glucose high in urine but blood sugar normal

[mizzsully]

hiya my 4 year old daughter has been unwell recently. took her to the doctors where her urine sample was +4 glucose +1 ketones but her blood sugar was 4.6...they repeated the test in the afternoon and again the urine was up but the blood sugar was 4.9

they said it could just be an infection...any ideas? xx

 

[mizzsully]

does anyone have any ideas???

 

[hanadr]

Seems odd.
there are differnt levels at which glucose "spills over" the kidney barrier.
Hana

 

[phoenix]

Normally the renal threshold referred to by Hana is about 10mmol/l but her glucose levels are low.
I've no idea whether a kidney infection could cause glucose to spill over at lower levels. The + 1 ketone is not high and could be because she hasn't been eating.
Obviously you need to keep an eye on her and go back to the doctor if you are worried, none of us are doctors so like you we can only speculate.

 

[SophiaW]

From what I understand the urine test is less acurate than a blood test both for glucose levels and ketones. Urine testing will give results from a few hours earlier and over a longer period of time whereas blood testing gives a result at that instant. If your daughter had a high blood glucose reading earlier on (more than approx 10 mmol/l) then it may show as elevated in her urine test but a blood test will show a lower glucose level now that it's later on and her blood glucose has returned to a normal level. The same applies to ketone testing which is why a blood ketone test is better and more acurate than a urine ketone test, it gives you a result now rather than based on a few hours ago.

Do you have a blood ketone test kit and strips? The Abbott Optium Xceed test meter for blood glucose testing also has ketone test strips that you can use for blood ketone testing, if you don't have this then get it on prescription and whenever your daughter is unwell with higher than usual blood glucose levels keep testing for ketones every few hours. For now I would keep your daughter well hydrated and keep testing her blood glucose and correcting any high readings with insulin to keep them in a good range. If she has a temperature try to keep it down with paracetamol, I find a high temp makes blood glucose more difficult to keep down. It's important to keep testing for ketones (blood) so try to get hold of ketone test strips as soon as possible. I've linked a document which explains about the different levels of ketones and what to do.

http://www.dmforum.org.uk/DMF/PDF/blood ... ing_A4.pdf

 

[borofergie]

Do you have a blood ketone test kit and strips? The Abbott Optium Xceed test meter for blood glucose testing also has ketone test strips that you can use for blood ketone testing, if you don't have this then get it on prescription and whenever your daughter is unwell with higher than usual blood glucose levels keep testing for ketones every few hours. For now I would keep your daughter well hydrated and keep testing her blood glucose and correcting any high readings with insulin to keep them in a good range. If she has a temperature try to keep it down with paracetamol, I find a high temp makes blood glucose more difficult to keep down. It's important to keep testing for ketones (blood) so try to get hold of ketone test strips as soon as possible. I've linked a document which explains about the different levels of ketones and what to do.

I have one of these, and I test every day (for ketosis, not ketoacidosis). Although the urine strips aren't very accurate in predicting quantity of ketones (because they're subject to dilution if you drink a lot), even at relatively small ketone levels (>1mmol/l) the ketostix strips always show something. I get the darkest colour on the ketostix if my blood ketone level goes above 2.5mmol/l which is a high value from a ketosis point of view, but an order of magnitude smaller than ketoacidosis levels.

Like everyone else has said, if you're worried then get her to the Doctors.

 

[SophiaW]

Borofergie, can I ask why you test every day? We only test when unwell and BG is running higher than usual.

 

[borofergie]

Borofergie, can I ask why you test every day? We only test when unwell and BG is running higher than usual.

Because I'm a T2 on no medication who eats <<20g a day, and so deliberately put myself in nutritional ketosis. Phinney and Volek recommend testing your ketone levels every day to make sure that you're actually in ketosis (which they define as above 0.5mmol/l). Ketosis does not lead to ketoacidosis.

I'll make a post about it, but this probably isn't the best place to discuss it.

 

[SophiaW]

Borofergie, can I ask why you test every day? We only test when unwell and BG is running higher than usual.

Because I'm a T2 on no medication who eats <<20g a day, and so deliberately put myself in nutritional ketosis. Phinney and Volek recommend testing your ketone levels every day to make sure that you're actually in ketosis (which they define as above 0.5mmol/l). Ketosis does not lead to ketoacidosis.

I'll make a post about it, but this probably isn't the best place to discuss it.

Okay, that makes sense, thanks Ketosis in your situation does not lead to ketoacidosis but for an unwell t1 ketosis can develop into ketoacidosis if not carefully managed.

 

[borofergie]

Okay, that makes sense, thanks Ketosis in your situation does not lead to ketoacidosis but for an unwell t1 ketosis can develop into ketoacidosis if not carefully managed.

Absolutely. The original poster is absolutely right to be worried about ketoacidosis, it's a very serious condition that requires urgent medical attention...

 

[phoenix]

Actually I'm not sure whether mizzsully's daughter has been diagnosed with diabetes. I assumed not in my reply but I may have been wrong.

 

[SophiaW]

Actually I'm not sure whether mizzsully's daughter has been diagnosed with diabetes. I assumed not in my reply but I may have been wrong.

Oh, good point. I had assumed the child already had a diagnosis of type 1 diabetes. Wrong of me to make assumptions, sorry about that! If she's not diagnosed then it could be an infection as the doctor says and ignore all my waffling on about testing for ketones with a blood test meter. As the others have said worth visiting the doctor again if you're still worried.

 

[borofergie]

Actually I'm not sure whether mizzsully's daughter has been diagnosed with diabetes. I assumed not in my reply but I may have been wrong.

Ahhhh. If she isn't taking insulin, then ketoacidosis is very unlikely. Blood ketones are a normal response to starvation or carbohydrate restriction.