Type 2 Diabetes

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Acanthosis

A skin condition characterized by darkened skin patches on the back of the neck and under the arms; common in people whose body is not responding correctly to the insulin that they make in their pancreas (insulin resistance). This skin condition is also seen in people who have pre-diabetes or type 2 diabetes.

ACE inhibitor

An oral medicine that lowers blood pressure; ACE stands for angiotensin (an-gee-oh-TEN-sin) converting enzyme. For people with diabetes, especially those who have protein (albumin) in the urine, it also helps slow down kidney damage.

Acesulfame

A dietary sweetener with no calories and no nutritional value. Also known as acesulfame-K. (Brand name: Sunett.)

Adhesive capsulitis

A condition of the shoulder associated with diabetes that results in pain and loss of the ability to move the shoulder in all directions. Also known as "frozen shoulder."

Adult-onset diabetes

Former term for type 2 diabetes.

AGEs

Stands for advanced glycation end products. AGEs are produced in the body when glucose links with protein. They play a role in damaging blood vessels, which can lead to diabetes complications.

Albuminuria

A condition in which the urine has more than normal amounts of a protein called albumin. Albuminuria may be a sign of nephropathy (kidney disease).

Alpha cell

A type of cell in the pancreas. Alpha cells make and release a hormone called glucagon. The body sends a signal to the alpha cells to make glucagon when blood glucose falls too low. Then glucagon reaches the liver where it tells it to release glucose into the blood for energy.

Amylin

A hormone formed by beta cells in the pancreas. Amylin regulates the timing of glucose release into the bloodstream after eating by slowing the emptying of the stomach.

Amyotrophy

A type of neuropathy resulting in pain, weakness, and/or wasting in the muscles.

Angiopathy

Any disease of the blood vessels (veins, arteries, capillaries) or lymphatic vessels.

Antibodies

Proteins made by the body to protect itself from "foreign" substances such as bacteria or viruses. People get type 1 diabetes when their bodies make antibodies that destroy the body's own insulin-making beta cells.

A1C

A test that measures a person's average blood glucose level over the past 2 to 3 months. Hemoglobin (HEE-mo-glo-bin) is the part of a red blood cell that carries oxygen to the cells and sometimes joins with the glucose in the bloodstream. Also called hemoglobin A1C or glycosylated (gly-KOH-sih-lay-ted) hemoglobin, the test shows the amount of glucose that sticks to the red blood cell, which is proportional to the amount of glucose in the blood.

Arteriosclerosis

Hardening of the arteries.

Artery

A large blood vessel that carries blood with oxygen from the heart to all parts of the body.

Aspart insulin

A rapid-acting insulin. On average, aspart insulin starts to lower blood glucose within 10 to 20 minutes after injection. It has its strongest effect 1 to 3 hours after injection but keeps working for 3 to 5 hours after injection.

Aspartame

A dietary sweetener with almost no calories and no nutritional value. (Brand names: Equal, NutraSweet.)

Clogging, narrowing, and hardening of the body's large arteries and medium-sized blood vessels. Atherosclerosis can lead to stroke, heart attack, eye problems, and kidney problems.

Autoimmune

Disorder of the body's immune system in which the immune system mistakenly attacks and destroys body tissue that it believes to be foreign.

Autonomic neuropathy

A type of neuropathy affecting the lungs, heart, stomach, intestines, bladder, or genitals.

Avandia

See rosiglitazone.

Background retinopathy

A type of damage to the retina of the eye marked by mild bleeding, fluid accumulation, and abnormal dilation of the blood vessels. Background retinopathy is an early stage of diabetic retinopathy. Also called simple or nonproliferative (non-pro-LIF-er-uh-tiv) retinopathy.

Basal rate

A steady trickle of low levels of longer-acting insulin, such as that used in insulin pumps.

Beta cell

A cell that makes insulin. Beta cells are located in the islets of the pancreas.

Blood glucose

The main sugar found in the blood and the body's main source of energy. Also called blood sugar.

Blood glucose level

The amount of glucose in a given amount of blood. It is noted in milligrams in a deciliter, or mg/dL.

A small, portable machine used by people with diabetes to check their blood glucose levels. After pricking the skin with a lancet, one places a drop of blood on a test strip in the machine. The meter (or monitor) soon displays the blood glucose level as a number on the meter's digital display.
Checking blood glucose level on a regular basis in order to manage diabetes. A blood glucose meter (or blood glucose test strips that change color when touched by a blood sample) is needed for frequent blood glucose monitoring.

Blood sugar

See blood glucose.

Blood urea nitrogen (BUN)

A waste product in the blood from the breakdown of protein. The kidneys filter blood to remove urea. As kidney function decreases, the BUN levels increase.

Blood vessels

Tubes that carry blood to and from all parts of the body. The three main types of blood vessels are arteries, veins, and capillaries.

Body mass index (BMI)

A measure used to evaluate body weight relative to a person's height. BMI is used to find out if a person is underweight, normal weight, overweight, or obese.

