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Glucose in the urine (glucosuria) occurs when blood glucose exceeds the kidney's reabsorption threshold (typically around 180 mg/dL), causing sugar to spill into the urine. It is a classic sign of uncontrolled or undiagnosed diabetes; a positive urine glucose on a routine urinalysis should always prompt a fasting blood glucose and HbA1c. A rare exception is SGLT2 inhibitor medication, which intentionally lowers the kidney threshold to cause glucosuria as a therapeutic mechanism.
Positive urine glucose occurs when blood glucose exceeds the renal threshold of approximately 180 mg/dL, indicating uncontrolled diabetes. Negative is expected.
Optimal is negative. Urine glucose is an insensitive screening tool for diabetes compared to blood glucose and HbA1c.