The detection of sugars in the urine of people with diabetes usually is attributed to Matthew Dobson. However, first attempts at quantification of urine sugars seem to have been made by Francis Home, an Edinburgh physician. Estimation of urine sugar as a measure of severity of diabetes had two major problems that, until recently, were shared with its contemporary equivalent, estimation of glycated haemoglobin. Firstly, both are surrogate measures of the average concentration of plasma glucose that is responsible for the microvascular and arterial damage that manifests itself in later years. Secondly, both also included in their measurement non-specific (nonglucose) substances when using available assays. Very recently, the glycated haemoglobin assay has been standardised by the scientific community to remove this non-specificity, but switching to this more accurate method for everyday reporting of results could lead to confusion and worsening of the control of diabetes.

Urine glucose remains of value only where the cost of self monitored blood glucose control is out of reach, but glycated haemoglobin (as HbA_1c) has become central to …