Bolus

An extra amount of insulin taken to cover an expected rise in blood glucose, often related to a meal or snack.

Borderline diabetes

A former term for pre-diabetes, impaired fasting glucose, or impaired glucose tolerance.

Brittle diabetes

A term used when a person's blood glucose level moves often from low to high and from high to low.

BUN

See blood urea nitrogen.

Callus

A small area of skin, usually on the foot, that has become thick and hard from rubbing or pressure.

Calorie

A unit representing the energy provided by food. Carbohydrate, protein, fat, and alcohol provide calories in the diet. Carbohydrate and protein have 4 calories per gram, fat has 9 calories per gram, and alcohol has 7 calories per gram.

One of the three main nutrients in food. Foods that provide carbohydrate are starches, vegetables, fruits, dairy products, and sugars.

Carbohydrate counting

A method of meal planning for people with diabetes based on counting the number of grams of carbohydrate in food.

Cardiovascular disease

Disease of the heart and blood vessels (arteries, veins, and capillaries).

Cataract

Clouding of the lens of the eye.

Cerebrovascular disease

Damage to blood vessels in the brain. Vessels can burst and bleed or become clogged with fatty deposits. When blood flow is interrupted, brain cells die or are damaged, resulting in a stroke.

Certified diabetes educator (CDE)

A health care professional with expertise in diabetes education who has met eligibility requirements and successfully completed a certification exam. See diabetes educator.

Charcot foot

A condition in which the joints and soft tissue in the foot are destroyed, causing deformity; it results from damage to the nerves.

Cholesterol

A type of fat produced by the liver and found in the blood; it is also found in some foods. Cholesterol is used by the body to make hormones and build cell walls.

Chronic

Describes something that is long-lasting. Opposite of acute.

Coma

A sleep-like state in which a person is not conscious. May be caused by hyperglycemia (high blood glucose) or hypoglycemia (low blood glucose) in people with diabetes.

Complications

Harmful effects of diabetes such as damage to the eyes, heart, blood vessels, nervous system, teeth and gums, feet and skin, or kidneys. Studies show that keeping blood glucose, blood pressure, and low-density lipoprotein cholesterol levels close to normal can help prevent or delay these problems.

Congestive heart failure

Loss of the heart's pumping power, which causes fluids to collect in the body, especially in the feet and lungs.

Conventional therapy

A term used in clinical trials where one group receives treatment for diabetes in which A1C and blood glucose levels are kept at levels based on current practice guidelines. However, the goal is not to keep blood glucose levels as close to normal as possible, as is done in intensive therapy. Conventional therapy includes use of medication, meal planning, and exercise, along with regular visits to health care providers. See coronary heart disease.

Coronary heart disease

Heart disease caused by narrowing of the arteries that supply blood to the heart. If the blood supply is cut off the result is a heart attack.

C-peptide

"Connecting peptide," a protein the pancreas releases into the bloodstream in equal amounts to insulin. A test of C-peptide levels shows how much insulin the body is making.

Creatinine

A waste product from protein in the diet and from the muscles of the body. Creatinine is removed from the body by the kidneys; as kidney disease progresses, the level of creatinine in the blood increases.

Dawn phenomenon

The early-morning (4 a.m. to 8 a.m.) rise in blood glucose level caused by the natural morning rise in a hormone called cortisol.

DCCT

See Diabetes Control and Complications Trial.

Dehydration

The loss of too much body fluid through frequent urinating, sweating, diarrhea, or vomiting.

Dextrose, also called glucose

Simple sugar found in blood that serves as the body's main source of energy.

Diabetes Control and Complications Trial (DCCT)

A study by the National Institute of Diabetes and Digestive and Kidney Diseases, conducted from 1983 to 1993 in people with type 1 diabetes. The study showed that intensive therapy compared to conventional therapy significantly helped prevent or delay diabetes complications. Intensive therapy included multiple daily insulin injections or the use of an insulin pump with multiple blood glucose readings each day. Complications followed in the study included diabetic retinopathy, neuropathy, and nephropathy.

Diabetes educator

A health care professional who teaches people who have diabetes how to manage their diabetes. Some diabetes educators are certified diabetes educators (CDEs). Diabetes educators are found in hospitals, physician offices, managed care organizations, home health care, and other settings.

Diabetes insipidus

A condition characterized by frequent and heavy urination, excessive thirst, and an overall feeling of weakness. This condition may be caused by a defect in the pituitary gland or in the kidney. In diabetes insipidus, blood glucose levels are normal. The condition is not related to diabetes, or high blood sugar.

Diabetes

A condition characterized by hyperglycemia resulting from the body's inability to use blood glucose for energy. In type 1 diabetes, the pancreas no longer makes insulin and therefore blood glucose cannot enter the cells to be used for energy. In type 2 diabetes, either the pancreas does not make enough insulin or the body is unable to use insulin correctly.

