The role of urine sugar in diabetic management
J. I. Malone, A. L. Rosenbloom, A. Grgic and F. T. Weber
The concentration of reducing sugar in the urine is commonly used in the
management of diabetes in children. Supplemental doses of regular insulin
are administered in response to the concentration of urine sugar according
to a protocol termed the "sliding scale." This practice assumes that the
concentration of sugar in urine is a good indicator of the plasma glucose
concentration. This assumption was tested by comparing urine sugar
concentrations in first and second voided urines with the plasma glucose
concentrations in 220 children with diabetes. The correlation was good (r =
.92) for both the first and second voided urine specimens. Thus, urine
sugar concentrations in general define the level of plasma glucose. The
large standard deviation of the plasma glucose at each concentration of
urine sugar, however, limits the usefulness of urine sugar as an accurate
reflection of the coincident plasma glucose concentration. The urine sugar
concentration, although useful for the general management of diabetes,
provides significant risk when used to guide frequent adjustments in
insulin administration. Therefore, the "sliding scale" should not be used
in the treatment of children with diabetes.
