Morning Spot Urine Glucose-to-Creatinine Ratios Predict Overnight Urinary Glucose Excretion in Patients With Type 2 Diabetes

• Published in: Annals of laboratory medicine Vol. 37; no. 1; pp. 9 - 17
• Main Authors: Kim, So Ra, Lee, Yong Ho, Lee, Sang Guk, Lee, Sun Hee, Kang, Eun Seok, Cha, Bong Soo, Lee, Hyun Chul, Kim, Jeong Ho, Lee, Byung Wan
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society for Laboratory Medicine 01.01.2017; 대한진단검사의학회
• Subjects: Adult; Aged; Blood Glucose - analysis; Creatinine - urine; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - pathology; Female; Glucose - analysis; Glucose - metabolism; Humans; Linear Models; Male; Middle Aged; Original; Prospective Studies; Urinalysis; 병리학; Urinary glucose-to-creatinine ratio; Urinary glucose excretion; Type 2 diabetes mellitus
• ISSN: 2234-3806; 2234-3814
• DOI: 10.3343/alm.2017.37.1.9

With the advent of sodium glucose co-transporter 2 inhibitors to control glucose and treat diabetes, laboratory data aided by either timed or spot glucose levels in the urine could be used as an alternative marker of drug response. The aim of this study was to assess the agreement between overnight urinary glucose excretion (UGE) and morning spot urinary glucose-to-creatinine ratio (UGCR). In this prospective cross-sectional study, we enrolled a total of 215 participants with either normal glucose tolerance (NGT), pre-diabetes, or type 2 diabetes mellitus (T2DM). To exclude external factors such as food intake and physical activity, urine samples collected overnight at an 8-hr interval and the first-voided morning spot urine were collected and compared. The median values of overnight 8-hr UGE in participants with NGT (N=14), pre-diabetes (N=41), and T2DM (N=160) were 35.0 mg, 35.6 mg, and 653.4 mg, respectively. In participants with T2DM, the median values of overnight 8-hr UGCR and first-voided morning spot UGCR (M-UGCR) were 1.37 mg/mg and 0.16 mg/mg, respectively. Quantitative analyses using an intraclass correlation coefficient (ICC) demonstrated a good reliability of measurement of the overnight 8-hr UGCR and M-UGCR (ICC=0.943, P<0.001). The M-UGCR was also significantly related to the overnight 8-hr UGE (r=0.828, P<0.001). M-UGCR and overnight 8-hr UGCR showed good agreement, suggesting that M-UGCR be used as a simple index for estimating overnight amounts of UGE in patients with T2DM.