Diabetes Prevention Program (DPP)

A study by the National Institute of Diabetes and Digestive and Kidney Diseases conducted from 1998 to 2001 in people at high risk for type 2 diabetes. All study participants had impaired glucose tolerance, also called pre-diabetes, and were overweight. The study showed that people who lost 5 to 7 percent of their body weight through a low-fat, low-calorie diet and moderate exercise (usually walking for 30 minutes 5 days a week) reduced their risk of getting type 2 diabetes by 58 percent. Participants who received treatment with the oral diabetes drug metformin reduced their risk of getting type 2 diabetes by 31 percent.

Diabetic eye disease

See diabetic retinopathy.

Diabetic ketoacidosis (DKA)

An emergency condition in which extremely high blood glucose levels, along with a severe lack of insulin, result in the breakdown of body fat for energy and an accumulation of ketones in the blood and urine. Signs of DKA are nausea and vomiting, stomach pain, fruity breath odor, and rapid breathing. Untreated DKA can lead to coma and death. This condition is usually seen in people with type 1 diabetes, but it occasionally occurs in people with longstanding type 2 diabetes.

Diabetic myelopathy

Damage to the spinal cord found in some people with diabetes.

Diabetic eye disease; damage to the small blood vessels in the retina. Loss of vision may result.

Diabetogenic

Causing diabetes. For example, some drugs cause blood glucose levels to rise, resulting in diabetes.

Diabetologist

A doctor who specializes in treating people who have diabetes.

Dialysis

The process of cleaning wastes from the blood artificially. This job is normally done by the kidneys. If the kidneys fail, the blood must be cleaned artificially with special equipment. The two major forms of dialysis are hemodialysis and peritoneal dialysis.

Dietitian

A health care professional who advises people about meal planning, weight control, and diabetes management. A registered dietitian (RD) has more training.

Dilated eye exam

A test done by an eye care specialist in which the pupil (the black center) of the eye is temporarily enlarged with eyedrops to allow the specialist to see the inside of the eye more easily.

Dipeptidyl peptidase IV antagonists

A new class of diabetes medicine taken as a pill; help hormones from your intestine stimulate insulin release. Also known as DPP-IV Inhibitors, or gliptins.

DKA

See diabetic ketoacidosis.

Dupuytren's contracture

A condition associated with diabetes in which the fingers and the palm of the hand thicken and shorten, causing the fingers to curve inward.

Edema

Swelling caused by excess fluid in the body.

Electromyography (EMG)

A test used to detect nerve function. It measures the electrical activity generated by muscles.

EMG

See electromyography.

Endocrine gland

A group of specialized cells that release hormones into the blood. For example, the islets in the pancreas, which secrete insulin, are endocrine glands.

Endocrinologist

A doctor who treats people who have endocrine gland problems such as diabetes.

End-stage renal disease (ESRD)

See kidney failure.

Enzyme

Protein made by the body that brings about a chemical reaction, for example, the enzymes produced by the gut to aid digestion.

Erectile dysfunction

See impotence.

Euglycemia

A normal level of glucose in the blood.

Exchange lists

One of several approaches for diabetes meal planning. Foods are categorized into three groups based on their nutritional content. Lists provide the serving sizes for carbohydrates, meat and meat alternatives, and fats. These lists allow for substitution for different groups to keep the nutritional content fixed.

Fasting blood glucose test

A check of a person's blood glucose level after the person has not eaten for 8 to 12 hours (usually overnight). This test is used to diagnose pre-diabetes and diabetes. It is also used to monitor people with diabetes.

Fat

1. One of the three main nutrients in food. Foods that provide fat are butter, margarine, salad dressing, oil, nuts, meat, poultry, fish, and some dairy products. 2. Excess calories are stored as body fat, providing the body with a reserve supply of energy and other functions.

50/50 insulin

Premixed insulin that is 50 percent intermediate-acting (NPH) insulin and 50 percent short-acting (regular) insulin.

Fluorescein angiography

A test to examine blood vessels in the eye; done by injecting dye into an arm vein and then taking photos as the dye goes through the eye's blood vessels.

Fructosamine test

Measures the number of blood glucose molecules (MAH-leh-kyools) linked to protein molecules in the blood. The test provides information on the average blood glucose level for the past 3 weeks.

Fructose

A sugar that occurs naturally in fruits and honey. Fructose has 4 calories per gram.

Gangrene

The death of body tissue, most often caused by a lack of blood flow and infection. It can lead to amputation.

Gastroparesis

A form of neuropathy that affects the stomach. Digestion of food may be incomplete or delayed, resulting in nausea, vomiting, or bloating, making blood glucose control difficult.

A type of diabetes mellitus that develops only during pregnancy and usually disappears upon delivery, but increases the risk that the mother will develop diabetes later. GDM is managed with meal planning, activity, and, in some cases, insulin.

Gingivitis

A condition of the gums characterized by inflammation and bleeding.

