. In the first part of the renal tubule, the proximal tubule, glucose is reabsorbed from the filtrate, across the tubular epithelium and into the bloodstream. The proximal tubule can only reabsorb a limited amount of glucose. When the blood glucose level exceeds about 160 – 180 mg/dl, the proximal tubule becomes overwhelmed and begins to excrete glucose in the urine.

Approximate correlation between dipstick designation and plasma concentration of glucose
Urine dipstick designation	Approximate plasma concentration
trace	100 mg/dL ^[2]
1+	250 mg/dL^[2]df
2+	500 mg/dL^[2]
3+	1000 mg/dL^[2]
4+	2000 mg/dL^[2]

This point is called the renal threshold of glucose (RTG).^[3] Some people, especially children and pregnant women, may have a low RTG (less than ~7 mmol/L^[3] glucose in blood to have glucosuria).

If the RTG is so low that even normal blood glucose levels produce the condition, it is referred to as renal glycosuria.

Glucose in urine can be identified by Benedict's qualitative test.

A urine dipstick can show a false-positive glucosuria if someone is taking Pyridium or AZO Standard, medications that relieve symptoms of urinary tract infection.

References

^ Rose, Burton; Rennke, Helmut (1994). Renal pathophysiology - the essentials (1st ed ed.). Philadelphia: Lippincott Williams & Wilkins. p. 194. ISBN 0-683-07354-0.
^ ^a ^b ^c ^d ^e Han BR, Oh YS, Ahn KH, Kim HY, Hong SC, Oh MJ, Kim HJ, Kim YT, Lee KW, Kim SH. BR, Han (Sep 2010). "Clinical Implication of 2nd Trimester Glycosuria.". Korean J Perinatol. 21 (3): 258–265. [1] [2]
^ ^a ^b AIDA on-line' Explanations

UpToDate Contents

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1. 腎疾患の診断における尿検査 urinalysis in the diagnosis of kidney disease
2. 2型糖尿病のスクリーニング screening for type 2 diabetes mellitus
3. 小児および思春期における1型糖尿病の疫学、症状、および診断 epidemiology presentation and diagnosis of type 1 diabetes mellitus in children and adolescents
4. 2型糖尿病の治療のためのジペプチジルペプチダーゼ4（DPP-4）阻害剤 dipeptidyl peptidase 4 dpp 4 inhibitors for the treatment of type 2 diabetes mellitus
5. 遠位（I型）および近位（II型）尿細管性アシドーシスの病因および診断 etiology and diagnosis of distal type 1 and proximal type 2 renal tubular acidosis

English Journal

A single dose of dapagliflozin, an SGLT-2 inhibitor, induces higher glycosuria in GCK- and HNF1A-MODY than in type 2 diabetes mellitus.

Hohendorff J1,2, Szopa M1,2, Skupien J1,2, Kapusta M3, Zapala B3, Platek T3, Mrozinska S1,2, Parpan T4, Glodzik W5, Ludwig-Galezowska A6, Kiec-Wilk B1,2, Klupa T1,2, Malecki MT7,8.
Endocrine.Endocrine.2017 Jun 7. doi: 10.1007/s12020-017-1341-2. [Epub ahead of print]
PMID 28593615

Renal Handling of Ketones in Response to Sodium-Glucose Cotransporter 2 Inhibition in Patients With Type 2 Diabetes.

Ferrannini E1, Baldi S2, Frascerra S2, Astiarraga B2, Barsotti E2, Clerico A3, Muscelli E2.
Diabetes care.Diabetes Care.2017 Jun;40(6):771-776. doi: 10.2337/dc16-2724. Epub 2017 Mar 21.
PMID 28325783

Antagonism of vasopressin V2 receptor improves albuminuria at the early stage of diabetic nephropathy in a mouse model of type 2 diabetes.

El Boustany R1, Taveau C2, Chollet C2, Velho G3, Bankir L2, Alhenc-Gelas F2, Roussel R4, Bouby N5.
Journal of diabetes and its complications.J Diabetes Complications.2017 Jun;31(6):929-932. doi: 10.1016/j.jdiacomp.2017.04.005. Epub 2017 Apr 6.
PMID 28412033