In order to assess different methods for early detection of unsuspected diabetes, urine and venous blood samples were collected at random from 1082 patients visiting a primary health care centre in southern Sweden. Blood glucose was analysed by the hexokinase method along with the Dextrostix-Eyetone reflectance meter. Urine glucose was determined by Clinistix, Diastix, Neostix, Rediatest, Clinitest and quantitatively by the hexokinase method. Patients fulfilling the criteria of a positive screen were subjected to a diagnostic investigation with an oral glucose tolerance test. Out of 89 positive screenees, 37 patients were classified as diabetics, showing a prevalence of diabetes in the study population of 3.4% according to the WHO criteria. Impaired glucose tolerance was found in 14 patients. In a control group of 56 patients, randomly selected among negative screenees, no cases of diabetes were found. Random blood glucose measurement by the hexokinase method, using 7 mmol/l as a screening level, had a significantly higher sensitivity (95%) than all urine glucose methods (59-30%) with comparable specificity (97-99%). Use of the Dextrostix-Eyetone reflectance meter resulted in a decrease in sensitivity to 75% without any change in specificity or predictability, compared with the hexokinase method. Urine testing for glucose was found to be a suboptimal method for early case finding of diabetes among patients receiving primary health care.
Blood and urine glucose values and the prevalence of diabetes mellitus were determined in the course of a health survey covering inhabitants of Tampere, Finland, aged 85 or over. Out of the total cohort, 561 (83%) subjects, of whom 82% were women, were examined. A high blood glucose level (greater than or equal to 7.0 mmol/l) was recorded in 10% of the males and 7% of the females. The prevalence of diabetes mellitus in the series was 17%. Five per cent of the total series were on drug treatment for their diabetes; 5% of the diabetics were on insulin therapy and 25% took oral antidiabetic drugs, while 70% were either on diet or had no treatment. Diabetes seems to be common among the very aged, but it is generally mild and easy to treat.
Screening for urinary tract infection was carried out in 27,722 schoolboys aged 5 to 14 using Uricult to perform urine cultures and Hema-combistix to detect hematuria, proteinuria and glycosuria. Cultures of 10(5) colonies per ml or more on two occasions were found in 40 cases (0.14%), but no case was confirmed by the family physician using standard culture techniques.Proteinuria was found in 136 cases (0.49%) and confirmed in 47 (37%) of the 126 children who were seen by their family physician. In this group 8.8% had evidence of pyelonephritic scarring on intravenous pyelograms without a positive urine culture.Hematuria was found in 19 children and confirmed in 10 (59%) of the 17 children who were seen by their family physician. No abnormalities were detected on intravenous pyelography in any case.Glycosuria was found in 12 cases and confirmed in five. Three of these children had renal glycosuria and two had previously undetected diabetes.
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Screening for urinary tract infection was carried out in 23,427 schoolgirls, aged 5 to 14 years, using Uricult and, for hematuria, glycosuria and proteinuria using Hema-combistix. Cultures of 10(5) colonies per ml. or more on two occasions were obtained in 2.3% and a positive culture was confirmed by the family physician using standard culture techniques in 82.7% of cases, giving an overall incidence of infection of 1.9%. Fifty-eight percent of these children had no previous history of any urinary tract symptoms. Of the infected group 9.5% had pyelonephritic scarring, 58.7% chronic cystitis and 58.7% urethral stenosis. Two additional cases had unilateral ureteropelvic junction obstruction with hydronephrosis. Reflux occurred in 26.6% of those investigated by voiding cystogram. In 58% of cases the urinary tract infection was not accompanied by significant proteinuria, hematuria or pyuria.Proteinuria was detected on two occasions in 1.6% of the children and confirmed by the family physician in 33% of cases, giving an overall incidence of 0.5%. In this group 9.2% had evidence of pyelonephritic scarring without a positive urine culture.Hematuria was detected on two occasions in 0.6% of the children and was confirmed by the family physician in 53%, giving an overall incidence of 0.3%. Only one case with pyelonephritic scarring was seen in this group.Of the 25 cases with pyelonephritic changes only six had been previously diagnosed radiologically.Four previously unrecognized diabetics were also detected.
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OBJECTIVE: To investigate the association between consumption of certain foods and macronutrients and urinary glucose excretion, which is a predictor of non-insulin-dependent diabetes mellitus. DESIGN: A cross-sectional study, Denmark, 1993-97. SUBJECTS: Participants in the Danish study 'Diet, Cancer and Health'. After exclusion of persons with postprandial urine samples and persons with diabetes or other diseases potentially resulting in glycosuria, the study population included 14 743 men and 18 064 women aged 50-64 y. We identified 183 men and 43 women with glucose in their urine. RESULTS: Consumption of poultry was negatively associated with glycosuria in both men (odds ratio, OR=0.87; 95% confidence interval, 95% CI=0.77-0.98) and women (OR=0.69; 0.48-1.00). Fiber from fruit showed a weak negative association with glycosuria in both men (0. 95; 0.90-1.01) and women (0.89; 0.78-1.02), whereas a significant negative association with total fiber (0.68; 0.51-0.91) and fiber from vegetables (0.94; 0.88-0.99) was seen in men. Intake of fish tended to reduce the risk of glycosuria in women only (0.80; 0.63-1. 02), whereas ingestion of milk products increased their risk significantly (1.15; 1.06-1.24). CONCLUSION: Although statistical significance and consistency in the two sexes were not achieved for all end-points, the study indicates a protective effect of dietary products like poultry, fruit and cereals against glycosuria and suggests a promoting effect of milk. SPONSORSHIP: The Danish National Board of Health and the Danish Cancer Society.