From the Guidelines
A large amount of glucose in urine is primarily caused by diabetes mellitus, where insufficient insulin production or insulin resistance prevents proper glucose uptake by cells, leading to high blood glucose that spills into urine. This condition is characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both, as described in the diagnosis and classification of diabetes mellitus study 1. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels.
Some key points to consider include:
- Symptoms of marked hyperglycemia include polyuria, polydipsia, weight loss, sometimes with polyphagia, and blurred vision 1.
- Impairment of growth and susceptibility to certain infections may also accompany chronic hyperglycemia 1.
- Long-term complications of diabetes include retinopathy with potential loss of vision; nephropathy leading to renal failure; peripheral neuropathy with risk of foot ulcers, amputations, and Charcot joints; and autonomic neuropathy causing gastrointestinal, genitourinary, and cardiovascular symptoms and sexual dysfunction 1.
It is essential to consult a healthcare provider promptly for proper evaluation if glucose is discovered in the urine, which typically includes blood glucose testing to determine the underlying cause 1. Treatment depends on the specific diagnosis but may include lifestyle modifications, medication, or addressing the primary condition causing the glycosuria. Other causes of glycosuria, such as pregnancy, certain medications, stress, hormonal disorders, pancreatic diseases, and rare genetic conditions like renal glycosuria, should also be considered and evaluated by a healthcare provider.
From the Research
Causes of Large Amounts of Glucose in Urine
- Uncontrolled type 2 diabetes mellitus can lead to high levels of glucose in the urine 2, 3, 4
- Inadequate treatment or management of type 2 diabetes mellitus can result in large amounts of glucose in the urine 3, 5
- Failure of sulfonylurea and metformin regimens in patients with type 2 diabetes mellitus can lead to high glucose levels in the urine 6
- Certain medications, such as pioglitazone, may improve glycemic control and reduce glucose levels in the urine, but may not be effective for all patients 2, 4, 6
Related Factors
- Insulin resistance and impaired pancreatic beta-cell secretory function can contribute to high glucose levels in the urine 2
- Hypoglycemia and weight gain are potential side effects of certain medications used to treat type 2 diabetes mellitus, which can affect glucose levels in the urine 3, 5
- Renal function and the progression of chronic kidney disease (CKD) can be influenced by the choice of medication and treatment regimen for type 2 diabetes mellitus 6