Gland

A group of cells that secrete substances. Endocrine glands secrete hormones. Exocrine glands secrete salt, enzymes, and water.

Glargine insulin

Very-long-acting insulin. On average, glargine insulin starts to lower blood glucose levels within 1 hour after injection and keeps working evenly for 24 hours after injection.

Glaucoma

An increase in fluid pressure inside the eye that may lead to loss of vision.

Glomerular filtration rate

Measure of the kidney's ability to filter and remove waste products.

Glomerulus

A tiny set of looping blood vessels in the kidney where the blood is filtered and waste products are removed.

A hormone produced by the alpha cells in the pancreas. It raises blood glucose. An injectable form of glucagon, available by prescription, may be used to treat severe hypoglycemia.

Glucose

One of the simplest forms of sugar.

Chewable tablets made of pure glucose used for treating hypoglycemia.

Glucose tolerance test

See oral glucose tolerance test.

Glycemic index

A ranking of carbohydrate-containing foods, based on the food's effect on blood glucose compared with a standard reference food.

Glycogen

The form of glucose found in the liver and muscles.

Glycosuria

The presence of glucose in the urine.

Glycosylated hemoglobin

See A1C.

Gram

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

HDL cholesterol

High-density-lipoprotein (HDL), a fat found in the blood, takes extra cholesterol from the blood to the liver for removal. Also called "good" cholesterol.

Hemodialysis

See dialysis.

Hemoglobin A1C test

See A1C.

Heredity

The passing of a trait from parent to child.

High blood glucose

See hyperglycemia.

High blood pressure

See hypertension.

Honeymoon phase

Temporary remission of hyperglycemia that occurs in some people newly diagnosed with type 1 diabetes, when some insulin secretion resumes for a short time, usually a few months, before stopping again.

Hormone

A chemical produced in one part of the body and released into the blood to trigger or regulate particular functions of the body. For example, insulin is a hormone made in the pancreas that tells other cells when to use glucose for energy. Synthetic hormones, made for use as medicines, can be the same or different from those made in the body.

Excessive blood glucose. Fasting hyperglycemia is blood glucose above a desirable level after a person has fasted for at least 8 hours. Postprandial hyperglycemia is blood glucose above a desirable level 1 to 2 hours after a person has eaten.

Hyperinsulinemia

A condition in which the level of insulin in the blood is higher than normal. Caused by overproduction of insulin by the body. Related to insulin resistance.

Hyperlipidemia

Higher than normal fat and cholesterol levels in the blood.

Hyperosmolar hyperglycemic nonketotic syndrome (HHNS)

An emergency condition in which one's blood glucose level is very high and ketones are not present in the blood or urine. If HHNS is not treated, it can lead to coma or death.

Hypertension

A condition present when blood flows through the blood vessels with a force greater than normal. Also called high blood pressure. Hypertension can strain the heart, damage blood vessels, and increase the risk of heart attack, stroke, kidney problems, and death.

Hypoglycemia

A condition that occurs when one's blood glucose is lower than normal, usually less than 70 mg/dL. Signs include hunger, nervousness, shakiness, perspiration, dizziness or light-headedness, sleepiness, and confusion. If left untreated, hypoglycemia may lead to unconsciousness. Hypoglycemia is treated by consuming a carbohydrate-rich food such as a glucose tablet or juice. It may also be treated with an injection of glucagons or intravenous glucose if the person is unconscious or unable to swallow. Also called an insulin reaction.

Hypoglycemia unawareness

A state in which a person does not feel or recognize the symptoms of hypoglycemia. People who have frequent episodes of hypoglycemia may no longer experience the warning signs of it. When their blood sugar gets dangerously low, these patients have confusion, seizures, and loss of consciousness.

Hypotension

Low blood pressure or a sudden drop in blood pressure. Hypotension may occur when a person rises quickly from a sitting or reclining position, causing dizziness or fainting.

IDDM (insulin-dependent diabetes mellitus)

Former term for type 1 diabetes.

Immune system

The body's system for protecting itself from viruses and bacteria or any "foreign" substances.

Impaired fasting glucose (IFG)

A condition in which a blood glucose test, taken after an 8- to 12-hour fast, shows a level of glucose higher than normal but not high enough for a diagnosis of diabetes. IFG, also called pre-diabetes, is a level of 100 mg/dL to 125 mg/dL. Most people with pre-diabetes are at increased risk for developing type 2 diabetes.

Impaired glucose tolerance (IGT)

A condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. IGT, also called pre-diabetes, is a level of 140 mg/dL to 199 mg/dL 2 hours after the start of an oral glucose tolerance test. Most people with pre-diabetes are at increased risk for developing type 2 diabetes. Other names for IGT that are no longer used are "borderline," "subclinical," "chemical," or "latent" diabetes.

Implantable insulin pump

A small pump placed inside the body to deliver insulin in response to remote-control commands from the user.

