Background Retinopathy

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

Basal/Bolus Insulin Administration (Poor Man's Pump)

Using several daily injections of clear insulin (either Regular or Lispro), at mealtimes -- the bolus doses -- together with one or more daily injections of cloudy insulin (either NPH or Ultralente insulin) -- the basal doses -- to achieve blood sugar control in a manner similar to that used by people who use insulin pumps.

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.
See also: alpha cell and delta cell.

Beta Cell Transplantation

See: Islet cell transplantation.

Biosynthetic Human Insulin

A man-made insulin that is very much like 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/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. Some meters have a memory that can store results from multiple tests. 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. Meters for a discussion and review of several meters currently available.

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. Lancets and Lancing Devices for a discussion and review of several blood-sampling devices currently available.

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

Diabetes that is very difficult to control. It is an antiquated term that has no place in current management of diabetes. In particular it is not a distinct form of diabetes, and usually will respond to a more intensive team approach to care.

Bronze Diabetes

See: hemochromatosis.

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: Foot care.

C.D.E. (Certified Diabetes Educator)

A health professional who is certified by the National Certification Board for Diabetes Educators to teach people with diabetes how to manage their condition. The criteria to obtain this certification include:

1. a degree in the health professions such as R.N. (nursing), M.D. or D.O. (physicians), R.D. (dietitians), R.Ph. or Pharm.D. (pharmacists), M.S.W. (social workers), and others.
2. at least two years' experience in diabetes education.
3. successful completion of a comprehensive examination covering the field.

Certified Diabetes Educators must be recredentialed every 5 years. Visit the American Association of Diabetes Educators website to learn more about diabetes education. You may also visit the National Certification Board for Diabetes Educators website to learn more about the Certification process.

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.
See: Proinsulin.

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

Capsaicin, derived from hot peppers, is the active ingredient in the creams 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, which are the basic problems in most forms of diabetes, then the body will not be able to use carbohydrates for energy the way it should.

Sometimes abbreviated CHO.
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."

Catheter

A hollow flexible tube used to infuse or drain fluids into or from the body. Example: A catheter is used to transfer insulin from an insulin pump to a needle that is placed in the skin of the person using an insulin pump.

Celiac syndrome (also spelled coeliac syndrome)

An autoimmune disorder of the upper intestinal mucosa that is triggered by cereal proteins, especially wheat gluten, and which leads to a malabsorption of all nutrients, primarily of fat. It can be detected by the presence of anti-transglutaminase antibodies. If these are positive it would be justifiable to take a mucosal biopsy and if this is positive, then dietary treatment is all that is required.

About 5% of people with autoimmune diabetes have positive anti-transglutaminase antibodies. Celiac syndrome may also be part of the Autoimmune Polyglandular Syndrome.

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 almost painless 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 walls of the larger arteries and cause a disease called atherosclerosis. Butter and egg yolks are examples of foods that have a lot of cholesterol.

Cholesterol is composed of several components:

1. HDL-Cholesterol (high-density lipoprotein cholesterol): This component of cholesterol seems to have protective effects, and higher levels are considered to be good to have.
2. LDL-Cholesterol (low-density lipoprotein cholesterol)
3. VLDL-Cholesterol (very low-density lipoprotein cholesterol)

Cholesterol is a lipid.

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.

For information about how important good control is in reducing the risk of complications, see The Diabetes Control and Complications Trial (DCCT).

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." The Diabetes Control and Complications Trial has shown that intensive therapy, rather than conventional therapy, can reduce the risk of complications.

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.

Cortisol

One of several hormones made in the adrenal glands. The primary responsibility of cortisol is to activate the immune system; it also is involved with the metabolism of glucose, and can cause elevation of the blood sugar level.

Cortisol is in the class of hormones called corticosteroids (or steroids). It, and synthetic versions such as prednisone, are available as prescription medications for treating severe illnesses including asthma and arthritis; they are sometimes also used for severe cases of minor illnesses like poison ivy rashes.

See also Your doctor advises using steroids at the Diabetes Monitor.

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.

Be sure to read Common Class of Viruses Implicated as Cause of Type 1 Diabetes.

