Diabetes affects millions of people around the world. Diabetes is responsible for hundreds of thousands of deaths yearly. This article contains the definition of diabetic terms.

Diabetes Dictionary of Terms

A

ACE InhibitorA type of drug used to lower blood pressure. Studies indicate that it may also help prevent or slow the progression of kidney disease in people with diabetes.

AcetohexamideA pill taken to lower the level of glucose (sugar) in the blood. Only some people with noninsulin-dependent diabetes take these pills. See also: Oral hypoglycemic agents.

AcetoneA chemical formed in the blood when the body uses fat instead of glucose (sugar) for energy. If acetone forms, it usually means that the cells do not have enough insulin, or cannot use the insulin that is in the blood, to use glucose for energy. Acetone passes through the body into the urine. Someone with a lot of acetone in the body can have breath that smells fruity and is called “acetone breath.” See also: Ketone bodies.

Acidosis

Too much acid in the body. For a person with diabetes, this can lead to diabetic ketoacidosis. See also: Diabetic ketoacidosis.

Acute

Happens for a limited period of time; abrupt onset; sharp, severe.

Adrenal Glands

Two organs that sit on top of the kidneys and make and release hormones such as adrenalin (epinephrine). This and other hormones, including insulin, control the body’s use of glucose (sugar).

Adult-Onset Diabetes

Former term for noninsulin-dependent or type II diabetes. See also: Noninsulin-dependent diabetes mellitus.

Adverse Effect

A harmful result.

Albuminuria

More than normal amounts of a protein called albumin in the urine. Albuminuria may be a sign of kidney disease, a problem that can occur in people who have had diabetes for a long time.

Aldose Reductase Inhibitor

A class of drugs being studied as a way to prevent eye and nerve damage in people with diabetes. Aldose reductase is an enzyme that is normally present in the eye and in many other parts of the body. It helps change glucose (sugar) into a sugar alcohol called sorbitol. Too much sorbitol trapped in eye and nerve cells can damage these cells, leading to retinopathy and neuropathy. Drugs that prevent or slow (inhibit) the action of aldose reductase are being studied as a way to prevent or delay these complications of diabetes.

Alpha Cell

A type of cell in the pancreas (in areas called the islets of Langerhans). Alpha cells make and release a hormone called glucagon, which raises the level of glucose (sugar) in the blood.

Amino Acid

The building blocks of proteins; the main material of the body’s cells. Insulin is made of 51 amino acids joined together.

Amyotrophy

A type of diabetic neuropathy that causes muscle weakness and wasting.

Angiopathy

Disease of the blood vessels (arteries, veins, and capillaries) that occurs when someone has diabetes for a long time. There are two types of angiopathy: macroangiopathy and microangiopathy. In macroangiopathy, fat and blood clots build up in the large blood vessels, stick to the vessel walls, and block the flow of blood. In microangiopathy, the walls of the smaller blood vessels become so thick and weak that they bleed, leak protein, and slow the flow of blood through the body. Then the cells, for example, the ones in the center of the eye, do not get enough blood and may be damaged.

Anomalies

Birth defects; abnormalities.

Antagonist

One agent that opposes or fights the action of another. For example, insulin lowers the level of glucose (sugar) in the blood, whereas glucagon raises it; therefore, insulin and glucagon are antagonists.

Antibodies

Proteins that the body makes to protect itself from foreign substances. In diabetes, the body sometimes makes antibodies to work against pork or beef insulins because they are not exactly the same as human insulin or because they have impurities. The antibodies can keep the insulin from working well and may even cause the person with diabetes to have an allergic or bad reaction to the beef or pork insulins.

Antidiabetic Agent

A substance that helps a person with diabetes control the level of glucose (sugar) in the blood so that the body works as it should. See also: Insulin; oral hypoglycemic agents.

Antigens

Substances that cause an immune response in the body. The body “sees” the antigens as harmful or foreign. To fight them, the body produces antibodies, which attack and try to eliminate the antigens.

Antiseptic

An agent that kills bacteria. Alcohol is a common antiseptic. Before injecting insulin, many people use alcohol to clean their skin to avoid infection.

Arteriosclerosis

A group of diseases in which the walls of the arteries get thick and hard. In one type of arteriosclerosis, fat builds up inside the walls and slows the blood flow. These diseases often occur in people who have had diabetes for a long time. See also: Atherosclerosis.

Artery

A large blood vessel that carries blood from the heart to other parts of the body. Arteries are thicker and have walls that are stronger and more elastic than the walls of veins. See also: Blood vessels.

Artificial Pancreas

A large machine used in hospitals that constantly measures glucose (sugar) in the blood and, in response, releases the right amount of insulin. Scientists are also working to develop a small unit that could be implanted in the body, functioning like a real pancreas.

Aspartame

A man-made sweetener that people use in place of sugar because it has very few calories.

Asymptomatic

No symptoms; no clear sign of disease present.

Atherosclerosis

One of many diseases in which fat builds up in the large- and medium-sized arteries. This buildup of fat may slow down or stop blood flow. This disease can happen to people who have had diabetes for a long time.

Autoimmune Disease

Disorder of the body’s immune system in which the immune system mistakenly attacks and destroys body tissue that it believes to be foreign. Insulin-dependent diabetes is an autoimmune disease because the immune system attacks and destroys the insulin-producing beta cells.

Autonomic Neuropathy

A disease of the nerves affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs. These nerves are not under a person’s conscious control and function automatically. Also called visceral neuropathy. See also: Neuropathy.


B

Background Retinopathy

Early stage of diabetic retinopathy; usually does not impair vision. Also called “nonproliferative retinopathy.”

Basal Rate

Refers to a continuous supply of low levels of insulin, as in insulin pump therapy.

Beta Cell

A type of cell in the pancreas in areas called the islets of Langerhans. Beta cells make and release insulin, a hormone that controls the level of glucose (sugar) in the blood.

Beta Cell Transplantation

See: Islet cell transplantation.

Biosynthetic Human Insulin

A man-made insulin that is very much like human insulin. See also: Human insulin.

Biphasic Insulin

A type of insulin that is a mixture of intermediate- and fast-acting insulin.

Blood Glucose

The main sugar that the body makes from the three elements of food-proteins, fats, and carbohydrates-but mostly from carbohydrates. Glucose is the major source of energy for living cells and is carried to each cell through the bloodstream. However, the cells cannot use glucose without the help of insulin.

Blood Glucose Meter

A machine that helps test how much glucose (sugar) is in the blood. A specially coated strip containing a fresh sample of blood is inserted in a machine, when then calculates the correct level of glucose in the blood sample and shows the result in a digital display. Some meters have a memory that can store results from multiple tests.

Blood Glucose Monitoring

A way of testing how much glucose (sugar) is in the blood. A drop of blood, usually taken from the fingertip, is placed on the end of a specially coated strip, called a testing strip. The strip has a chemical on it that makes it change color according to how much glucose is in the blood. A person can tell if the level of glucose is low, high, or normal in one of two ways. The first is by comparing the color on the end of the strip to a color chart that is printed on the side of the test strip container. The second is by inserting the strip into a small machine, called a meter, which “reads” the strip and shows the level of blood glucose in a digital window display. Blood testing is more accurate than urine testing in monitoring blood glucose levels because it shows what the current level of glucose is, rather than what the level was an hour or so previously.

Blood Pressure

The force of the blood on the walls of arteries. Two levels of blood pressure are measured-the higher, or systolic, pressure, which occurs each time the heart pushes blood into the vessels, and the lower, or diastolic, pressure, which occurs when the heart rests. In a blood pressure reading of 120/80, for example, 120 is the systolic pressure and 80 is the diastolic pressure. A reading of 120/80 is said to be the normal range. Blood pressure that is too high can cause health problems such as heart attacks and strokes.

Blood-Sampling Devices

A small instrument for pricking the skin with a fine needle to obtain a sample of blood to test for glucose (sugar). See also: Blood glucose monitoring.

Blood Sugar

See: Blood glucose

Blood Urea Nitrogen (BUN)

A waste product of the kidneys. Increased levels of BUN in the blood may indicate early kidney damage.

Blood Vessels

Tubes that act like a system of roads or canals to carry blood to and from all parts of the body. The three main types of blood vessels are arteries, veins, and capillaries. The heart pumps blood through these vessels so that the blood can carry with it oxygen and nutrients that the cells need or take away waste that the cells do not need.