Impotence

The inability to get or maintain an erection for sexual activity. Also called erectile (ee-REK-tile) dysfunction (dis-FUNK-shun).

Incretin mimetics

Medications for type 2 diabetes taken by injection. These medicines act like hormones naturally produced by your intestine to help the pancreas release insulin.

Injection

Inserting liquid medication or nutrients into the body with a syringe. A person with diabetes may use short needles or pinch the skin and inject at an angle to avoid an intramuscular injection of insulin.

Injection site rotation

Changing the places on the body where insulin is injected. Rotation prevents the formation of lipodystrophies.

Injection sites

Places on the body where insulin is usually injected.

Insulin

A hormone that helps the body use glucose for energy. The beta cells of the pancreas make insulin. When the body cannot make enough insulin, insulin is taken by injection or through use of an insulin pump.

Insulin adjustment

A change in the amount of insulin a person with diabetes takes based on factors such as meal planning, activity, and blood glucose levels.

Insulin-dependent diabetes mellitus (IDDM)

Former term for type 1 diabetes.

Insulinoma

A tumor of the beta cells in the pancreas. An insulinoma may cause the body to make extra insulin, leading to hypoglycemia.

A device for injecting insulin that looks like a fountain pen and holds replaceable cartridges of insulin. Also available in disposable form.

Insulin reaction

When the level of glucose in the blood is too low (at or below 70 mg/dL). Also known as hypoglycemia.

Insulin receptors

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

Insulin resistance

The body's inability to respond to and use the insulin it produces. Insulin resistance may be linked to obesity, hypertension, and high levels of fat in the blood.

Insulin shock

See hypoglycemia.

Intensive therapy

A treatment for diabetes in which blood glucose is kept as close to normal as possible through frequent injections or use of an insulin pump; meal planning; adjustment of medicines; and exercise based on blood glucose test results and frequent contact with a person's health care team.

Intermediate-acting insulin

A type of insulin that starts to lower blood glucose within 1 - 2 hours after injection and has its strongest effect 6 - 12 hours after injection, depending on the type used. See NPH insulin.

Intramuscular injection

Inserting liquid medication into a muscle with a syringe. Glucagon may be given by subcutaneous or intramuscular injection for hypoglycemia.

Islets

Groups of cells located in the pancreas that make hormones that help the body break down and use food. For example, alpha cells make glucagon and beta cells make insulin. Also called islets of Langerhans .

Islets of Langerhans

See islets.

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

Juvenile diabetes

Former term for insulin-dependent diabetes mellitus (IDDM), or type 1 diabetes.

Ketoacidosis

See diabetic ketoacidosis.

Ketone

A chemical produced when there is a shortage of insulin in the blood and the body breaks down body fat for energy. High levels of ketones can lead to diabetic ketoacidosis and coma. Sometimes referred to as ketone bodies.

Ketonuria

A condition occurring when ketones are present in the urine, a warning sign of diabetic ketoacidosis.

Ketosis

A ketone buildup in the body that may lead to diabetic ketoacidosis. Signs of ketosis are nausea, vomiting, and stomach pain.

See nephropathy.

Kidney failure

A chronic condition in which the body retains fluid and harmful wastes build up because the kidneys no longer work properly. A person with kidney failure needs dialysis or a kidney transplant. Also called end-stage renal disease or ESRD.

The two bean-shaped organs that filter wastes from the blood and form urine. The kidneys are located near the middle of the back. They send urine to the bladder.

Kussmaul breathing

The rapid, deep, and labored breathing of people who have diabetic ketoacidosis.

A spring-loaded device used to prick the skin with a small needle to obtain a drop of blood for blood glucose monitoring.

Laser surgery treatment

A type of therapy that uses a strong beam of light to treat a damaged area. The beam of light is called a laser. A laser is sometimes used to seal blood vessels in the eye of a person with diabetes. See photocoagulation.

LDL cholesterol

Low-density lipoprotein (LDL), a fat found in the blood, takes cholesterol around the body to where it is needed for cell repair and also deposits it on the inside of artery walls. Also called "bad" cholesterol.

Lipid

A term for fat in the body. Lipids can be broken down by the body and used for energy.

Lipid profile

A blood test that measures total cholesterol, triglycerides, and HDL cholesterol. LDL cholesterol is then calculated from the results. A lipid profile is one measure of a person's risk of cardiovascular disease.

Lipoatrophy

Loss of fat under the skin resulting in small dents. Lipoatrophy may be caused by repeated injections of insulin in the same spot.

Lipodystrophy

Defect in the breaking down or building up of fat below the surface of the skin, resulting in lumps or small dents in the skin surface. (See lipohypertrophy or lipoatrophy.) Lipodystrophy may be caused by repeated injections of insulin in the same spot. Insulin injected into an area of lipodystrophy may not get into the bloodstream quick enough.

Lipohypertrophy

Buildup of fat below the surface of the skin, causing lumps. Lipohypertrophy may be caused by repeated injections of insulin in the same spot.