Creatinine

An end-product of protein metabolism found in the blood and urine, that can be used to help assess if the kidneys are working adequately. A related test, using simultaneous measurements of a timed urine sample plus a blood creatinine test, is called the creatinine clearance.

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.

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.

The Nephrogenic Diabetes Insipidus Network helps families with children who have diabetes insipidus.

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 1) and noninsulin-dependent (Type 2). 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 Dermopathy

A characteristic skin disorder found in up to 50% of male adults and 30% of female adults with diabetes. The lesions may be round or oval and usually are red or reddish brown, and usually measure 1-3 inches. They usually occur on the thigh or shin, but may appear also on the scalp, forearm and trunk. There is not an effective treatment and the lesions tend to disappear spontaneously after several years.

Diabetic Ketoacidosis (DKA)

Severe, out-of-control diabetes (high blood sugar) that needs emergency treatment. DKA is caused by a profound lack of circulating insulin. 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.

DIDMOAD

See: Wolfram Syndrome.

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.

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) and Nerve Conduction Velocity (NCV) Studies

Tests used to diagnose neuropathy and check for nerve damage. These tests are usually both run at the same time, using the same equipment.

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.
See the list of companies that sell Medical Alert Jewelry.

Endocrine pancreas

The part of the pancreas that produces hormones that govern sugar metabolism. Compare with the exocrine pancreas.

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

Produced or made inside the body; for instance, insulin made by a person's own pancreas is endogenous insulin.

Pronounced: en-DODGE-in-us

Compare: Exogenous

Endogenous Antibodies

In Type 1 diabetes, several different autoantibodies against normal tissues are found. These antibodies are associated with the destruction of the beta cells of the pancreas, although their exact role is uncertain. Some of the autoantibodies which are found in diabetes patients include islet-cell antibodies (ICA's), anti-insulin antibodies (AIA's) and anti-GAD antibodies.

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 several hormones made in the adrenal glands. It helps the liver release glucose (sugar), and limits the release of insulin from the pancreas.
Epinephrine is responsible for some of the symptoms of hypoglycemia, including anxiety, sweating, tremor, pallor, nausea, and rapid heart beat.
Epinephrine is also called adrenalin. It is available as a prescription medication, for treating severe allergic reactions by antagonizing the effects of histamine and reducing capillary permeability.

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.

Compare to hyperglycemia and hypoglycemia.

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
6. fats

Within a food group, each serving has about the same amount of carbohydrate, protein, fat, and calories.

Exocrine pancreas

The part of the pancreas that produces enzymes that are needed in intestinal digestion. Compare with the endocrine pancreas.

Exogenous

Produced or made outside the body; for instance, insulin that is commercially produced (made from pork or beef pancreas or by biosynthetic processes) is exogenous insulin when given to people.

Pronounced: ex-SODGE-in-us

Compare: Endogenous

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 over 140 mg/dl, it usually 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.

Another name for fat is lipid.
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.

First Phase Insulin Release

Release of insulin into the bloodstream from the beta cell within a few minutes after the blood glucose level rises. It is thought that this almost immediate release is due to release of insulin that was previously manufactured, and was being stored in the beta cell.
See also: Second Phase Insulin Release

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."

Fructosamine

A term referring to the linking of blood sugar onto protein molecules in the bloodstream. The fructosamine value depends upon the average blood sugar level during the past three weeks. The fructosamine test could be viewed as complementary to the glycohemoglobin, as the two tests are different reflections of diabetes control: glycohemoglobin looks back approximately eight to twelve weeks, and the fructosamine test looks back about three weeks.

Note: the term fructosamine has nothing to do with the term fructose.

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.
See also: Glucose, Sugar.

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.

GAD (Glutamic Acid Decarboxylase)

A normal enzyme found in all cells that initiates the metabolism of a substance called glutamic acid. Glutamic acid is a component of all proteins and is also part of the cycle for the disposal of a waste product called ammonia. The presence of antibodies to GAD (called anti-GAD antibodies) in the blood is an early indication of the start of the autoimmune process in Type 1A Diabetes.

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 is available as a prescription item, for use to treat severe insulin reactions. The glucagon is injected and raises blood glucose levels within a half-hour. It is frequently recommended that people with Type 1 diabetes, and other people taking insulin injections, have a family member learn how to administer glucagon.