Bolus

An extra boost of insulin given to cover expected rise in blood glucose (sugar) such as the rise that occurs after eating.

Borderline Diabetes

A term no longer used. See: Impaired glucose tolerance.

Brittle Diabetes

A term used when a person’s blood glucose (sugar) level often swings quickly from high to low and from low to high. Also called labile and unstable diabetes.

Bronze Diabetes

A genetic disease of the liver in which the body takes in too much iron from food. Also called “hemocromatosis.”

Bunion

A bump or bulge on the first joint of the big toe caused by the swelling of a sac of fluid under the skin. Shoes that fit well can keep bunions from forming. Bunions can lead to other problems such as serious infections. See also: Foot care.


C

C.D.E. (Certified Diabetes Educator)

A health care professional who is qualified by the American Association of Diabetes Educators to teach people with diabetes how to manage their condition. The health care team for diabetes should include a diabetes educator, preferably a C.D.E.

C-Peptide

A substance that the pancreas releases into the bloodstream in equal amounts to insulin. A test of C-peptide levels will show how much insulin the body is making.

Calcium Channel Blocker

A drug used to lower blood pressure.

Callus

A small area of skin, usually on the foot, that has become thick and hard from rubbing or pressure. Calluses may lead to other problems such as serious infection. Shoes that fit well can keep calluses from forming. See also: Foot care.

Calorie

Energy that comes from food. Some foods have more calories than others. Fats have many calories. Most vegetables have few. People with diabetes are advised to follow meal plans with suggested amounts of calories for each meal and/or snack. See also: Meal plan; exchange lists.

Capillary

The smallest of the body’s blood vessels. Capillaries have walls so thin that oxygen and glucose can pass through them and enter the cells, and waste products such as carbon dioxide can pass back into the blood to be carried away and taken out of the body. Sometimes people who have had diabetes for a long time find that their capillaries become weak, especially those in the kidney and the retina of the eye. See also: Blood vessels.

Capsaicin

A topical ointment made from chili peppers used to relieve the pain of peripheral neuropathy.

Carbohydrate

One of the three main classes of foods and a source of energy. Carbohydrates are mainly sugars and starches that the body breaks down into glucose (a simple sugar that the body can use to feed its cells). The body also uses carbohydrates to make a substance called glycogen that is stored in the liver and muscles for future use. If the body does not have enough insulin or cannot use the insulin it has, then the body will not be able to use carbohydrates for energy the way it should. This condition is called diabetes. See also: Fats; protein.

Cardiologist

A doctor who sees and takes care of people with heart disease; a heart specialist.

Cardiovascular

Relating to the heart and blood vessels (arteries, veins, and capillaries); the circulatory system.

Carpal Tunnel Syndrome

A nerve disorder affecting the hand that may occur in people with diabetes; caused by a pinched nerve.

Cataract

Clouding of the lens of the eye. In people with diabetes, this condition is sometimes referred to as “sugar cataract.”

Cerebrovascular Disease

Damage to the blood vessels in the brain, resulting in a stroke. The blood vessels become blocked because of fat deposits or they become thick and hard, blocking the flow of blood to the brain. Sometimes, the blood vessels may burst, resulting in a hemorrhagic stroke. People with diabetes are at higher risk of cerebrovascular disease. See also: Macrovascular disease; stroke.

Charcot Foot

A foot complication associated with diabetic neuropathy that results in destruction of joints and soft tissue. Also called “Charcot’s joint” and “neuropathic arthropathy.”

Chemical Diabetes

A term no longer used. See: Impaired glucose tolerance.

Chlorpropamide

A pill taken to lower the level of glucose (sugar) in the blood. Only some people with noninsulin-dependent diabetes take these pills. See also: Oral hypoglycemic agents

Cholesterol

A fat-like substance found in blood, muscle, liver, brain, and other tissues in people and animals. The body makes and needs some cholesterol. Too much cholesterol, however, may cause fat to build up in the artery walls and cause a disease that slows or stops the flow of blood. Butter and egg yolks are foods that have a lot of cholesterol.

Chronic

Present over a long period of time. Diabetes is an example of chronic disease.

Circulation

The flow of blood through the heart and blood vessels of the body.

Clinical Trial

A scientifically controlled study carried out in people, usually to test the effectiveness of a new treatment.

Coma

A sleep-like state; not conscious. May be due to a high or low level of glucose (sugar) in the blood. See also: Diabetic coma.

Comatose

In a coma; not conscious.

Complications of Diabetes

Harmful effects that may happen when a person has diabetes. Some effects, such as hypoglycemia, can happen any time. Others develop when a person has had diabetes for a long time. These include damage to the retina of the eye (retinopathy), the blood vessels (angiopathy), the nervous system (neuropathy), and the kidneys (nephropathy). Studies show that keeping blood glucose levels as close to the normal, nondiabetic range as possible may help prevent, slow, or delay harmful effects to the eyes, kidneys, and nerves.

Congenital Defects

Problems or conditions that are present at birth.

Congestive Heart Failure

Heart failure caused by loss of pumping power by the heart, resulting in fluids collecting in the body. Congestive heart failure often develops gradually over several years, although it also can happen suddenly. It can be treated by drugs and in some cases, by surgery.

Contraindication

A condition that makes a treatment not helpful or even harmful.

Controlled Disease

Taking care of oneself so that a disease has less of an effect on the body. People with diabetes can “control” the disease by staying on their diets, by exercising, by taking medicine if it is needed, and by monitoring their blood glucose. This care will help keep the glucose (sugar) level in the blood from becoming either too high or too low.

Conventional Therapy

A system of diabetes management practiced by most people with diabetes; the system consists of one or two insulin injections each day, daily self-monitoring of blood glucose, and a standard program of nutrition and exercise. The main objective in this form of treatment is to avoid very high and very low blood glucose (sugar). Also called: “Standard Therapy.”

Coronary Disease

Damage to the heart. Not enough blood flows through the vessels because they are blocked with fat or have become thick and hard; this harms the muscles of the heart. People with diabetes are at a higher risk of coronary disease.

Coxsackie B4 Virus

An agent that has been shown to damage the beta cells of the pancreas in lab tests. This virus may be one cause of insulin-dependent diabetes.

Creatinine

A chemical found in the blood and passed in the urine. A test of the amount of creatinine in blood or in blood and urine shows if the kidney is working right or if it is diseased. This is called the creatinine clearance test.

CSII: Continuous Subcutaneous Insulin Infusion

See: Insulin pump.

Cyclamate

A man-made chemical that people used instead of sugar. The Food and Drug Administration banned the sale of cyclamates in 1973 because lab tests showed that large amounts of cyclamates can cause bladder cancer in rats.


D

Dawn Phenomenon

A sudden rise in blood glucose levels in the early morning hours. This condition sometimes occurs in people with insulin-dependent diabetes and (rarely) in people with noninsulin-dependent diabetes. Unlike the Somogyi effect, it is not a result of an insulin reaction. People who have high levels of blood glucose in the mornings before eating may need to monitor their blood glucose during the night. If blood glucose levels are rising, adjustments in evening snacks or insulin dosages may be recommended. See also: Somogyi effect.

Debridement

The removal of infected, hurt, or dead tissue.

Dehydration

Great loss of body water. A very high level of glucose (sugar) in the urine causes loss of a great deal of water, and the person becomes very thirsty.

Delta Cell

A type of cell in the pancreas in areas called the islets of Langerhans. Delta cells make somatostatin, a hormone that is believed to control how the beta cells make and release insulin and how the alpha cells make and release glucagon.

Desensitization

A method to reduce or stop a response such as an allergic reaction to something. For instance, if a person with diabetes has a bad reaction to taking a full dose of beef insulin, the doctor gives the person a very small amount of the insulin at first. Over a period of time, larger doses are given until the person is taking the full dose. This is one way to help the body get used to the full dose and to avoid having the allergic reaction.

Dextrose

A simple sugar found in the blood. It is the body’s main source of energy. Also called glucose. See also: Blood glucose.

Diabetes Control and Complications Trial (DCCT)

A 10-year study (1983-1993) funded by the National Institute of Diabetes and Digestive and Kidney Diseases to assess the effects of intensive therapy on the long-term complications of diabetes. The study proved that intensive management of insulin-dependent diabetes prevents or slows the development of eye, kidney, and nerve damage caused by diabetes.

