Urinary excretion of calcium, inorganic phosphorus, magnesium, glucose, and creatinine was measured in first-void spot urine samples collected 4 days apart in 220 insulin-dependent diabetic (IDDM) children (mean age 11.9 yr) attending a summer camp. A single control urine sample was obtained from 33 healthy nondiabetic siblings (mean age 11.2 yr). Mean ± SD urinary calciumcreatinine ratios (UCa/cr) did not significantly differ between IDDM and control subjects (0.14 ± 0.09 vs. 0.12 ± 0.09, respectively, P = 0.156). Mean urinary magnesium-creatinine ratios (UMg/Cr) were elevated in IDDM compared with control subjects (0.15 ± 0.06 vs. 0.08 ± 0.03, respectively, P = 0.0001). Similarly, mean urinary phosphorus-creatinine ratios (UP/cr) were significantly increased over those in control subjects (1.12 ± 0.33 vs. 0.40 ± 0.22, respectively, P = 0.0001). Uca/cr′ UMg/Cr′, and Up/Cr were correlated with increasing mean urine glucose content (P = 0.0001). No correlations were found when Uca/cr′ UMg/Cr′, or Up/Cr were compared with patient age, duration of diabetes, glycosylated hemoglobin, or insulin dosage. Urine losses of phosphorus and magnesium were present even when glycemic control was considered good by several methods (glycosylated hemoglobin, short-term glycemic index, or urinary glucose content). Glomerular hyperfiltration was unable to account for increased urinary mineral content. In conclusion, the data indicate that urinary excretion of phosphorus and magnesium is elevated in children with IDDM, regardless of glycemic control. In the presence of glucosuria, this loss is further enhanced. Urinary calcium excretion is significantly higher only during periods of glucosuria. The data suggest that children with IDDM could be at risk for mineral deficiencies in the absence of intensive insulin management.
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April 01 1990
Hyperphosphaturia and Hypermagnesuria in Children With IDDM
Stephen W Ponder, MD;
Stephen W Ponder, MD
Department of Pediatrics, The Cleveland Clinic Foundation
Cleveland, Ohio
Divisions of Endocrinology and of Nephrology and Diabetes, Department of Pediatrics, University of Texas Medical Branch
Calveston, Texas
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Ben H Brouhard, MD;
Ben H Brouhard, MD
Department of Pediatrics, The Cleveland Clinic Foundation
Cleveland, Ohio
Divisions of Endocrinology and of Nephrology and Diabetes, Department of Pediatrics, University of Texas Medical Branch
Calveston, Texas
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Luther B Travis, MD
Luther B Travis, MD
Department of Pediatrics, The Cleveland Clinic Foundation
Cleveland, Ohio
Divisions of Endocrinology and of Nephrology and Diabetes, Department of Pediatrics, University of Texas Medical Branch
Calveston, Texas
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Address correspondence and reprint requests to Stephen W. Ponder, MD, Division of Pediatric Endocrinology, Route C-63, University of Texas Medical Branch, Calveston, TX 77550.
Diabetes Care 1990;13(4):437–441
Article history
Received:
June 23 1989
Revision Received:
October 18 1989
Accepted:
October 18 1989
PubMed:
2180662
Citation
Stephen W Ponder, Ben H Brouhard, Luther B Travis; Hyperphosphaturia and Hypermagnesuria in Children With IDDM. Diabetes Care 1 April 1990; 13 (4): 437–441. https://doi.org/10.2337/diacare.13.4.437
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