Gluconeogenesis

The formation of glucose from protein within the liver.

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, Fructose, Sugar.

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 Index

A ranking of foods based on their immediate effect on blood sugar levels. The Glycemic Index measures how much your blood sugar increases over a period of two or three hours after a meal.

Carbohydrate foods that break down quickly during digestion have the highest glycemic index.

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, Glucosuria

Having glucose (sugar) in the urine.
See also: Renal Glycosuria.

Glycosylated Hemoglobin Test (Glycohemoglobin)

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 and HbA1c Measurement.

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.

Graves' Disease

A form of thyroid disease, with overactivity of the thyroid function, enlargement of the size of the gland, and bulging eyes (exophthalmos) being common features. Named after a 19th century Irish physician.

Graves' is autoimmune in nature. It is found somewhat more commonly than expected in people with type 1 diabetes.

HCF Diet

A high-carbohydrate, high-fiber diet.

Hemochromatosis

A disease with excessive storage of iron, especially in the liver and other tissues, including the pancreas and skin; it may be genetic or the result of repeated transfusions. Pancreatic involvement may sometimes lead to destruction of islet cells and to a secondary form of diabetes.
Sometimes called "Bronze Diabetes" because of the association of discoloration of the skin and 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.
See also: Glycohemoglobin.

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 (Human Leukocyte Antigen)

A pattern of cell surface proteins that identifies the cell to the immune system as 'self' or 'non-self'. Certain patterns (haplotypes) as defined by DNA analysis can indicate a susceptibility to Type 1 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.

Honeymoon Period

The period of time shortly after the diagnosis of Type 1 diabetes during which there is some restoration of insulin production and the blood sugar levels improve to normal, or near-normal, levels. Unfortunately, like other honeymoons, this diabetes honeymoon doesn't last forever; it may last for weeks, months, or occasionally, years.

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 Type 1 diabetes, hyperglycemia may lead to diabetic ketoacidosis.
See also: Euglycemia and Hypoglycemia.

Hyperglycemic hyperosmolar nonketotic syndrome

See Nonketotic Coma.

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

See Nonketotic Coma.

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: Euglycemia, Hyperglycemia, and Reactive Hypoglycemia.

Hypoglycemia Unawareness

A situation in which the usual epinephrine-induced symptoms of a fall in blood sugar are, for a variety of reasons, either not felt or not recognized.

This situation may be dangerous, as the patient may go from functioning normally to unconscious within a short time. It is generally thought that if such a patient is allowed to maintain somewhat elevated blood sugar levels for several weeks, that the hypoglycemic unawareness may resolve.

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.

IDDM (Insulin-dependent diabetes mellitus)

See: Type 1 Diabetes Mellitus.

Idiopathic

Of unknown origin.

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

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).
What is Insulin? and Diabetes Team Questions about Insulin.

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)

See: Type 1 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 Lispro

See Lispro Insulin

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 short-acting insulin into the body. The insulin flows from the pump through a plastic tube (called a catheter) that is connected to a needle inserted into the skin and taped in place.

Insulin is delivered at different rates, which can be either manually set or preprogrammed: 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. Both the basal and bolus rates are adjustable by the user, in response to blood sugar tests done with standard methods; no available pump can measure the sugar level and calculate what changes to make in the insulin doses.

The pump runs on batteries and can be worn clipped to a belt or carried in a pocket. It is usually used by people with insulin-dependent diabetes, although it is occasionally recommended for people with other forms of diabetes. See also: Insulin Pumps Diabetes Team Questions about Insulin Pumps.

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

A state in which a given level of serum insulin produces a less than expected biological effect. Patients may vary from normoglycemic to severely diabetic despite large doses of insulin. Many people with Type 2 diabetes produce enough insulin, but their bodies do not respond to the action of insulin. This may happen because the person is overweight and does 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 (see Syndrome X).

Another kind of insulin resistance may rarely happen in people who take insulin injections. They may have to take very high doses of insulin every day (e.g., 200 units or more (in adults)) to bring their blood glucose down to the normal range. This has also been called "insulin insensitivity."

Insulin Shock

A term no longer used. See 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.

