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Sir.—Dr Malone and colleagues (Am J Dis Child 130:1324, 1976) correlated plasma glucose levels with the semi-quantitative estimation of the concentration of total reducing substance (TRS) in a simultaneously obtained urine sample in a group of diabetic children. Although the correlation is good (r = 0.92), they suggest that, in general, the concentration of TRS in urine is a poor method for estimating the level of glycemia because some patients had hyperglycemia with little or no glycosuria and some patients had normal plasma glucose levels with high concentrations of TRS in their urine. The authors suggest that this may be explained by rapid changes in the concentration of glucose in plasma or by variability in the renal threshold for glucose. The notion that the renal threshold for glucose might be so markedly changed as to explain the results in the exceptional cases is unsupported by the data and seems to
FINKELSTEIN JW. Diabetic Management. Am J Dis Child. 1977;131(11):1305. doi:10.1001/archpedi.1977.02120240123027