Diabetes Insipidus

A disease of the pituitary gland or kidney, not diabetes mellitus. Diabetes insipidus is often called “water diabetes” to set it apart from “sugar diabetes.” The cause and treatment are not the same as for diabetes mellitus. “Water diabetes” has diabetes in its name because most people who have it show most of the same signs as someone with diabetes mellitus-they have to urinate often, get very thirsty and hungry, and feel weak. However, they do not have glucose (sugar) in their urine.

Diabetes Mellitus

A disease that occurs when the body is not able to use sugar as it should. The body needs sugar for growth and energy for daily activities. It gets sugar when it changes food into glucose (a form of sugar). A hormone called insulin is needed for the glucose to be taken up and used by the body. Diabetes occurs when the body cannot make use of the glucose in the blood for energy because either the pancreas is not able to make enough insulin or the insulin that is available is not effective. The beta cells in areas of the pancreas called the islets of Langerhans usually make insulin.

There are two main types of diabetes mellitus: insulin-dependent (Type I) and noninsulin-dependent (Type II). In insulin-dependent diabetes (IDDM), the pancreas makes little or no insulin because the insulin-producing beta cells have been destroyed. This type usually appears suddenly and most commonly in younger people under age 30. Treatment consists of daily insulin injections or use of an insulin pump, a planned diet and regular exercise, and daily self-monitoring of blood glucose.

In noninsulin-dependent diabetes (NIDDM), the pancreas makes some insulin, sometimes too much. The insulin, however, is not effective (see Insulin Resistance). NIDDM is controlled by diet and exercise and daily monitoring of glucose levels. Sometimes oral drugs that lower blood glucose levels or insulin injections are needed. This type of diabetes usually develops gradually, most often in people over 40 years of age. NIDDM accounts for 90 to 95 percent of diabetes.

The signs of diabetes include having to urinate often, losing weight, getting very thirsty, and being hungry all the time. Other signs are blurred vision, itching, and slow healing of sores. People with untreated or undiagnosed diabetes are thirsty and have to urinate often because glucose builds to a high level in the bloodstream and the kidneys are working hard to flush out the extra amount. People with untreated diabetes often get hungry and tired because the body is not able to use food the way it should.

In insulin-dependent diabetes, if the level of insulin is too low for a long period of time, the body begins to break down its stores of fat for energy. This causes the body to release acids (ketones) into the blood. The result is called ketoacidosis, a severe condition that may put a person into a coma if not treated right away.

The causes of diabetes are not known. Scientists think that insulin- dependent diabetes may be more than one disease and may have many causes. They are looking at hereditary (whether or not the person has parents or other family members with the disease) and at factors both inside and outside the body, including viruses.

Noninsulin-dependent diabetes appears to be closely associated with obesity and with the body resisting the action of insulin.

Diabetic Amyotrophy

A disease of the nerves leading to the muscles. This condition affects only one side of the body and occurs most often in older men with mild diabetes. See also: Neuropathy.

Diabetic Angiopathy

See: Angiopathy.

Diabetic Coma

A severe emergency in which a person is not conscious because the blood glucose (sugar) is too low or too high. If the glucose level is too low, the person has hypoglycemia; if the level is too high, the person has hyperglycemia and may develop ketoacidosis. See also: Hyperglycemia; hypoglycemia; diabetic ketoacidosis.

Diabetic Ketoacidosis (DKA)

Severe, out-of-control diabetes (high blood sugar) that needs emergency treatment. DKA happens when blood sugar levels get too high. This may happen because of illness, taking too little insulin, or getting too little exercise. The body starts using stored fat for energy, and ketone bodies (acids) build up in the blood.

Ketoacidosis starts slowly and builds up. The signs include nausea and vomiting, which can lead to loss of water from the body, stomach pain, and deep and rapid breathing. Other signs are a flushed face, dry skin and mouth, a fruity breath odor, a rapid and weak pulse, and low blood pressure. If the person is not given fluids and insulin right away, ketoacidosis can lead to coma and even death.

Diabetic Myelopathy

Spinal cord damage found in some people with diabetes.

Diabetic Nephropathy

See: Nephropathy

Diabetic Neuropathy

See: Neuropathy

Diabetic Osteopathy

Loss of foot bone as viewed by x-ray; usually temporary. Also called “disappearing bone disease.”

Diabetic Retinopathy

A disease of the small blood vessels of the retina of the eye. When retinopathy first starts, the tiny blood vessels in the retina become swollen, and they leak a little fluid into the center of the retina. The person’s sight may be blurred. This condition is called background retinopathy. About 80 percent of people with background retinopathy never have serious vision problems, and the disease never goes beyond this first stage.

However, if retinopathy progresses, the harm to sight can be more serious. Many new, tiny blood vessels grow out and across the eye. This is called neovascularization. The vessels may break and bleed into the clear gel that fills the center of the eye, blocking vision. Scar tissue may also form near the retina, pulling it away from the back of the eye. This stage is called proliferative retinopathy, and it can lead to impaired vision and even blindness. See also: Photocoagulation or vitrectomy for treatments.

Diabetogenic

Causing diabetes; some drugs cause blood glucose (sugar) to rise, resulting in diabetes.

Diabetologist

A doctor who sees and treats people with diabetes mellitus.

Diagnosis

The term used when a doctor finds that a person has a certain medical problem or disease.

Dialysis

A method for removing waste such as urea from the blood when the kidneys can no longer do the job. The two types of dialysis are: hemodialysis and peritoneal dialysis. In hemodialysis, the patient’s blood is passed through a tube into a machine that filters out waste products. The cleansed blood is then returned to the body.

In peritoneal dialysis, a special solution is run through a tube into the peritoneum, a thin tissue that lines the cavity of the abdomen. The body’s waste products are removed through the tube. There are three types of peritoneal dialysis. Continuous ambulatory peritoneal dialysis (CAPD), the most common type, needs no machine and can be done at home. Continuous cyclic peritoneal dialysis (CCPD) uses a machine and is usually performed at night when the person is sleeping. Intermittent peritoneal dialysis (IPD) uses the same type of machine as CCPD, but is usually done in the hospital because treatment takes longer. Hemodialysis and peritoneal dialysis may be used to treat people with diabetes who have kidney failure.

Diastolic Blood Pressure

See: Blood pressure.

Diet Plan

See: Meal plan.

Dietitian

An expert in nutrition who helps people with special health needs plan the kinds and amounts of foods to eat. A registered dietitian (R.D.) has special qualifications. The health care team for diabetes should include a dietitian, preferably an R.D.

Dilated Pupil Examination

A necessary part of an examination for diabetic eye disease. Special drops are used to enlarge the pupils, enabling the doctor to view the back of the eye for damage.

Distal Sensory Neuropathy

See: Peripheral neuropathy.

Diuretic

A drug that increases the flow of urine to rid the body of extra fluid.

DKA See: Diabetic ketoacidosis.

DNA (Deoxyribonucleic Acid)

A chemical substance in plant and animal cells that tells the cells what to do and when to do it. DNA is the information about what each person inherits from his or her parents.

Dupuytren’s Contracture

A condition that causes the fingers to curve inward and may also affect the palm. The condition is more common in people with diabetes and may precede diabetes.


E

Edema

A swelling or puffiness of some part of the body such as the ankles. Water or other body fluids collect in the cells and cause the swelling.

Electromyography (EMG)

Test used to diagnose neuropathy and check for nerve damage.

Emergency Medical Identification

Cards, bracelets, or necklaces with a written message used by people with diabetes or other medical problems to alert others in case of a medical emergency such as coma.

Endocrine Glands

Glands that release hormones into the bloodstream. They affect how the body uses food (metabolism). They also influence other body functions. One endocrine gland is the pancreas. It releases insulin so the body can use sugar for energy. See also: Gland.

Endocrinologist

A doctor who treats people who have problems with their endocrine glands. Diabetes is an endocrine disorder. See also: Endocrine glands.

Endogenous

Grown or made inside the body. Insulin made by a person’s own pancreas is endogenous insulin. Insulin that is made from beef or pork pancreas or derived from bacteria is exogenous because it comes from outside the body and must be injected.

End-Stage Renal Disease (ESRD)

The final phase of kidney disease; treated by dialysis or kidney transplantation. See also: Dialysis; nephropathy.

Enzymes

A special type of protein. Enzymes help the body’s chemistry work better and more quickly. Each enzyme usually has its own chemical job to do such as helping to change starch into glucose (sugar).

Epidemiology

The study of a disease that deals with how many people have it, where they are, how many new cases develop, and how to control the disease.

