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Efficacy of urinary glucose for diabetes screening: a reconsideration

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Abstract

Aims

Previous studies indicated that urinary glucose (UG) had a limited efficacy in diabetes screening. This study was designed to have a re-evaluation of its efficacy, taking into consideration the collection method of urine and the measurement approach for UG among Chinese adults.

Methods

This cross-sectional study enrolled a total of 7689 participants without known diabetes, who were fasted and asked to empty bladders before a 75 g glucose loading. Urine was collected 2 h post glucose loading, and UG was measured using quantitative and qualitative approaches. The efficacy of UG in detecting diabetes was assessed by the receiver operating characteristic (ROC) curve.

Results

The area under the ROC curve was 0.89 for quantitative UG and 0.87 for qualitative UG. Quantitative UG was positively correlated with fasting plasma glucose (FPG) and 2 h plasma glucose (2 h PG) (r = 0.55 and 0.56, respectively, both P < 0.001). Quantitative UG displayed a sensitivity of 82.9% and a specificity of 84.7% in detecting diabetes at the corresponding optimal cutoff of 130 mg. Qualitative UG exhibited a sensitivity of 80.2% and a specificity of 85.6% at the optimal cutoff of glycosuria + 1. In addition, the sensitivity of both quantitative and qualitative UG was significantly higher than that of HbA1c (≥ 6.5%) (P < 0.001) and had a comparable sensitivity to 2 h PG (≥ 11.1 mmol/L) (P = 0.493).

Conclusions

UG, either quantitatively or qualitatively measured at 2 h post glucose loading, was effective in diabetes screening. This indicates that UG is a feasible approach for diabetes screening.

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Acknowledgements

We owe our sincere thanks to the local research teams and colleagues for assistance in participant recruitment. We are grateful to many residents of Jiangsu Province who participated in this study. We thank all the staff who were involved in this study for their important contributions.

Funding

This work was supported by a grant from the National Key R&D Program of China (2016YFC1305700), the National Key Scientific Instrument and Equipment Development Project of China (No. 51627808) and  the Key Program for Clinical Medicine and Science and Technology, Jiangsu Province, China (BL2014079).

Author information

Author notes

  1. Juan Chen, Haijian Guo, **aoning Li and Zilin Sun contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nan**g, 210009, Jiangsu, China

    Juan Chen, Suixia Yuan, Shanhu Qiu, Wei Li, **aohang Wang, Min Cai, Hong Sun & Zilin Sun

  2. Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nan**g, 210009, Jiangsu, China

    Haijian Guo

  3. Institute of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nan**g, 210009, Jiangsu, China

    Chen Qu, Tao Mao & **aoning Li

  4. Department of Endocrinology and Metabolism, The first Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China

    Hong Sun

  5. School of Public Health, Southeast University, Nan**g, 210009, Jiangsu, China

    Bei Wang

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  1. Juan Chen
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Correspondence to Zilin Sun.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Jiangsu Provincial Center for Disease Control and Prevention and Zhongda Hospital, Southeast University and with the 1964 Helsinki Declaration and its later amendments.

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Informed consent was obtained from all participants included in the study.

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Data are available from the corresponding author for researchers who meet the criteria for access to confidential data. Please contact Zilin Sun (email: sunzilin1963@126.com).

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Chen, J., Guo, H., Yuan, S. et al. Efficacy of urinary glucose for diabetes screening: a reconsideration. Acta Diabetol 56, 45–53 (2019). https://doi.org/10.1007/s00592-018-1212-1

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