Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (955 page)

BOOK: Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis
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   Hypoglycemia
   Limitations
   Normal glucose levels do not rule out infection because up to 50% of patients who have bacterial meningitis have normal CSF glucose levels.
GLUCOSE, URINE
   Definition
   Detection of glucose on a semiquantitative urine dipstick or Clinitest tablets is an insensitive means of screening for type 2 diabetes. The high rate of false-negative results suggests that the urine dipstick is not adequate as a screening test. In addition, not all patients with glucosuria have diabetes. Glucosuria can occur with defects in renal tubular function, as seen in type 2 (proximal) renal tubular acidosis and in familial renal glucosuria, a genetic disorder associated with salt-wasting, polyuria, and volume depletion.
   
Normal range:
see Table 16.37.

TABLE 16–37. Normal Values for Urine Glucose

   Use
   Aiding the evaluation of glucosuria and renal tubular defects
   Management of DM
   Interpretation

Increased In

   Any cause of increased blood glucose
   Endocrine disorders (DM, thyrotoxicosis, gigantism, acromegaly, Cushing syndrome)

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