Lispro insulin

A rapid-acting insulin. On average, lispro insulin starts to lower blood glucose within 5 minutes after injection. It has its strongest effect 30 minutes to 1 hour after injection but keeps working for 3 hours after injection.

Liver

An organ in the body that changes food into energy, removes alcohol and poisons from the blood, and makes bile, a substance that breaks down fats and helps rid the body of wastes.

Long-acting insulin

A type of insulin that starts to lower blood glucose within 4 to 6 hours after injection and has its strongest effect 10 to 18 hours after injection. See ultralente insulin.

Low blood sugar

See hypoglycemia.

Macrovascular disease

Disease of the large blood vessels, such as those found in the heart. Lipids and blood clots build up in the large blood vessels and can cause atherosclerosis, coronary heart disease, stroke, and peripheral vascular disease.

Macula

The part of the retina in the eye used for reading and seeing fine detail.

Macular edema

Swelling of the macula.

Metabolic syndrome

The tendency of several conditions to occur together, including obesity, insulin resistance, diabetes or pre-diabetes, hypertension, and high lipids.

Metabolism

The term for the way cells chemically change food so that it can be used to store or use energy and make the proteins, fats, and sugars needed by the body.

Mg/dL

Milligrams per deciliter, a unit of measure that shows the concentration of a substance in a specific amount of fluid. In the United States, blood glucose test results are reported as mg/dL. Medical journals and other countries use millimoles per liter (mmol/L). To convert to mg/dL from mmol/L, multiply mmol/L by 18. Example: 10 mmol/L _ 18 = 180 mg/dL.

Microalbumin

Small amounts of the protein called albumin in the urine detectable with a special lab test.

Microaneurysm

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

Microvascular disease

Disease of the smallest blood vessels, such as those found in the eyes, nerves, and kidneys. The walls of the vessels become abnormally thick but weak. Then they bleed, leak protein, and slow the flow of blood to the cells.

Mixed dose

A combination of two types of insulin in one injection. Usually a rapid- or short-acting insulin is combined with a longer acting insulin (such as NPH insulin) to provide both short-term and long-term control of blood glucose levels.

Mmol/L

Millimoles per liter, a unit of measure that shows the concentration of a substance in a specific amount of fluid. In most of the world, except for the United States, blood glucose test results are reported as mmol/L. In the United States, milligrams per deciliter (mg/dL) is used. To convert to mmol/L from mg/dL, divide mg/dL by 18. Example: 180 mg/dL 18 = 10 mmol/L.

MODY

Maturity-onset diabetes of the young. A rare type of inherited diabetes that is usually mild and can be controlled with pills. MODY may be first diagnosed in childhood.

Monofilament

A short piece of nylon, like a hairbrush bristle, mounted on a wand. To check sensitivity of the nerves in the foot, the doctor touches the filament to the bottom of the foot.

Mononeuropathy

Neuropathy affecting a single nerve.

Myocardial infarction

An interruption in the blood supply to the heart because of narrowed or blocked blood vessels. Also called a heart attack.

Nephrologist

A doctor who treats people who have kidney problems.

Nephropathy

Disease of the kidneys. Hyperglycemia and hypertension can damage the kidneys' glomeruli. When the kidneys are damaged, protein leaks out of the kidneys into the urine. Damaged kidneys can no longer remove waste and extra fluids from the bloodstream.

Nerve conduction studies

Tests used to measure for nerve damage; one way to diagnose neuropathy.

Nerve disease

See neuropathy.

Neurologist

A doctor who specializes in problems of the nervous system, such as neuropathy.

Neuropathy

Disease of the nervous system. The three major forms in people with diabetes are peripheral neuropathy, autonomic neuropathy, and mononeuropathy. The most common form is peripheral neuropathy, which affects mainly the legs and feet.

Noninsulin-dependent diabetes mellitus (NIDDM)

Former term for type 2 diabetes.

Noninvasive blood glucose monitoring

Measuring blood glucose without pricking the finger to obtain a blood sample.

NPH insulin

An intermediate-acting insulin; NPH stands for neutral protamine Hagedorn. On average, NPH insulin starts to lower blood glucose within 1 to 2 hours after injection. It has its strongest effect 6 to 10 hours after injection but keeps working about 10 hours after injection. Also called N insulin.

Nutritionist

A person with training in nutrition; may or may not have specialized training and qualifications. See dietitian.

OGTT

See oral glucose tolerance test.

Ophthalmologist

A medical doctor who diagnoses and treats all eye diseases and eye disorders. Ophthalmologists can also prescribe glasses and contact lenses.

Optometrist

A primary eye care provider who prescribes glasses and contact lenses. Optometrists can diagnose and treat certain eye conditions and diseases.

A test to diagnose pre-diabetes and diabetes. The oral glucose tolerance test is given by a health care professional after an overnight fast. A blood sample is taken, then the patient drinks a high-glucose beverage. Blood samples are taken at intervals for 2 to 3 hours. Test results are compared with a standard and show how the body uses glucose over time.

