Absorption of glucose from urinary conduits in diabetics and non-diabetics.

Abstract

The ability of urinary conduits to absorb glucose was investigated. A solution containing 1% glucose and the inert marker phenol red was put into conduits in diabetic and non-diabetic patients. Samples were withdrawn at intervals for analysis and the fall in concentrations plotted against time. The loops in the patients without diabetes did not absorb glucose, but glucose was absorbed in one of the three diabetics.Ileal loops in patients with diabetes may absorb urinary glucose. This should be checked in any diabetic with urinary diversion before advice is given on long term management. Routine testing of conduit urine for glucose may not be an adequate screen for diabetes in patients with urinary diversions.

An Analysis of the 90-Day Day Outcomes of Robot- Assisted Continent Colon Pouch Urinary Diversion

“…Diabetes has been identi ed as a risk factor for adverse outcomes and a decline in renal function following continent cutaneous urinary diversion (modi ed Indiana pouch or appendiceal stoma) (24), both of which were con rmed by the results of this study. Moreover, there is a risk of enhanced glucose absorption from urinary conduits in diabetic vs non-diabetic patients from both the ileum and colon (25), which could potentially worsen existing diabetes, further increasing the risk of postoperative complications.…”

Metabolic Changes after Urinary Diversion

“…Urine glucose screening in diabetes patients might be inaccurate due to glucose absorption. Therefore, blood tests should be performed for surveillance [ 32 ]. On the therapeutic level, mainly drugs that are secreted unchanged in urine and absorbed by the intestine can cause problems.…”

Mucosal Morphology of Ileal Conduits with Particular Reference to Urinary Infections

“…The pathogenesis and conse quences of this histological change are unclear. Among other things, exposure of the ileal conduit to a different bacterial flora has been thought to damage the ileal mucosa [6,10], There are reports suggesting that the mor phological changes in ileal mucosa exposed to urine are adaptive and protect these patients from absorption of urine [12,14], as well as glucose in long established con duits [18]. Others have the opinion that the changes do not prevent the occurrence of severe electrolyte distur…”

“…The more severely affected areas were situated adjacent to the stoma and ureteral orifices. In their opinion the marked villous atro phy helps to explain the lack of absorptive capacity that they found in long established conduits, at least for glu cose [18], Garner et al [8] studied the histology of 8 ileal …”