Epinephrine

One of the secretions of the adrenal glands. It helps the liver release glucose (sugar) and limit the release of insulin. It also makes the heart beat faster and can raise blood pressure; also called adrenalin.

Etiology

The study of what causes a disease; also the cause or causes of a certain disease.

Euglycemia

A normal level of glucose (sugar) in the blood.

Exchange Lists

A grouping of foods by type to help people on special diets stay on the diet. Each group lists food in serving sizes. A person can exchange, trade, or substitute a food serving in one group for another food serving in the same group. The lists put foods in six groups: (1) starch/bread, (2) meat, (3) vegetables, (4) fruit, (5) milk, and (6) fats. Within a food group, each serving has about the same amount of carbohydrate, protein, fat, and calories.

Exogenous

Grown or made outside the body; for instance, insulin made from pork or beef pancreas is exogenous insulin for people.

 

F

Fasting Blood Glucose Test

A method for finding out how much glucose (sugar) is in the blood. The test can show if a person has diabetes. A blood sample is taken in a lab or doctor’s office. The test is usually done in the morning before the person has eaten. The normal, nondiabetic range for blood glucose is from 70 to 110 mg/dl, depending on the type of blood being tested. If the level is 126 mg/dl or greater, it means the person has diabetes (except for newborns and some pregnant women).

Fats

One of the three main classes of foods and a source of energy in the body. Fats help the body use some vitamins and keep the skin healthy. They also serve as energy stores for the body. In food, there are two types of fats: saturated and unsaturated.

Saturated fats are solid at room temperature and come chiefly from animal food products. Some examples are butter, lard, meat fat, solid shortening, palm oil, and coconut oil. These fats tend to raise the level of cholesterol, a fat-like substance in the blood.

Unsaturated fats, which include monounsaturated fats and polyunsaturated fats, are liquid at room temperature and come from plant oils such as olive, peanut, corn, cottonseed, sunflower, safflower, and soybean. These fats tend to lower the level of cholesterol in the blood. See also: Carbohydrate; protein.

Fatty Acids

A basic unit of fats. When insulin levels are too low or there is not enough glucose (sugar) to use for energy, the body burns fatty acids for energy. The body then makes ketone bodies, waste products that cause the acid level in the blood to become too high. This in turn may lead to ketoacidosis, a serious problem. See also: Diabetic ketoacidosis.

Fiber

A substance found in foods that come from plants. Fiber helps in the digestive process and is thought to lower cholesterol and help control blood glucose (sugar). The two types of fiber in food are soluble and insoluble. Soluble fiber, found in beans, fruits, and oat products, dissolves in water and is thought to help lower blood fats and blood glucose (sugar). Insoluble fiber, found in whole-grain products and vegetables, passes directly through the digestive system, helping to rid the body of waste products.

Fluorescein Angiography

A method of taking a picture of the flow of blood in the vessels of the eye by tracing the progress of an injected dye.

Food Exchange

See: Exchange lists.

Foot Care

Taking special steps to avoid foot problems such as sores, cuts, bunions, and calluses. Good care includes daily examination of the feet, toes, and toenails and choosing shoes and socks or stockings that fit well. People with diabetes have to take special care of their feet because nerve damage and reduced blood flow sometimes mean they will have less feeling in their feet than normal. They may not notice cuts and other problems as soon as they should.

Fractional Urine

Urine that a person collects for a certain period of time during 24 hours; usually from breakfast to lunch, from lunch to supper, from supper to bedtime, and from bedtime to rising. Also called “block urine.”

Fructose

A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories.

Fundus of the Eye

The back or deep part of the eye, including the retina.

Funduscopy

A test to look at the back area of the eye to see if there is any damage to the vessels that bring blood to the retina. The doctor uses a device called an ophthalmoscope to check the eye.


G

Galactose

A type of sugar found in milk products and sugar beets. It is also made by the body. It is considered a nutritive sweetener because it has calories.

Gangrene

The death of body tissue. It is most often caused by a loss of blood flow, especially in the legs and feet.

Gastroparesis

A form of nerve damage that affects the stomach. Food is not digested properly and does not move through the stomach in a normal way, resulting in vomiting, nausea, or bloating and interfering with diabetes management. See also: Autonomic neuropathy.

Gene

A basic unit of heredity. Genes are made of DNA, a substance that tells cells what to do and when to do it. The information in the genes is passed from parent to child-for example, a gene might tell some cells to make the hair red or the eyes brown.

Genetic

Relating to genes. See also: Gene; heredity.

Gestation

The length of pregnancy.

Gestational Diabetes Mellitus (GDM)

A type of diabetes mellitus that can occur when a woman is pregnant. In the second half of the pregnancy, the woman may have glucose (sugar) in the blood at a higher than normal level. However, when the pregnancy ends, the blood glucose levels return to normal in about 95 percent of all cases.

Gingivitis

An inflammation of the gums that if left untreated may lead to periodontal disease, a serious gum disorder. Signs of gingivitis are inflamed and bleeding gums. See also: Periodontal disease.

Gland

A group of special cells that make substances so that other parts of the body can work. For example, the pancreas is a gland that releases insulin so that other body cells can use glucose (sugar) for energy. See also: Endocrine glands.

Glaucoma

An eye disease associated with increased pressure within the eye. Glaucoma can damage the optic nerve and cause impaired vision and blindness.

Glomerular Filtration Rate

Measure of the kidneys’ ability to filter and remove waste products.

Glomeruli

Network of tiny blood vessels in the kidneys where the blood is filtered and waste products are removed.

Glucagon

A hormone that raises the level of glucose (sugar) in the blood. The alpha cells of the pancreas (in areas called the islets of Langerhans) make glucagon when the body needs to put more sugar into the blood.

An injectable form of glucagon, which can be bought in a drug store, is sometimes used to treat insulin shock. The glucagon is injected and quickly raises blood glucose levels. See also: Alpha cell.

Glucose

A simple sugar found in the blood. It is the body’s main source of energy; also known as dextrose. See also: Blood glucose.

Glucose Tolerance Test

A test to see if a person has diabetes. The test is given in a lab or doctor’s office in the morning before the person has eaten. A first sample of blood is taken from the person. Then the person drinks a liquid that has glucose (sugar) in it. After one hour, a second blood sample is drawn, and, after another hour, a third sample is taken. The object is to see how well the body deals with the glucose in the blood over time.

Glycemic Response

The effect of different foods on blood glucose (sugar) levels over a period of time. Researchers have discovered that some kinds of foods may raise blood glucose levels more quickly than other foods containing the same amount of carbohydrates.

Glycogen

A substance made up of sugars. It is stored in the liver and muscles and releases glucose (sugar) into the blood when needed by cells. Glycogen is the chief source of stored fuel in the body.

Glycogenesis (or glucogenesis)

The process by which glycogen is formed from glucose. See also: Glycogen.

Glycosuria

Having glucose (sugar) in the urine.

Glycosylated Hemoglobin Test

A blood test that measures a person’s average blood glucose (sugar) level for the 2- to 3-month period before the test. See: Hemoglobin A1C.

Gram

A unit of weight in the metric system. There are 28 grams in 1 ounce. In some diet plans for people with diabetes, the suggested amounts of food are given in grams.


H

HCF Diet

A high-carbohydrate, high-fiber diet.

Hemocromatosis

See: Bronze diabetes.

Hemodialysis

A mechanical method of cleaning the blood for people who have kidney disease. See also: Dialysis.

Hemoglobin A1C (HbA1C)

The substance of red blood cells that carries oxygen to the cells and sometimes joins with glucose (sugar). Because the glucose stays attached for the life of the cell (about 4 months), a test to measure hemoglobin A1C shows what the person’s average blood glucose level was for that period of time.

Heredity

The passing of a trait such as color of the eyes from parent to child. A person “inherits” these traits through the genes.

High Blood Pressure

When the blood flows through the vessels at a greater than normal force. High blood pressure strains the heart; harms the arteries; and increases the risk of heart attack, stroke, and kidney problems. Also called hypertension.

Hives (Urticaria)

A skin reaction that results in slightly elevated patches that are redder or paler than the surrounding skin and often are accompanied by itching.

HLA Antigens

Proteins on the outer part of the cell that help the body fight illness. These proteins vary from person to person. Scientists think that people with certain types of HLA antigens are more likely to develop insulin-dependent diabetes.

Home Blood Glucose Monitoring

A way a person can test how much glucose (sugar) is in the blood. Also called self-monitoring of blood glucose. See also: Blood glucose monitoring.

