DETERMINATION OF GLUCOSURIA AND PROTEINURIA AMONG ADULT FROM THE AGE 30 TO 70 ATTENDING GENERAL HOSPITAL NASARAWA

DETERMINATION OF GLUCOSURIA AND PROTEINURIA AMONG ADULT FROM THE AGE 30 TO 70 ATTENDING GENERAL HOSPITAL NASARAWA

ABSTRACT

Glucosuria, is the present of glucose in the urine and proteinuria is also the present of protein in the urine. Glucosuria and proteinuria are major causes of illness and death especially among adult between the age of 30 – 70 years. It is estimated that more than one million adult living in Africa especially in remote areas with poor access to health services die annually from direct and indirect effects of glucosuria and proteinuria. The first freshly voided early morning urine is collected in a chemically clean and dry container. Combi 9 and Glucometer detection method were used to examine the present of glucosuria and proteinuria. The glucosuria and proteinuria was  found among 30 – 70 years old. 48 people were positive in the age of (51-70) and 15 people were negative in the age of (30-50). There is need for adult to know their glucosuria and proteinuria status, in other to prevent the occurrence of these long time deadly disease.

CHAPTER ONE

INTRODUCTION

1. Background of the Study

Glucosuria, glucose in the urine, results from the glomerular filtration of more glucose than the renal tubule can absorb. It occurs in all normal individuals in amounts up to 25 mg/dl (Khitan & Glassock, 2019). Abnormally increased glucosuria (more than 25mg/dl in random fresh urine (4), results from either an elevated plasma glucose, an impaired renal glucose absorptive capacity, or both (Khitan & Glassock, 2019). Proteinuria is a condition characterized by the presence of greater than normal amounts of protein in the urine. It is usually associated with some kind of disease or abnormality but may occasionally be seen in healthy individuals. Plasma, the liquid portion of blood, contains many different proteins. One of the many functions of the kidneys is to conserve plasma protein so that it is not eliminated along with waste products.

Glucosuria and proteinuria is a common symptom of both type 1 diabetes, type 2 diabetes and kidney disease. Diabetes mellitus also known simply as diabetes is a group of metabolic disorder of carbohydrate metabolism in which glucose is underutilized producing hyperglycemia over a long period (Rose & Rannke, 2009). It is characterized by high blood glucose either because the body does not produce enough insulin or because cells do not respond to the insulin that is produced (DeFronzo et al, 2013). Some causes of diabetes mellitus includes; Insufficient insulin production and utilization, Fibrocystic disease of the pancreas, Destruction of pancreatic islets of langerhans figure 1, Infant with low birth weight has a high potential of developing type 2 diabetes later in life (Joslin Diabetes Center, 2015), age older than 45 years, obesity weight greater than 120% of desirable body weight (true for 90% of patients with type 2 diabetes mellitus), history of impaired glucose tolerance (IGT) or impaired fasting glucose level (IFG), hypertension, blood pressure greater than 140/90mm/Hg or hyperlipidemia (high density lipoprotein (HDL) cholesterol less than 35mg/L or triglyceride level greater than 250mg/L, history of gestational diabetes or delivering a baby with body weight more than 5kg (American Diabetes Association, 2014).

Untreated, diabetes which is as a result of glucosuria and proteinuria can cause many complications. Acute complications include diabetic ketoacidosis and nonketotic hyperosmolar coma (Ripsin, Kang and Urban, 2009). Serious long-term complications include heart disease, stroke, kidney failure, foot ulcers and damage to the eyes (Ripsin, Kang and Urban, 2009). The classic symptoms of untreated diabetes are weight loss, polyuria (frequent urination), polydipsia (increased thirst), and polyphagia (increased hunger) which are known to show rapidly in a type1while developing much more slowly and even subtly or absent in type 2 diabetes. Several other signs and symptoms can mark the onset of diabetes, although they are not specific to the disease.

Since glucosuria and proteinuria are often found only on routine examination of the urine, the importance of this research work become very obvious. Thus it becomes very important to carryout this study to determine the cases of glucosuria and proteinuria among adult from the age of 30 to 70 attending general hospital Nasarawa.

1. Statement of the problem

Glucosuria and proteinuria which is a sign of diabetes has become the major cause of sickness and death in many industrialized countries. More than 85% of patients with diabetes have non-insulin-dependent diabetes; 50% of these patients are still undiagnosed.1,2 Patients with NIDDM may remain asymptomatic for 9 to 12 years before such conditions as retinopathy, microalbuminuria or proteinuria, neuropathy, and probable cardiovascular disease develop insidiously to cause irreversible or permanent damage (Chuo, Matern, Mansfield and Chen, 2012). Early determination of glucosiria and proteinuria is therefore important for patients with possible symptoms for diabetes. Results from clinical trials and epidemiologic studies show that screening for diabetes mellitus using urinary reagent strips has been effective in detecting glucosuria (glucose in the urine). Patients with diabetes mellitus must maintain tight glycemic control to prevent or reduce the risk of long-term complications.  In the past decade, studies of the correlation between the presence of glucosuria and proteinuria determined by urinary reagent strips and diabetes mellitus was rare. The purpose of this prospective study is therefore to determine glucosuria and proteinuria cases among adult attending General Hospital Nasarawa.

1. Objective of the study

The general objective of this study is to determine glucosuria and proteinuria among adult from the age of 30 to 70 years attending general hospital Nasarawa.

The specific objectives include:

1. The explore the concept of glucosuria and proteinuria
2. To detect the presence of glucose in the urine of the study population.
3. To detect the presence of glucosuria and proteinuria among the adults attending general hospital Nasarawa
4. To assess the prevalence of diabetes associated glucosuria and proteinuria among the population

1. Scope of the study

The scope of this study is limited to the determination of glucosuria and proteinuria among adults attending general hospital Nasarawa, the scope of the study is limited to adult between the age bracket of 30 to 70 years attending general hospital Nasarawa.

1. Significance of the study

Diabetes is a growing problem in the developing countries including Nigeria. Most cases of diabetes in Nigeria remain undiagnosed because many of the symptoms seem so harmless and most people especially in the rural areas are still ignorant of the disease. Early detection of diabetes mellitus and its treatment can decrease the chances of developing the complications.

The findings of this study on the determination of glucosuria and proteinuria among adult from age 30 to 70 years will be very significant to the general populace as it will enlighten them on the need to go for medical checkup and early diagnosis of diabetes. The findings of the study will also be of great significant to government ages in the health sectors to make policies that will be geared towards reducing the occurrence and management of diabetes and related diseases. Finally the study will contribute to the wealth of knowledge as it will serve as references for researchers who are interested in carrying further studies on the subject matter.

1. Definition of terms

Glucosuria: Glucosuria is defined as the presence of glucose in the urine, results from the glomerular filtration of more glucose than the renal tubule can absorb

Proteinuria: Proteinuria  is defined as the presence of abnormal quantities of protein in the urine, which may indicate damage to the kidneys.

Adult: An adult is a mature, fully developed person. An adult has reached the age when they are legally responsible for their actions. Becoming a father signified that he was now an adult.

Diabetes: Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves.

Diagnosis: Diagnosis is the process of determining which disease or condition explains a person’s symptoms and signs. It is most often referred to as diagnosis with the medical context being implicit.