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 Antibodies (ICA's)

Specialized proteins, called antibodies, that are found in the blood of many people with Type 1 diabetes at the time of diagnosis. Most people with Type 1 diabetes have antibodies to a variety of islet cell proteins that are apparently released as a consequence of damage to the beta cells of the pancreas. The presence of these antibodies therefore is a useful indicator that the autoimmune process has begun. The antibodies that are presently routinely assayed include:

• IAA anti insulin
• GAD65 anti glutamic acid decarboxylase
• ICA512 a specific islet cell antibody
• EMA antiendomyseal antibodies (a test for celiac synmdrome, another autoimmune disorder occurring in 5% of new-onset Type 1 diabetes)
• Anti 21-hydroxylase (a test for Addison's disease, also an autoimmune condition found in 2% of new onset Type 1 diabetes)

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. Transplantation of the pancreas itself is surgically feasible, and is sometimes advised for some patients. See also: Pancreas Transplant.

Islet Cells (Islets/Islands of Langerhans)

(Pronouciation: EYE-let cells). The clumps of cells within the pancreas that include those cells that make insulin and other hormones. The cells include several subvarieties, including:

• alpha cells, which make glucagon;
• beta cells, which make insulin;
• delta cells, which make somatostatin;

and PP cells and D1 cells, about which little is known. The islet cells appear under low-power magnification to be islands (islets) within the pancreas. First described by Dr. Paul Langerhans in 1869, whose name is now associated with these islands.

Jet Injector

A device that uses high pressure to propel insulin through the skin and into the body. When used properly, injections are painless. However, the devices are more complicated to use than a syringe and often require cleaning.
See: Jet Injector Overview.

Juvenile Onset Diabetes

Former term for insulin-dependent or type 1 diabetes.
See: Insulin-dependent diabetes mellitus.

Ketoacidosis

See: Diabetic ketoacidosis.

Ketones (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.

Ketotic Hypoglycemia

A poorly-understood disorder of childhood, marked by hypoglycemia and ketosis. There is carbohydrate deprivation, with consequent dependence on fat stores for energy. Ketotic hypoglycemia can often be effectively treated by simple dietary changes involving frequent feedings of carbohydrate and protein.

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."

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.

Late-onset Autoimmune Diabetes of Adulthood (LADA)

Autoimmune diabetes (Type 1A diabetes) occurring in individuals who are older than the usual age of onset of type 1 diabetes (that is, over 30 years of age at diagnosis). Sometimes, patients with LADA are mistakenly thought to have Type 2 diabetes, based on their age at the time of diagnosis. However, positive anti-body tests would help make the diagnosis of LADA.

Lancet

A fine, sharp-pointed blade or needle for pricking the skin.
See Lancets and Lancing Devices for a discussion and review of several lancets currently available.

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).

The two most commonly measured kinds of lipids are triglycerides and cholesterol.

Lipoatrophy

Small depressions in the subcutaneous tissues just under the skin that form when a person keeps injecting insulin into the same spot. Injecting around the depressed area can very slowly fill in the depression (over a period of many months).
See also: Lipodystrophy.

Lipodystrophy

Lumps (lipohypertrophy) or depressions (lipoatrophy) below the surface of the skin that form when a person keeps injecting insulin into the same spot. Both forms of lipodystrophies are harmless. People can decrease this problem by changing (rotating) the places where they inject their insulin. Using purified insulins may also help.
See also: Injection site rotation.

Lipohypertrophy

Bulging of an area of the skin (due to fat accumulation) that forms when a person keeps injecting insulin into the same spot. Continued injection into these lumpy areas delays the absorption of insulin, and is not recommended even though injecting into the lumpy area is painless (as there are no nerve endings in the lump).
See also: Lipodystrophy.

Lispro Insulin

Lispro insulin is an insulin analog in which the position of two amino acids are switched. The resulting lispro insulin does not form hexamers (clumps of six molecules linked together) and is thus faster acting than regular insulin. It can be injected immediately before a meal, compared with regular which should be injected 30 minutes or more before a meal.

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 2 diabetes.
See: Type 2 Diabetes.

Maturity-Onset Diabetes of the Young (MODY)

Term for noninsulin-dependent or Type 2 diabetes in youngsters. MODY was initially reported in families with an autosomal-dominant inherited disorder, where there were several children with obesity and diabetes which could be controlled with weight reduction and oral hypoglycemic medications.