Homeostatis

When the body is working as it should because all of its systems are in balance.

Hormone

A chemical released by special cells to tell other cells what to do. For instance, insulin is a hormone made by the beta cells in the pancreas. When released, insulin tells other cells to use glucose (sugar) for energy.

Human Insulin

Man-made insulins that are similar to insulin produced by your own body. Human insulin has been available since October 1982.

Hyperglycemia

Too high a level of glucose (sugar) in the blood; a sign that diabetes is out of control. Many things can cause hyperglycemia. It occurs when the body does not have enough insulin or cannot use the insulin it does have to turn glucose into energy. Signs of hyperglycemia are a great thirst, a dry mouth, and a need to urinate often. For people with insulin-dependent diabetes, hyperglycemia may lead to diabetic ketoacidosis.

Hyperinsulinism

Too high a level of insulin in the blood. This term most often refers to a condition in which the body produces too much insulin. Researchers believe that this condition may play a role in the development of noninsulin-dependent diabetes and in hypertension. See also: Syndrome X.

Hyperlipemia

See: Hyperlipidemia.

Hyperlipidemia

Too high a level of fats (lipids) in the blood. See also: Syndrome X.

Hyperosmolar Coma

A coma (loss of consciousness) related to high levels of glucose (sugar) in the blood and requiring emergency treatment. A person with this condition is usually older and weak from loss of body fluids and weight. The person may or may not have a previous history of diabetes. Ketones (acids) are not present in the urine.

Hypertension

Blood pressure that is above the normal range. See also: High blood pressure.

Hypoglycemia

Too low a level of glucose (sugar) in the blood. This occurs when a person with diabetes has injected too much insulin, eaten too little food, or has exercised without extra food. A person with hypoglycemia may feel nervous, shaky, weak, or sweaty, and have a headache, blurred vision, and hunger. Taking small amounts of sugar, sweet juice, or food with sugar will usually help the person feel better within 10-15 minutes. See also: Insulin shock.

Hypotension

Low blood pressure or a sudden drop in blood pressure. A person rising quickly from a sitting or reclining position may have a sudden fall in blood pressure, causing dizziness or fainting.


I

IDDM

See: Insulin-dependent diabetes mellitus.

IGT

See: Impaired glucose tolerance.

Immunosuppressive Drugs

Drugs that block the body’s ability to fight infection or foreign substances that enter the body. A person receiving a kidney or pancreas transplant is given these drugs to stop the body from rejecting the new organ or tissue. Cyclosporin is a commonly used immunosuppressive drug.

Impaired Glucose Tolerance (IGT)

Blood glucose (sugar) levels higher than normal but not high enough to be called diabetes. People with IGT may or may not develop diabetes. Other names (no longer used) for IGT are “borderline,” “subclinical,” “chemical,” or “latent” diabetes.

Implantable Insulin Pump

A small pump placed inside of the body that delivers insulin in response to commands from a hand-held device called a programmer.

Impotence

The loss of a man’s ability to have an erect penis and to emit semen. Some men may become impotent after having diabetes for a long time because the nerves or blood vessels have become damaged. Sometimes the problem has nothing to do with diabetes and may be treated with counseling.

Incidence

How often a disease occurs; the number of new cases of a disease among a certain group of people for a certain period of time.

Ingestion

Taking food, water, or medicine into the body by mouth.

Injection

Putting liquid into the body with a needle and syringe. A person with diabetes injects insulin by putting the needle into the tissue under the skin (called subcutaneous). Other ways of giving medicine or nourishment by injection are to put the needle into a vein (intravenous) or into a muscle (intramuscular).

Injection Sites

Places on the body where people can inject insulin most easily. These are:

  • The outer area of the upper arm.
  • Just above and below the waist, except the area right around the navel (a 2-inch circle).
  • The upper area of the buttock, just behind the hip bone.
  • The front of the thigh, midway to the outer side, 4 inches below the top of the thigh to 4 inches above the knee.

These areas can vary with the size of the person.Injection Site Rotation

Changing the places on the body where a person injects insulin. Changing the injection site keeps lumps or small dents from forming in the skin. These lumps or dents are called lipodystrophies. However, people should try to use the same body area for injections that are given at the same time each day-for example, always using the stomach for the morning injection or an arm for the evening injection. Using the same body area for these routine injections lessens the possibility of changes in the timing and action of insulin.

Insulin

A hormone that helps the body use glucose (sugar) for energy. The beta cells of the pancreas (in areas called the islets of Langerhans) make the insulin. When the body cannot make enough insulin on its own, a person with diabetes must inject insulin made from other sources, i.e., beef, pork, human insulin (recombinant DNA origin), or human insulin (pork-derived, semisynthetic).

Insulin Allergy

When a person’s body has an allergic or bad reaction to taking insulin made from pork or beef or from bacteria, or because the insulin is not exactly the same as human insulin or because it has impurities.

The allergy can be of two forms. Sometimes an area of skin becomes red and itchy around the place where the insulin is injected. This is called a local allergy.

In another form, a person’s whole body can have a bad reaction This is called a systemic allergy. The person can have hives or red patches all over the body or may feel changes in the heart rate and in the rate of breathing. A doctor may treat this allergy by prescribing purified insulins or by desensitization. See also: Desensitization.

Insulin Antagonist

Something that opposes or fights the action of insulin. Insulin lowers the level of glucose (sugar) in the blood, whereas glucagon raises it; therefore, glucagon is an antagonist of insulin.

Insulin Binding

When insulin attaches itself to something else. This can occur in two ways. First, when a cell needs energy, insulin can bind with the outer part of the cell. The cell then can bring glucose (sugar) inside and use it for energy. With the help of insulin, the cell can do its work very well and very quickly. But sometimes the body acts against itself. In this second case, the insulin binds with the proteins that are supposed to protect the body from outside substances (antibodies). If the insulin is an injected form of insulin and not made by the body, the body sees the insulin as an outside or “foreign” substance. When the injected insulin binds with the antibodies, it does not work as well as when it binds directly to the cell.

Insulin-Dependent Diabetes Mellitus (IDDM)

A chronic condition in which the pancreas makes little or no insulin because the beta cells have been destroyed. The body is then not able to use the glucose (blood sugar) for energy. IDDM usually comes on abruptly, although the damage to the beta cells may begin much earlier. The signs of IDDM are a great thirst, hunger, a need to urinate often, and loss of weight. To treat the disease, the person must inject insulin, follow a diet plan, exercise daily, and test blood glucose several times a day. IDDM usually occurs in children and adults who are under age 30. This type of diabetes used to be known as “juvenile diabetes,” “juvenile-onset diabetes,” and “ketosis-prone diabetes.” It is also called type I diabetes mellitus.

Insulin-Induced Atrophy

Small dents that form on the skin when a person keeps injecting a needle in the same spot. They are harmless. See also: Lipoatrophy; injection site rotation.

Insulin-Induced Hypertrophy

Small lumps that form under the skin when a person keeps injecting a needle in the same spot. See also: Lipodystrophy; injection site rotation.

Insulin Pen

An insulin injection device the size of a pen that includes a needle and holds a vial of insulin. It can be used instead of syringes for giving insulin injections.

Insulin Pump

A device that delivers a continuous supply of insulin into the body. The insulin flows from the pump through a plastic tube that is connected to a needle inserted into the body and taped in place. Insulin is delivered at two rates: a low, steady rate (called the basal rate) for continuous day-long coverage, and extra boosts of insulin (called bolus doses) to cover meals or when extra insulin is needed. The pump runs on batteries and can be worn clipped to a belt or carried in a pocket. It is used by people with insulin-dependent diabetes.

Insulin Reaction

Too low a level of glucose (sugar) in the blood; also called hypoglycemia. This occurs when a person with diabetes has injected too much insulin, eaten too little food, or exercised without extra food. The person may feel hungry, nauseated, weak, nervous, shaky, confused, and sweaty. Taking small amounts of sugar, sweet juice, or food with sugar will usually help the person feel better within 10-15 minutes. See also: Hypoglycemia; insulin shock.

Insulin Receptors

Areas on the outer part of a cell that allow the cell to join or bind with insulin that is in the blood. When the cell and insulin bind together, the cell can take glucose (sugar) from the blood and use it for energy.