Oral hypoglycemic agents

Medicines taken by mouth by people with type 2 diabetes to keep blood glucose levels as close to normal as possible. Classes of oral hypoglycemic agents are alpha-glucosidase inhibitors, biguanides, D-phenylalanine derivatives, meglitinides, sulfonylureas, DPP-IV antagonists, and thiazolidinediones.

An organ that makes insulin and enzymes for digestion. The pancreas is located behind the lower part of the stomach and is about the size of a hand.

Pancreas transplantation

A surgical procedure to take a healthy whole or partial pancreas from a donor and place it into a person with diabetes.

Pedorthist

A health care professional who specializes in fitting shoes for people with disabilities or deformities. A pedorthist can custom-make shoes or orthotics (special inserts for shoes).

Periodontal disease

Disease of the gums.

Periodontist

A dentist who specializes in treating people who have gum diseases.

Peripheral neuropathy

Nerve damage that affects the feet, legs, or hands. Peripheral neuropathy causes pain, numbness, or a tingling feeling.

Peripheral vascular disease (PVD)

A disease of the large blood vessels of the arms, legs, and feet. PVD may occur when major blood vessels in these areas are blocked and do not receive enough blood. The signs of PVD are aching pains in the thighs and calves, particularly with walking, and slow-healing foot sores.

Photocoagulation

A treatment for diabetic retinopathy. A strong beam of light (laser) is used to seal off bleeding blood vessels in the eye and to burn away extra blood vessels that should not have grown there.

Podiatrist

A doctor who treats people who have foot problems. Podiatrists also help people keep their feet healthy by providing regular foot examinations and treatment.

Podiatry

The care and treatment of feet.

Point system

A meal planning system that uses points to rate the caloric content of foods.

Polydipsia

Excessive thirst; may be a sign of diabetes.

Polyphagia

Excessive hunger; may be a sign of diabetes.

Polyuria

Excessive urination; may be a sign of diabetes.

Postprandial blood glucose

The blood glucose level taken 1 to 2 hours after eating.

Pre-diabetes

A condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. People with pre-diabetes are at increased risk for developing type 2 diabetes and for heart disease and stroke. Other names for pre-diabetes are impaired glucose tolerance and impaired fasting glucose and borderline diabetes.

Premixed insulin

A commercially produced combination of two different types of insulin. See 50/50 insulin and 70/30 insulin.

Preprandial blood glucose

The blood glucose level taken before eating.

Proinsulin

The substance made first in the pancreas and then broken into several pieces to become insulin.

Proliferative retinopathy

A condition in which fragile new blood vessels grow along the retina and in the vitreous humor of the eye.

Prosthesis

A man-made substitute for a missing body part such as an arm or a leg.

1. One of the three main nutrients in food. Foods that provide protein include meat, poultry, fish, cheese, milk, dairy products, eggs, and dried beans. 2. Proteins are also used in the body for cell structure, hormones such as insulin, and other functions.

Proteinuria

The presence of protein in the urine, indicating that the kidneys are not working properly.

Pump

See insulin pump.

Rapid-acting insulin

A type of insulin that starts to lower blood glucose within 5 to 10 minutes after injection and has its strongest effect 30 minutes to 3 hours after injection, depending on the type used. See aspart insulin and lispro insulin.

Rebound hyperglycemia

A swing to a high level of glucose in the blood after a low level. See Somogyi effect.

Receptors

See insulin receptors.

Recognized Diabetes Education Programs

Diabetes self-management education programs that are approved by the American Diabetes Association.

Regular insulin

Short-acting insulin. On average, regular insulin starts to lower blood glucose within 30 minutes after injection. It has its strongest effect 2 to 5 hours after injection but keeps working 5 to 8 hours after injection. Also called R insulin.

Renal

Having to do with the kidneys. A renal disease is a disease of the kidneys. Renal failure means the kidneys have stopped working.

Renal threshold of glucose

The blood glucose concentration at which the kidneys start to spill glucose into the urine.

Retina

The light-sensitive layer of tissue that lines the back of the eye.

See background retinopathy, proliferative retinopathy, and diabetic retinopathy.

Risk factor

Anything that raises the chances of a person developing a disease.

Saccharin

A sweetener with no calories and no nutritional value.

Secondary diabetes

A type of diabetes caused by another disease or certain drugs or chemicals.

70/30 insulin

Premixed insulin that is 70 percent intermediate-acting (NPH) insulin and 30 percent short-acting (regular) insulin.

Sharps container

A container for disposal of used needles and syringes; often made of hard plastic so that needles cannot poke through.

Short-acting insulin

A type of insulin that starts to lower blood glucose within 30 minutes after injection and has its strongest effect 2 to 5 hours after injection. See regular insulin.

Side effects

The unintended action(s) of a drug.

Sliding scale

A set of instructions for adjusting insulin on the basis of blood glucose test results, meals, or activity levels.