Mauriac Syndrome

A condition that occurs as the result of chronic poor control of diabetes. It leads to an enlarged liver due to excessive glycogen deposition, short stature and delayed puberty. There is usually a history of repeated hospitalizations for ketoacidosis and hemoglobin A1c tests can be as high as twice the upper level of normal. Kidney function is usually not affected although it may be an additional complication of poor control. Eating disorders are sometimes an accompaniment.

MDI

Multiple daily injections (of insulin). One of several terms that are used to describe insulin programs that are designed to obtain tight control of blood sugar by giving several shots every day.

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.

Meter/Monitor, Blood Glucose

See Blood Glucose Meter.

Metformin

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

See also: Oral hypoglycemic agents.

mg/dl

The unit of measurement of how much of a substance (such as sugar) is in a specific amount of fluid (such as blood or urine). Primarily used in the United States; most of the world uses mmol/L as the unit of measurement.

(Note: To convert blood sugar to mg/dl from mmol/L, multiply by 18.)

Microalbumin

Small amounts of protein in the urine that cannot be detected by the usual "dipstick" test done for routine urinanalysis testing for other reasons. Specialized dipsticks, or urine collections over a period of 12-24 hours, are used to measure the amount of microalbumin. If there is persistent microalbumin over several repeated tests at different times, the risk of diabetic nephropathy and macrovascular disease are both higher.

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.

mmol/L (millimols per liter)

The unit of measurement of how much of a substance (such as sugar) is in a specific amount of fluid (such as blood or urine). Most of the world uses mmol/L; however, in the United States, mg/dl is used as the unit of measurement.

(Note: To convert blood sugar to mmol/L from mg/dl, divide by 18.)

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.

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

Any disease of the kidneys. Kidney damage caused by diabetes, called diabetic nephropathy, can occur in several ways. The typical form of diabetic nephropathy, called diabetic glomerulosclerosis, has large amounts of urine protein, hypertension, and is slowly progressive. It usually doesn't occur until after many years of diabetes, and can be delayed by tight control of the blood sugar. Usually the best lab test for early detection of diabetic nephropathy is measurement of microalbumin in the urine.

Nerve Conduction Velocity (NCV) Studies and Electromyography (EMG)

Tests used to diagnose neuropathy and check for nerve damage. These tests are usually both run at the same time, using the same equipment.

Nesidioblastosis

A group of rare conditions occurring in infancy in which excessively large amounts of insulin are secreted by the beta cells in relation to the prevailing blood sugar level. Sometimes the condition occurs later in life, and sometimes it is due to an autosomal recessive genetic defect. Also called Persistent Hyperinsulinemic Hypoglycemia of Infancy (PHHI).

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 (Noninsulin-dependent diabetes mellitus)

See: Type 2 diabetes mellitus.

NOD Mouse

A strain of mice in which the female has an especially high incidence of a diabetes similar to Type 1 in humans. Much used as a research model for prevention and new onset treatment.

Noninsulin-Dependent Diabetes Mellitus (NIDDM)

See: Type 2 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 (Hyperglycemic hyperosmolar nonketotic syndrome, Hyperglycemic hyperosmolar nonketotic coma)

A complication of diabetes caused by a lack of insulin and dehydration. It is diagnosed when the patient has:

1. very high levels of glucose (sugar) in the blood;
2. absence of ketoacidosis;
3. severe dehydration;
4. a sleepy, confused, or comatose state.

Nonketotic coma is more likely to be associated with Type 2 diabetes, and is sometimes the initial presenting situation for Type 2 diabetes. Nonketotic coma is uncommon in Type 1 Diabetes.

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.

Nutritionist

See: Dietitian.

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.

OBOB mouse

(Obese-obese mouse) A variety of mouse that tends to be fat, and diabetic. A model for research on NIDDM.

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.

Ophthalmopathy

Eye disease. There are several disorders that can affect vision in people with diabetes; the most severe is diabetic retinopathy.

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 in the blood. The pills work for some people with Type 2 diabetes if their 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.