Insulin Resistance

Many people with noninsulin-dependent diabetes produce enough insulin, but their bodies do not respond to the action of insulin. This may happen because the person is overweight and has too many fat cells, which do not respond well to insulin. Also, as people age, their body cells lose some of the ability to respond to insulin. Insulin resistance is also linked to high blood pressure and high levels of fat in the blood. Another kind of insulin resistance may happen in some people who take insulin injections. They may have to take very high doses of insulin every day (200 units or more) to bring their blood glucose (sugar) down to the normal range. This is also called “insulin insensitivity.

Insulin Shock

A severe condition that occurs when the level of blood glucose (sugar) drops quickly. The signs are shaking, sweating, dizziness, double vision, convulsions, and collapse. Insulin shock may occur when an insulin reaction is not treated quickly enough. See also: Hypoglycemia; insulin reaction.

Insulinoma

A tumor of the beta cells in areas of the pancreas called the islets of Langerhans. Although not usually cancerous, such tumors may cause the body to make extra insulin and may lead to a blood glucose (sugar) level that is too low.

Intensive Intermittent Claudication

Pain in the muscles of the leg that occurs off and on, usually while walking or exercising, and results in lameness (claudication). The pain results from a narrowing of the blood vessels feeding the muscle. Drugs are available to treat this condition.

Intensive Management

A form of treatment for insulin-dependent diabetes in which the main objective is to keep blood glucose (sugar) levels as close to the normal range as possible. The treatment consists of three or more insulin injections a day or use of an insulin pump; four or more blood glucose tests a day; adjustment of insulin, food intake, and activity levels based on blood glucose test results; dietary counseling; and management by a diabetes team. See also: Diabetes Control and Complications Trial; team management.

Intramuscular Injection

Putting a fluid into a muscle with a needle and syringe.

Intravenous Injection

Putting a fluid into a vein with a needle and syringe.

Islet Cell Transplantation

Moving the beta (islet) cells from a donor pancreas and putting them into a person whose pancreas has stopped producing insulin. The beta cells make the insulin that the body needs to use glucose (sugar) for energy. Although transplanting islet cells may one day help people with diabetes, the procedure is still in the research stage.

Islets of Langerhans

Special groups of cells in the pancreas. They make and secrete hormones that help the body break down and use food. Named after Paul Langerhans, the German scientist who discovered them in 1869, these cells sit in clusters in the pancreas. There are five types of cells in an islet: beta cells, which make insulin; alpha cells, which make glucagon; delta cells, which make somatostaton; and PP cells and D1 cells, about which little is known.


J

Jet Injector

A device that uses high pressure to propel insulin through the skin and into the body.

Juvenile Onset Diabetes

Former term for insulin-dependent or type I diabetes. See: Insulin-dependent diabetes mellitus.

K

 

Ketone Bodies

Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then “spill” over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. See also: Diabetic ketoacidosis.

Ketonuria

Having ketone bodies in the urine; a warning sign of diabetic ketoacidosis (DKA).

Ketosis

A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting, and stomach pain. Ketosis can lead to ketoacidosis.

Kidney Disease

Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy.

Kidneys

Two organs in the lower back that clean waste and poisons from the blood. The kidneys are shaped like two large beans, and they act as the body’s filter. They also control the level of some chemicals in the blood such as hydrogen, sodium, potassium, and phosphate.

Kidney Threshold

The point at which the blood is holding too much of a substance such as glucose (sugar) and the kidneys “spill” the excess sugar into the urine. See also: Renal threshold.

Kussmaul Breathing

The rapid, deep, and labored breathing of people who have ketoacidosis or who are in a diabetic coma. Kussmaul breathing is named for Adolph Kussmaul, the 19th century German doctor who first noted it. Also called “air hunger.”


L

Labile Diabetes

A term used to indicate when a person’s blood glucose (sugar) level often swings quickly from high to low and from low to high. Also called brittle diabetes.

Lactic Acidosis

The buildup of lactic acid in the body. The cells make lactic acid when they use glucose (sugar) for energy. If too much lactic acid stays in the body, the balance tips and the person begins to feel ill. The signs of lactic acidosis are deep and rapid breathing, vomiting, and abdominal pain. Lactic acidosis may be caused by diabetic ketoacidosis or liver or kidney disease.

Lactose

A type of sugar found in milk and milk products (cheese, butter, etc.). It is considered a nutritive sweetener because it has calories.

Lancet

A fine, sharp-pointed blade or needle for pricking the skin.

Laser Treatment

Using a special strong beam of light of one color (laser) to heal a damaged area. A person with diabetes might be treated with a laser beam to heal blood vessels in the eye. See also: Photocoagulation.

Latent Diabetes

Former term for impaired glucose tolerance. See also: Impaired glucose tolerance.

Lente Insulin

A type of insulin that is intermediate-acting.

Limited Joint Mobility

A form of arthritis involving the hand; it causes the fingers to curve inward and the skin on the palm to tighten and thicken. This condition mainly affects people with IDDM.

Lipid

A term for fat. The body stores fat as energy for future use just like a car that has a reserve fuel tank. When the body needs energy, it can break down the lipids into fatty acids and burn them like glucose (sugar).

Lipoatrophy

Small dents in the skin that form when a person keeps injecting the needle in the same spot. See also: Lipodystrophy.

Lipodystrophy

Lumps or small dents in the skin that form when a person keeps injecting the needle in the same spot. Lipodystrophies are harmless. People who want to avoid them can do so by changing (rotating) the places where they inject their insulin. Using purified insulins may also help. See also: Injection site rotation.


M

Macroangiopathy

See: Angiopathy.

Macrosomia

Abnormally large; in diabetes, refers to abnormally large babies that may be born to women with diabetes.

Macrovascular Disease

A disease of the large blood vessels that sometimes occurs when a person has had diabetes for a long time. Fat and blood clots build up in the large blood vessels and stick to the vessel walls. Three kinds of macrovascular disease are coronary disease, cerebrovascular disease, and peripheral vascular disease.

Macular Edema

A swelling (edema) in the macula, an area near the center of the retina of the eye that is responsible for fine or reading vision. Macular edema is a common complication associated with diabetic retinopathy. See also: Diabetic retinopathy; retina.

Maturity-Onset Diabetes

Former term for noninsulin-dependent or type II diabetes. See: Noninsulin-dependent diabetes mellitus.

Meal Plan

A guide for controlling the amount of calories, carbohydrates, proteins, and fats a person eats. People with diabetes can use such plans as the Exchange Lists or the Point System to help them plan their meals so that they can keep their diabetes under control. See also: Exchange lists; point system.

Metabolism

The term for the way cells chemically change food so that it can be used to keep the body alive. It is a two-part process. One part is called catabolism-when the body uses food for energy. The other is called anabolism-when the body uses food to build or mend cells. Insulin is necessary for the metabolism of food.

Metformin

A drug treatment for type 2 diabetes; belongs to a class of drugs called biguanides.

Mg/dL

Milligrams per deciliter. Term used to describe how much glucose (sugar) is in a specific amount of blood. In self-monitoring of blood glucose, test results are given as the amount of glucose in milligrams per deciliter of blood. A fasting reading of 70 to 110 mg/dL is considered in the normal (nondiabetic) range.

Microaneurysm

A small swelling that forms on the side of tiny blood vessels. These small swellings may break and bleed into nearby tissue. People with diabetes sometimes get microaneurysms in the retina of the eye.

Microangiopathy

See: Angiopathy.

Microvascular Disease

Disease of the smallest blood vessels that sometimes occurs when a person has had diabetes for a long time. The walls of the vessels become abnormally thick but weak, and therefore they bleed, leak protein, and slow the flow of blood through the body. Then some cells, for example, the ones in the center of the eye, may not get enough blood and may be damaged.

Mixed Dose

Combining two kinds of insulin in one injection. A mixed dose commonly combines regular insulin, which is fast acting, with a longer acting insulin such as NPH. A mixed dose insulin schedule may be prescribed to provide both short-term and long-term coverage.

Mononeuropathy

A form of diabetic neuropathy affecting a single nerve. The eye is a common site for this form of nerve damage. See also: Neuropathy.

Morbidity Rate

The sickness rate; the number of people who are sick or have a disease compared with the number who are well.

Mortality Rate

The death rate; the number of people who die of a certain disease compared with the total number of people. Mortality is most often stated as deaths per 1,000, per 10,000, or per 100,000 persons.

Myocardial Infarction

Also called a heart attack; results from permanent damage to an area of the heart muscle. This happens when the blood supply to the area is interrupted because of narrowed or blocked blood vessels.

