Kabadi U M
Endocrinology Section, VA Medical Center, Phoenix, AZ 85012.
J Fam Pract. 1992 Apr;34(4):495-7.
Urine glucose testing has been deemed by some to be nonessential in the management of diabetes mellitus since the technique and equipment for self-monitoring of blood glucose has become available. However, most physicians have experienced pitfalls in the management of diabetes mellitus when insulin dosage is adjusted daily based solely on the patient's monitoring of blood glucose. There have also been recent reports suggesting the use of urine glucose testing as a reliable and a reasonable alternative to monitoring of blood glucose in the management of diabetic subjects, including those using insulin as the mode of therapy. In this report, we describe a patient in whom diabetic ketoacidosis occurred during hospitalization as a result of inadequate insulin administration due to inaccurate capillary blood glucose test results. Furthermore, urine glucose and ketone values obtained simultaneously had been disregarded. If insulin therapy had been adjusted according to urine glucose results rather than blood glucose readings, diabetic ketoacidosis could have been averted in this patient. Urine glucose testing may provide a reliable backup for suspect whole blood glucose values and may prevent catastrophic events requiring expensive hospitalization. This report also delineates several potential procedural problems that exist in the technique of whole blood glucose monitoring and provides recommendations to overcome these deficiencies.
自从有了自我血糖监测技术和设备后，一些人认为尿糖检测在糖尿病管理中并非必不可少。然而，大多数医生在仅根据患者的血糖监测结果每日调整胰岛素剂量时，都在糖尿病管理中遇到过问题。最近也有报告表明，在糖尿病患者（包括那些使用胰岛素作为治疗方式的患者）的管理中，尿糖检测可作为监测血糖的一种可靠且合理的替代方法。在本报告中，我们描述了一名患者，其在住院期间因毛细血管血糖检测结果不准确导致胰岛素给药不足而发生糖尿病酮症酸中毒。此外，同时获得的尿糖和酮体值被忽视了。如果根据尿糖结果而非血糖读数调整胰岛素治疗，该患者本可避免发生糖尿病酮症酸中毒。尿糖检测可为可疑的全血血糖值提供可靠的备份，并可预防需要昂贵住院治疗的灾难性事件。本报告还阐述了全血血糖监测技术中存在的几个潜在操作问题，并提出了克服这些不足的建议。
