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


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Korea.|Diabetes Center, Severance Hospital, Seoul, Korea.
So Ra
SR
Kim
Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Korea.|Diabetes Center, Severance Hospital, Seoul, Korea.
Yong Ho
YH
Lee
Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
Sang Guk
SG
Lee
Diabetes Center, Severance Hospital, Seoul, Korea.
Sun Hee
SH
Lee
Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Korea.|Diabetes Center, Severance Hospital, Seoul, Korea.
Eun Seok
ES
Kang
Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Korea.|Diabetes Center, Severance Hospital, Seoul, Korea.
Bong Soo
BS
Cha
Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Korea.|Diabetes Center, Severance Hospital, Seoul, Korea.
Hyun Chul
HC
Lee
Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
Jeong Ho
JH
Kim
Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Korea.|Diabetes Center, Severance Hospital, Seoul, Korea. bwanlee@yuhs.ac.
Byung Wan
BW
Lee
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003404:Creatinine / Q000652:urine*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology*; D005260:Female; D005947:Glucose / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016482:Urinalysis
D001786:Blood Glucose; D003404:Creatinine; D005947:Glucose
Type 2 diabetes mellitus; Urinary glucose excretion; Urinary glucose-to-creatinine ratio