Myo-inositol

A substance in the cell that is thought to play a role in helping the nerves to work. Low levels of myo-inositol may be involved in diabetic neuropathy.


N

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

One of the 17 institutes that make up the National Institutes of Health, an agency of the Public Health Service.

Necrobiosis Lipoidica Diabeticorum

A skin condition usually on the lower part of the legs. The lesions can be small or extend over a large area. They are usually raised, yellow, and waxy in appearance and often have a purple border. Young women are most often affected. This condition occurs in people with diabetes, or it may be a sign of diabetes. It also occurs in people who do not have diabetes.

Neovascularization

The term used when new, tiny blood vessels grow in a new place, for example, out from the retina. See also: Diabetic retinopathy.

Nephrologist

A doctor who sees and treats people with kidney diseases.

Nephropathy

Disease of the kidneys caused by damage to the small blood vessels or to the units in the kidneys that clean the blood. People who have had diabetes for a long time may have kidney damage.

Nerve Conduction Studies

Tests to determine nerve function; can detect early neuropathy.

Neurologist

A doctor who sees and treats people with problems of the nervous system.

Neuropathy

Disease of the nervous system. Many people who have had diabetes for a while have nerve damage. The three major forms of nerve damage are: peripheral neuropathy, autonomic neuropathy, and mononeuropathy. The most common form is peripheral neuropathy, which mainly affects the feet and legs. See also: Peripheral neuropathy; autonomic neuropathy; mononeuropathy.

NIDDM

See: Noninsulin-dependent diabetes mellitus.

Noninsulin-Dependent Diabetes Mellitus (NIDDM)

The most common form of diabetes mellitus; about 90 to 95 percent of people who have diabetes have NIDDM. Unlike the insulin-dependent type of diabetes, in which the pancreas makes no insulin, people with noninsulin-dependent diabetes produce some insulin, sometimes even large amounts. However, either their bodies do not produce enough insulin or their body cells are resistant to the action of insulin (see Insulin Resistance). People with NIDDM can often control their condition by losing weight through diet and exercise. If not, they may need to combine insulin or a pill with diet and exercise. Generally, NIDDM occurs in people who are over age 40. Most of the people who have this type of diabetes are overweight. Noninsulin-dependent diabetes mellitus used to be called “adult-onset diabetes,” “maturity-onset diabetes,” “ketosis-resistant diabetes,” and “stable diabetes.” It is also called type II diabetes mellitus.

Noninvasive Blood Glucose Monitoring

A way to measure blood glucose without having to prick the finger to obtain a blood sample. Several noninvasive devices are currently being developed.

Nonketotic Coma

A type of coma caused by a lack of insulin. A nonketotic crisis means: (1) very high levels of glucose (sugar) in the blood; (2) absence of ketoacidosis; (3) great loss of body fluid; and (4) a sleepy, confused, or comatose state. Nonketotic coma often results from some other problem such as a severe infection or kidney failure.

NPH Insulin

A type of insulin that is intermediate-acting.

Nutrition

The process by which the body draws nutrients from food and uses them to make or mend its cells.

 

O

Obesity

When people have 20 percent (or more) extra body fat for their age, height, sex, and bone structure. Fat works against the action of insulin. Extra body fat is thought to be a risk factor for diabetes.

Obstetrician

A doctor who sees and gives care to pregnant women and delivers babies.

OGTT

See: Oral glucose tolerance test.

Ophthalmologist

A doctor who sees and treats people with eye problems or diseases.

Optometrist

A person professionally trained to test the eyes and to detect and treat eye problems and some diseases by prescribing and adapting corrective lenses and other optical aids and by suggesting eye exercise programs.

Oral Glucose Tolerance Test (OGTT)

A test to see if a person has diabetes. See: Glucose tolerance test.

Oral Hypoglycemic Agents

Pills or capsules that people take to lower the level of glucose (sugar) in the blood. The pills work for some people whose pancreas still makes some insulin. They can help the body in several ways such as causing the cells in the pancreas to release more insulin.

Six types of these pills are for sale in the United States. Four, known as “first-generation” drugs, have been in use for some time. Two types, called “second-generation” drugs, have been developed recently. They are stronger than first-generation drugs and have fewer side effects. All oral hypoglycemic agents belong to a class of drugs known as sulfonylureas. Each type of pill is sold under two names: one is the generic name as listed by the Food and Drug Administration; the other is the trade name given by the manufacturer. They are:

First-Generation Agents:

Generic Name: Tolbutamide
Trade Name: Orinase

Generic Name: Acetohexamide
Trade Name: Dymelor

Generic Name: Tolazamide
Trade Name: Tolinase

Generic Name: Chloropropamide
Trade Name: Diabinese

Second-Generation Agents:

Generic Name: Glipizide Trade Name: Glucotrol

Generic Name: Glyburide Trade Name: Diabeta, Micronase

Overt Diabetes

Diabetes in the person who shows clear signs of the disease such as a great thirst and the need to urinate often.

P

 

A set of s

P

Pancreas

An organ behind the lower part of the stomach that is about the size of a hand. It makes insulin so that the body can use glucose (sugar) for energy. It also makes enzymes that help the body digest food. Spread all over the pancreas are areas called the islets of Langerhans. The cells in these areas each have a special purpose. The alpha cells make glucagon, which raises the level of glucose in the blood; the beta cells make insulin; the delta cells make somatostatin. There are also the PP cells and the D1 cells, about which little is known.

Pancreas Transplant

A surgical procedure that involves replacing the pancreas of a person who has diabetes with a healthy pancreas that can make insulin. The healthy pancreas comes from a donor who has just died or from a living relative. A person can donate half a pancreas and still live normally.

At present, pancreas transplants are usually performed in persons with insulin-dependent diabetes who have severe complications. This is because after the transplant the patient must take immunosuppressive drugs that are highly toxic and may cause damage to the body.

Pancreatectomy

A procedure in which a surgeon takes out the pancreas.

Pancreatitis

Inflammation (pain, tenderness) of the pancreas; it can make the pancreas stop working. It is caused by drinking too much alcohol, by disease in the gallbladder, or by a virus.

Peak Action

The time period when the effect of something is as strong as it can be such as when insulin in having the most effect on lowering the glucose (sugar) in the blood.

Pediatric Endocrinologist

A doctor who sees and treats children with problems of the endocrine glands; diabetes is an endocrine disorder. See also: Endocrine glands.

Periodontal Disease

Damage to the gums. People who have diabetes are more likely to have gum disease than people who do not have diabetes.

Periodontist

A specialist in the treatment of diseases of the gums.

Peripheral Neuropathy

Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called “somatic neuropathy” or “distal sensory polyneuropathy.”

Peripheral Vascular Disease (PVD)

Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. See also: Macrovascular disease.

Peritoneal Dialysis

A way to clean the blood of people who have kidney disease. See also: Dialysis.

Pharmacist

A person trained to prepare and distribute medicines and to give information about them.

Photocoagulation

Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy.

Pituitary Gland

An endocrine gland in the small, bony cavity at the base of the brain. Often called “the master gland,” the pituitary serves the body in many ways-in growth, in food use, and in reproduction.

Podiatrist

A doctor who treats and takes care of people’s feet.

Podiatry

The care and treatment of human feet in health and disease.

Point System

A way to plan meals that uses points to rate food. The foods are placed in four classes: calories, carbohydrates, proteins, and fats. Each food is given a point value within its class. A person with a planned diet for the day can choose foods in the same class that have the same point values for meals and snacks.

Polydipsia

A great thirst that lasts for long periods of time; a sign of diabetes.

Polyphagia

Great hunger; a sign of diabetes. People with this great hunger often lose weight.

Polyunsaturated Fats

A type of fat that comes from vegetables. See also: Fats.

Polyuria

Having to urinate often; a common sign of diabetes.

Postprandial Blood Glucose

Blood taken 1-2 hours after eating to see the amount of glucose (sugar) in the blood.

Preeclampsia

A condition that some women with diabetes have during the late stages of pregnancy. Two signs of this condition are high blood pressure and swelling because the body cells are holding extra water.

Prevalence

The number of people in a given group or population who are reported to have a disease.

Previous Abnormality of Glucose Tolerance (PrevAGT)

A term for people who have had above-normal levels of blood glucose (sugar) when tested for diabetes in the past but who show as normal on a current test. PrevAGT used to be called either “latent diabetes” or “prediabetes.”

Prognosis

Telling a person now what is likely to happen in the future because of having a disease.

