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Diabetes

Sugar in urine

12/11/2006

Question:

If a lot of sugar was detected in urine,what else should I know? I guess it is better than protein. My husbands blood sugar has been between 160 & 180 for a while as the information states. He knows about the effect of diet and exercise but has trouble following it. I`m looking for positive information that would help me help him.

Answer:

Sugar (glucose) in the urine is not normal and reflects much higher than normal glucose levels in the blood that exceed the ability of the kidney to reabsorb glucose. In normal individuals, blood glucose levels are maintained in a very tight range, between 60-110mg/dl fasting and between meals, with brief increases after meals and snacks, usually no higher than 140mg/dl range in a nondiabetic patient. When blood sugars are above 180 mg/dl, the kidneys excrete some of the excess sugar into the urine. If protein is found in the urine, this is a sign of kidney damage or nephropathy. Blood sugars in the 160-180 range are considered too high. Has your husband been diagnosed with diabetes? A fasting blood sugar of >126 mg/dl or a random blood sugar >200 mg/dl is diagnostic of diabetes. If he has diabetes and is on medication, it would be wise to consult his doctor to have his medication changed and seek the care of a diabetes educator to better understand and control his blood sugars. If he is not on medication, it may be necessary that he start to help prevent the complications that can come with diabetes. Of course, dyslipidemia, hypertension, and abnormal platelet function all need to be addressed in the patient in the context of optimum diabetes care.

Following a carbohydrate counting diet is a wonderful way to help control blood sugars. For a man who wishes to lose weight, it is recommended to have 45-60 grams of carbohydrate per meal. What is nice about carb counting is that any food can be incorporated into a meal plan. For example, he could have 1 ½ c of cold cereal (30g), 1c milk (15g) and ½ banana (15g) for breakfast; a sandwich with 2 slices of bread (30g), a small handful of pretzels (15g), and a small cookie (15g) for lunch; and a grilled chicken breast (0g), salad (0g), small dinner roll (15g), 2/3c rice (30g) and a small piece of fruit (15g) for dinner. Looking at the total carbohydrate line on a food product's nutrition label will tell you how many grams of carbohydrate are in one serving of the food (the serving size is listed on the top of the label). It is wise to measure out your foods to be sure your portion sizes are accurate. You can support your husband by choosing healthy foods such as whole grains, lean meats, fruits and vegetables. Exercise can also help to lower blood sugars and should be a part of a healthy lifestyle. It could be as easy as parking further away when going to the store, taking a flight of stairs instead of the elevator, or walking in place during your favorite ½ hour TV show. Every little bit counts!

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Response by:

Connie A Gottfried, MPH, RD, LD, CDE Connie A Gottfried, MPH, RD, LD, CDE
Formerly
Case Western Reserve University

Laurie   Sadler, MD Laurie Sadler, MD
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University