Okay, let's tackle this question. The patient is a 35-year-old man named Ramu with normal fasting and postprandial blood sugar levels but has +++ urine sugar. The question is about diagnosing this situation.

First, I need to recall the possible reasons for glucose in urine despite normal blood sugar levels. Normally, glucose is reabsorbed in the proximal tubule of the kidney. If the blood glucose is too high, the renal threshold is exceeded, leading to glucosuria. But if blood glucose is normal, maybe there's a problem with the renal tubules' ability to reabsorb glucose.

The condition where the kidneys don't reabsorb glucose properly is called renal glycosuria. This is a type of Fanconi syndrome, but Fanconi usually has more symptoms like phosphaturia and aminoaciduria. However, isolated renal glycosuria can occur due to a defect in the sodium-glucose cotransporter 2 (SGLT2) in the proximal tubules.

Now, looking at the options (even though they aren't provided, I need to infer based on common choices). The correct answer would be renal glycosuria. Other options might include diabetes mellitus, but his blood sugars are normal. Renal glycosuria is a rare condition, so maybe the options include that. Other possibilities like Fanconi syndrome or diabetes insipidus (which causes polyuria but not glucosuria) are less likely here.

Wait, diabetes insipidus is about water balance, not glucose. Hypoglycemia is unlikely because he's not having low blood sugar. So the main differential is between renal glycosuria and other causes of glucosuria. Since his blood sugars are normal, it's definitely a renal issue.

Clinical pearl: Remember that glucosuria can occur without hyperglycemia due to renal defects. Also, Fanconi syndrome has more systemic issues, so if the patient only has glucosuria without other electrolyte issues, it's more likely isolated renal glycosuria.

So the correct answer is renal glycosuria. The other options would be incorrect because they don't fit the clinical picture of normal blood sugars with glucosuria.

**Core Concept**
This question tests understanding of **renal glucose reabsorption** and **pathophysiology of glucosuria**. Normally, glucose is reabsorbed in the proximal renal tubule via **SGLT2 (sodium-glucose cotransporter 2)**. Glucosuria occurs when blood glucose exceeds the renal threshold (typically >180–200 mg/dL) or when there is a **defect in tubular reabsorption**, as in **renal glycosuria**.

**Why the Correct Answer is Right**
The patient has **normal blood glucose levels** but **glucosuria**, indicating a **renal tubular defect** in glucose reabsorption. **Renal glycosuria** is a rare autosomal recessive disorder caused by **SGLT2 deficiency**, leading to urinary glucose loss despite euglycemia. This condition is asymptomatic and often discovered incidentally, with no associated hyperglycemia or diabetes mellitus.

**Why Each Wrong Option is Incorrect**
**Option A:** *Diabetes mellitus* is incorrect because fasting and postprandial glucose

✓ Correct Answer: A. Renal Glycosuria