Ask the Doctor: Am I diabetic?

Sugar in urine normally happens when one has excessive amounts of sugar in blood as is the case with diabetes mellitus. When there is excessive sugar in the blood (above 180 mg percent), it will overwhelm the kidneys and the sugar will appear in the urine.

However, there is a great individual variation of this blood sugar amount that may lead to sugar appearing in urine (renal threshold) so that sugar may appear in urine when blood levels are lower. This is especially true in children and pregnant women where it can appear when blood levels are as low as 120mg percent.

Sometimes, people may take a meal with lots of sugar, causing the blood sugar levels to exceed the renal threshold and this sugar appears in urine when one is not diabetic. This so-called alimentary lag may lead to one being suspected to be diabetic when they are not. Fasting blood sugar and other blood tests may show that one is not diabetic.

Some people whose fasting blood sugar is above 100 mg percent but not yet diagnosed as diabetic (prediabetes) may also show sugar in their urine. These require to take dietary and other lifestyle measures to delay the onset of diabetes. Sugar in urine can also be caused by other non-high blood sugar conditions including an inherited condition in which the filtering mechanism of the kidneys allows sugar to pass through into the urine.

Medical conditions including where the kidneys leak protein Nephrotic syndrome and a kidney transplant may also show glucose in urine. Whereas diabetes used to be diagnosed or checked through urine, because of many non-diabetic causes of sugar in urine apart from sugar in urine not telling whether at the time of checking urine the blood sugar is high, urinary diagnosis of sugar has been abandoned for blood sugar levels.

Nowadays, there is a new type of drug for the treatment of diabetes known as gliflozins that can cause one to urinate out excess sugar hence leading to confusion about whether one’s blood sugar is under control or not.

Can lack of sex cause back pain?

I have had chronic back pain for a while now and I have been told that it is caused by lack of sex. Is this true and if so, how often should one have sex in a month to avoid the pain? Jejefu

Dear Jejefu,

Backache is mostly caused by problems with structures of the back including muscles, ligaments, tendons, nerves, cushions between bones (discs), and skin but can result from ailing areas remote from the back including abdominal organs such as kidneys or a constipated rectum. Structures of the back as we age may show wear and tear effects and hurt while abdominal organs such as the kidneys are more likely to fail with advance in age.

Many Ugandans, men and women wrongly believe that lack of sex can cause a buildup of water in the back leading to backache. However, it may be too much sex that may hurt the back leading to back pain. 

You must get your back checked properly to find the real cause of the backache whose treatment will not interfere with your sex life given that back pain can interfere with sex. 

Do I have an STD?

I masturbate often but nowadays my semen has a fish odour. Do I have an STD even after not having sex for 12 years? Paul

Dear Paul,

Many women or even their male sexual partners may complain that the female’s genitals smell after sex unaware that this could be because of semen rather than a woman’s sexual fluids. The women will then visit doctors alone without the treatment offering any help. Semen in normal cases may smell like chlorine in a swimming pool because it contains ammonia among other substances. When a man takes long to ejaculate, this smell may even be stronger.

Also, a man’s semen may change with changes in diet with lots of meat leading to a strong smell and pineapple a sweet odour. Reducing the amount of meat and adding more pineapple to the diet may improve the semen smell.

If semen smell does not change even when one has not been sexually active, he should be checked for prostate gland infections which can give semen a foul smell. Also, infections on the head of the penis and inside the foreskin can lead to sexual odours. If this does not improve with better penile hygiene or better management of diabetes, it may require circumcision to help out.

Masturbation once in a while may be healthy but if it substitutes for natural vaginal sex ending up without sex for 12 years can interfere with reproduction.