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. 2024 Jan 29;37(2):130-136.
doi: 10.1515/jpem-2023-0295. Print 2024 Feb 26.

Review on the screening of urine glucose for early diagnosis of type 2 diabetes mellitus in school children and adolescents with obesity in Hong Kong

Gloria Shir-Wey Pang  1   2 , Thomas Wai-Hung Chung  3 , Heather Hiu-Ting Choy  3 , Ching-Yin Lee  4 , Joanna Yuet-Ling Tung  1   5 , Antony Chun-Cheung Fu  2 , Jennifer Wing-Yan Tsang  6 , Ho-Chung Yau  6 , Kiran M Belaramani  7 , Lap-Ming Wong  7 , Betty Wai-Man But  8 , Jasmine Chi-Kwan Chow  8 , Shirley Man-Yee Wong  8 , Patrick Chi-Hung Cheung  9 , Priscilla Wai-Chee Lo  9 , Kwok-Leung Ng  9 , Sarah Wing-Yiu Poon  5 , Kwong Tat Chan  10 , Angela Mo-Kit Chan  11 , Sammy Wai-Chun Wong  11 , Ming-Kut Tay  12 , Ying-Ki Chung  4 , Yuen-Yu Lam  13 , Elaine Yin-Wah Kwan  1   10
Affiliations

Review on the screening of urine glucose for early diagnosis of type 2 diabetes mellitus in school children and adolescents with obesity in Hong Kong

Gloria Shir-Wey Pang et al. J Pediatr Endocrinol Metab. .

Abstract

Objectives: Obesity and type 2 diabetes mellitus (T2DM) are growing health concerns. Since 2005, Student Health Service (SHS) and Hong Kong Paediatric Society formulated a protocol on urine glucose screening (UGS) for early diagnosis of T2DM in students with obesity in Hong Kong. This study reviews students with T2DM captured by this screening program and compare the data with the Hong Kong Children Diabetes Registry (HKCDR) database, to see if the UGS program facilitates early diagnosis of T2DM.

Methods: Students between the ages of 10-18 years old with age- and sex-specific body mass index (BMI) >97th percentile who attended SHS between the school years from 2005/06 to 2017/18 were recruited for UGS. Those tested positive for random urine glucose underwent diagnostic testing for T2DM according to ADA guidelines. Demographic data and investigatory results from UGS and HKCDR within the same time period were compared.

Results: A total of 216,526 students completed UGS in the said period; 415 (0.19 %) students were tested positive for urine glucose of which 121 students were diagnosed with T2DM. UGS picked up 23 % of the newly diagnosed T2DM cases. When compared to the HKCDR database, students diagnosed via UGS were significantly younger, less obese, and had fewer diabetic related complications. The negative predictive value of UGS is high and can effectively rule out T2DM.

Conclusions: Urine glucose screening is an inexpensive and simple test that allows for early diagnosis of T2DM among obese school students. Other methods including POCT HbA1c can be explored to improve program effectiveness.

Keywords: screening; type 2 diabetes mellitus; urine glucose.

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