Proinsulin

The substance made first in the pancreas that is then made into insulin. When insulin is purified from the pancreas of pork or beef, all the proinsulin is not fully removed. When some people use these insulins, the proinsulin can cause the body to react with a rash, to resist the insulin, or even to make dents or lumps in the skin at the place where the insulin is injected. The purified insulins have less proinsulin and other impurities than the other types of insulins.

Proliferative Retinopathy

A disease of the small blood vessels of the retina of the eye. See also: Diabetic retinopathy.

Prosthesis

A man-made substitute for a missing body part such as an arm or a leg; also an implant such as for the hip.

Protein

One of the three main classes of food. Proteins are made of amino acids, which are called the building blocks of the cells. The cells need proteins to grow and to mend themselves. Protein is found in many foods such as meat, fish, poultry, and eggs. See also: Carbohydrate; fats.

Proteinuria

Too much protein in the urine. This may be a sign of kidney damage.

Pruritus

Itching skin; may be a symptom of diabetes.

Purified Insulins

Insulins with much less of the impure proinsulin. It is thought that the use of purified insulins may help avoid or reduce some of the problems of people with diabetes such as allergic reactions.


R

Reagents

Strips or tablets that people use to test the level of glucose (sugar) in their blood and urine or the level of acetone in their urine. These reagents are treated with chemicals that change color during the test. Each type of reagent has its own color code to show how much glucose or acetone there is at the time of the test.

Rebound

A swing to a high level of glucose (sugar) in the blood after having a low level. See also: Somogyi effect.

Receptors

Areas on the outer part of a cell that allow the cell to join or bind with insulin that is in the blood. See also: Insulin receptors.

Regular Insulin

A type of insulin that is fast acting.

Renal

A term that means having something to do with the kidneys.

Renal Threshold

When the blood is holding so much of a substance such as glucose (sugar) that the kidneys allow the excess to spill into the urine. This is also called “kidney threshold,” “spilling point,” and “leak point.”

Retina

The center part of the back lining of the eye that senses light. It has many small blood vessels that are sometimes harmed when a person has had diabetes for a long time.

Retinopathy

A disease of the small blood vessels in the retina of the eye. See also: Diabetic retinopathy.

Risk Factor

Anything that raises the chance that a person will get a disease. With noninsulin-dependent diabetes, people have a greater risk of getting the disease if they weigh a lot more (20 percent or more) than they should.


S

Saccharin

A man-made sweetener that people use in place of sugar because it has no calories.

Saturated Fat

A type of fat that comes from animals. See also: Fats.

Secondary Diabetes

When a person gets diabetes because of another disease or because of taking certain drugs or chemicals.

Secrete

To make and give off such as when the beta cells make insulin and then release it into the blood so that the other cells in the body can use it to turn glucose (sugar) into energy.

Segmental Transplantation

A surgical procedure in which a part of a pancreas that contains insulin-producing cells is placed in a person whose pancreas has stopped making insulin.

Self-Monitoring of Blood Glucose

A way as person can test how much glucose (sugar) is in the blood. Also called home blood glucose monitoring. See also: Blood glucose monitoring.

Shock

A severe condition that disturbs the body. A person with diabetes can go into shock when the level of blood glucose (sugar) drops suddenly. See also: Insulin shock.

Sliding Scale

Adjusting insulin on the basis of blood glucose tests, meals, and activity levels.

Somatic Neuropathy

See: Peripheral neuropathy.

Somatostatin

A hormone made by the delta cells of the pancreas (in areas called the islets of Langerhans). Scientists think it may control how the body secretes two other hormones, insulin and glucagon.

Somogyi Effect

A swing to a high level of glucose (sugar) in the blood from an extremely low level, usually occurring after an untreated insulin reaction during the night. The swing is caused by the release of stress hormones to counter low glucose levels. People who experience high levels of blood glucose in the morning may need to test their blood glucose levels in the middle of the night. If blood glucose levels are falling or low, adjustments in evening snacks or insulin doses may be recommended. This condition is named after Dr. Michael Somogyi, the man who first wrote about it. Also called “rebound.”

Sorbitol

A sugar alcohol the body uses slowly. It is a sweetener used in diet foods. It is called a nutritive sweetener because it has four calories in every gram, just like table sugar and starch.

Sorbitol is also produced by the body. Too much sorbitol in cells can cause damage. Diabetic retinopathy and neuropathy may be related to too much sorbitol in the cells of the eyes and nerves.

Spilling Point

When the blood is holding so much of a substance such as glucose (sugar) that the kidneys allow the excess to spill into the urine. See also: Renal threshold.

Split Dose

Division of a prescribed daily dose of insulin into two or more injections given over the course of a day. Also may be referred to as multiple injections. Many people who use insulin feel that split doses offer more consistent control over blood glucose (sugar) levels.

Stiff Hand Syndrome

Thickening of the skin of the palm that results in loss of ability to hold hand straight. This condition occurs only in people with diabetes.

Stroke

Disease caused by damage to blood vessels in the brain. Depending on the part of the brain affected, a stroke can cause a person to lose the ability to speak or move a part of the body such as an arm or a leg. Usually only one side of the body is affected. See also: Cerebrovascular disease.

Subclinical Diabetes

A term no longer used. See: Impaired glucose tolerance.

Subcutaneous Injection

Putting a fluid into the tissue under the skin with a needle and syringe. See also: Injection.

Sucrose

Table sugar; a form of sugar that the body must break down into a more simple form before the blood can absorb it and take it to the cells.

Sugar

A class of carbohydrates that taste sweet. Sugar is a quick and easy fuel for the body to use. Types of sugar are lactose, glucose, fructose, and sucrose.

Sulfonylureas

Pills or capsules that people take to lower the level of glucose (sugar) in the blood. See also: Oral hypoglycemic agents.

Symptom

A sign of disease. Having to urinate often is a symptom of diabetes.

Syndrome

igns or a series of events occurring together that make up a disease or health problem.

Syndrome X

Term describing a combination of health conditions that place a person at high risk for heart disease. These conditions are noninsulin-dependent diabetes, high blood pressure, high insulin levels, and high levels of fat in the blood.

Syringe

A device used to inject medications or other liquids into body tissues. The syringe for insulin has a hollow plastic or glass tube (barrel) with a plunger inside. The plunger forces the insulin through the needle into the body. Most insulin syringes now come with a needle attached. The side of the syringe has markings to show how much insulin is being injected.

Systemic

A word used to describe conditions that affect the entire body. Diabetes is a systemic disease because it involves many parts of the body such as the pancreas, eyes, kidneys, heart, and nerves.

Systolic Blood Pressure

See: Blood pressure.


T

Team Management

Describes a diabetes treatment approach in which medical care is provided by a physician, diabetes nurse educator, dietitian, and behavioral scientist working together with the patient.

Thrush

An infection of the mouth. In people with diabetes, this infection may be caused by high levels of glucose (sugar) in mouth fluids, which helps the growth of fungus that causes the infection. Patches of whitish-colored skin in the mouth are signs of this disease.

Tolazamide

A pill taken to lower the level of glucose (sugar) in the blood. Only some people with noninsulin-dependent diabetes take these pills. See also: Oral hypoglycemic agents.

Tolbutamide

A pill taken to lower the level of glucose (sugar) in the blood. Only some people with noninsulin-dependent diabetes take these pills. See also: Oral hypoglycemic agents.

Toxemia of Pregnancy

A condition in pregnant women in which poisons such as the body’s own waste products build up and may cause harm to both the mother and baby. The first signs of toxemia are swelling near the eyes and ankles (edema), headache, high blood pressure, and weight gain that the mother might confuse with the normal weight gain of being pregnant. The mother may have both glucose (sugar) and acetone in her urine. The mother should tell the doctor about these signs at once.

Toxic

Harmful; having to do with poison.

Transcutaneous Electronic Nerve Stimulation (TENS)

A treatment for painful neuropathy.

Trauma

A wound, hurt, or injury to the body. Trauma can also be mental such as when a person feels great stress.

Triglyceride

A type of blood fat. The body needs insulin to remove this type of fat from the blood. When diabetes is under control and a person’s weight is what it should be, the level of triglycerides in the blood is usually about what it should be.

Twenty-Four Hour Urine

The total amount of a person’s urine for a 24-hour period.

Type I Diabetes Mellitus

See: Insulin-dependent diabetes mellitus.

Type II Diabetes Mellitus

See: Noninsulin-dependent diabetes mellitus.