Somogyi effect

Also called rebound hyperglycemia -- when the blood glucose level swings high following hypoglycemia. The Somogyi effect may show up as a high blood sugar in the morning, following an untreated hypoglycemic episode during the night and is caused by the release of stress hormones.

Sorbitol

1. A sugar alcohol (sweetener) with 4 calories per gram. 2. A substance produced by the body in people with diabetes that can cause damage to the eyes and nerves.

Split mixed dose

Division of a prescribed daily dose of insulin into two or more injections given over the course of the day.

Another name for carbohydrate, one of the three main nutrients in food.
Condition caused by damage to blood vessels in the brain; may cause loss of ability to speak or to move parts of the body.

Subcutaneous injection

Putting a fluid into the tissue under the skin with a needle and syringe.

Sucralose

A sweetener made from sugar but with no calories and no nutritional value.

Sucrose

A two-part sugar made of glucose and fructose. Known as table sugar or white sugar, it is found naturally in sugar cane and in beets.

Sugar

1. A class of carbohydrates with a sweet taste; includes glucose, fructose, and sucrose. 2. A term used to refer to blood glucose.

Sugar alcohols

Sweeteners that produce a smaller rise in blood glucose than other carbohydrates. Their calorie content is about 2 calories per gram. Includes erythritol, hydrogenated starch hydrolysates, isomalt, lactitol, maltitol, mannitol, sorbitol, and xylitol. Also known as polyols (PAH-lee-alls.)

Sugar diabetes

Former term for diabetes mellitus.

A class of oral medicine for type 2 diabetes that lowers blood glucose by helping the pancreas make more insulin and by helping the body better use the insulin it makes. (Generic names: Acetohexamide, chlorpropamide, glimepiride, glipizide, glyburide, tolazamide, tolbutamide.)

Syndrome x

See insulin resistance and metabolic syndrome.

Syringe

A device used to inject medications or other liquids into body tissues. The syringe for insulin has a hollow plastic tube with a plunger inside and a needle on the end.

Team management

A diabetes treatment approach in which medical care is provided by a team of health care professionals including a doctor, a dietitian, a nurse, a diabetes educator, and others. These people act as advisers to the person with diabetes.

Tight control

See intensive therapy.

Triglyceride

The storage form of fat in the body. High triglyceride levels may occur when diabetes is out of control.

Type 1 diabetes

A condition characterized by high blood glucose levels caused by a total lack of insulin. Occurs when the body's immune system attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin. Type 1 diabetes develops most often in young people but can appear in adults.

Type 2 diabetes

A condition characterized by high blood glucose levels caused by either a lack of insulin or the body's inability to use insulin efficiently. Type 2 diabetes develops most often in middle-aged and older adults but can appear in young people.

Type I diabetes

Former term for type 1 diabetes.

Type II diabetes

Former term for type 2 diabetes.

Ulcer

A deep open sore or break in the skin.

Unit of insulin

The basic measure of insulin. U-100 insulin means 100 units of insulin per milliliter (mL) or cubic centimeter (cc) of solution. Most insulin made today in the United States is U-100.

U-100

See unit of insulin.

Urea

A waste product found in the blood that results from the normal breakdown of protein in the liver. Urea is normally removed from the blood by the kidneys and then excreted in the urine.

Uremia

The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion.

Urine

The liquid waste product filtered from the blood by the kidneys, stored in the bladder, and expelled from the body by the act of urinating.

Urine testing

Also called urinalysis; a test of a urine sample to diagnose diseases of the urinary system and other body systems. In people with diabetes, a doctor may check for:1. Glucose, a sign of diabetes or other diseases.2. Protein, a sign of kidney damage, or nephropathy. (Also see albuminuria.)3. White blood cells, a sign of urinary tract infection.4. Ketones, a sign of diabetic ketoacidosis or other conditions. Urine may also be checked for signs of bleeding. Some tests use a single urine sample. For others, 24-hour collection may be needed. And sometimes a sample is "cultured" to see exactly what type of bacteria grows.

Urologist

A doctor who treats people who have urinary tract problems. A urologist also cares for men who have problems with their genital organs, such as impotence.

Vascular

Relating to the body's blood vessels.

Vein

A blood vessel that carries blood to the heart.

Very-long-acting insulin

A type of insulin that starts to lower blood glucose within 1 hour after injection and keeps working evenly for 24 hours after injection. See glargine insulin.

Vitrectomy

Surgery to restore sight in which the surgeon removes the cloudy vitreous humor in the eye and replaces it with a salt solution.

Wound care

Steps taken to ensure that a wound such as a foot ulcer heals correctly. People with diabetes need to take special precautions so wounds do not become infected.

Xylitol

A carbohydrate-based sweetener found in plants and used as a substitute for sugar; provides calories. Found in some mints and chewing gum.

Review Date: 7/8/2012

Reviewed By: Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Previoulsy reviewed by Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. (5/13/2010)

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