Assessment and monitoring of metabolic control

Monitoring of urine glucose

• Provides useful but different information from SMBG
• Reflects glycemic levels over the preceding several hours
• Is related to the renal threshold for glucose, which in children is approximately 9–10 mmol/l
• Can be less traumatic than SMBG for some children

Limitations of urine glucose monitoring

• Uncertain correlation with BG levels
• Inability to detect hypoglycemia
• Less valuable as an educational tool
• Unhelpful in hyperglycemic crises because of the lag phase between recovery and changes in urine glucose

Target

• As many urine tests as possible should show no glycosuria without the occurrence of frequent or severe hypoglycemia

Equipment

• Most centers use specific glucose-oxidase strips which are relatively inexpensive and convenient
• Some non-specific reducing agent methods are used such as Clinitest tablets or Benedict’s test. These are less convenient to use
  [They are also potentially dangerous if the chemical reagents are in contact with the skin or gastrointestinal tract]