Overt Diabetes

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

Pancreas

An organ behind the lower part of the stomach that is about the size of a hand. It has two major responsibilities: part (the endocrine pancreas) makes insulin so that the body can use glucose (sugar) for energy. Another part (the exocrine pancreas) 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 Type 1 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.

Peptide

Two or more amino acids linked together chemically. If the number of amino acids is relatively great, the string is sometimes called a polypeptide; a very long string of amino acids is called a protein.

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."
See also: Neuropathy

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.

Pioglitazone

A drug used as a treatment for Type 2 (noninsulin-dependent) diabetes; belongs to a class of drugs called thiazolidinediones.
See also: Oral hypoglycemic agents.

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

Excessive thirst; may be a symptom of uncontrolled diabetes.

Polyphagia

Excessive hunger; may be a symptom of uncontrolled diabetes.

Polyunsaturated Fats

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

Polyuria

Excessive urination; may be a symptom of uncontrolled diabetes.

Poor Man's Pump (Basal/Bolus Insulin Administration)

Using several daily injections of clear insulin (either Regular or Lispro), at mealtimes -- the bolus doses -- together with one or more daily injections of cloudy insulin (either NPH or Ultralente insulin) -- the basal doses -- to achieve blood sugar control in a manner similar to that used by people who use insulin pumps.

Postprandial

Occurring after a meal. Example: Blood taken 1-2 hours after eating to see the amount of glucose in the blood would be called a postprandial blood glucose test.

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 initial protein made by the beta cells of the pancreas that later is broken into several pieces. Proinsulin consists of three parts: C-Peptide and two long strands of amino acids (called the alpha and beta chains) that later become linked together to form the insulin molecule.

From every molecule of proinsulin, one molecule of insulin plus one molecule of C-Peptide are produced.

(It may be noted that commercial production of exogenous insulin purifies the original insulin, and removes any residual proinsulin and C-Peptide that might have been initially present.)

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.
See also Microalbumin.

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.

Reactive hypoglycemia

A fall in blood sugar which causes symptoms during the period following meals. Simply put, the body has trouble braking the secretion of insulin after a meal, resulting in the blood sugar dropping further than it should. Reactive hypoglycemia is different from spontaneous hypoglycemia, which is not assoicated with meal ingestion. Reactive hypoglycemia generally has a benign prognosis.
See also: Hypoglycemia.

Reagents, Reagent Strips

Terms no longer used for diabetes blood and urine glucose or acetone test strips.

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.

Repaglinide

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.

Renal Glycosuria

Glycosuria occurring when there is a normal amount of sugar in the blood, due to an inherited inability of the kidneys to reabsorb glucose completely.

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."

Resistance to Insulin

See Insulin Resistance.

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.

Rosiglitazone

A drug used as a treatment for Type 2 (noninsulin-dependent) diabetes; belongs to a class of drugs called thiazolidinediones.
See also: Oral hypoglycemic agents.

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.

Second Phase Insulin Release

Delayed release of insulin into the bloodstream from the beta cell after the blood glucose level rises. It is thought that this delayed release is due to release of insulin that is manufactured in the beta cell after the blood sugar starts to rise.
See also: First Phase Insulin Release.

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 causes severe low blood pressure, decreased level of consciousness, and is a threat to life.

Shock, insulin

A term no longer used.
See Hypoglycemia; insulin reaction.

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."
See also: Dawn Phenomenon, 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.
See also: Glucose, fructose.

Sulfonylureas

One of several different classes of pills that lower the level of glucose in the blood. Used in Type 2 diabetes. There are several sulfonylurea pills available. Four, known as "first-generation" drugs, have been in use for some time.
See also: Oral hypoglycemic agents.

Symptom

A manifestation relating to the body or its functions that is suggestive of disease.
Example: frequent urination is a symptom of diabetes.

Syndrome

A set of signs or a series of events occurring together that make up a disease or health problem.

Syndrome X

A phrase describing a combination of health conditions that place a person at high risk for heart disease. These conditions are Type 2 diabetes, hypertension (high blood pressure), hyperlipidemia (high levels of fat in the blood), and obesity. According to theory, all of these conditions are associated with high blood insulin levels, and it is claimed that the underlying problem in patients with Syndrome X is faulty insulin release from the beta cells of the pancreas.

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.

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.

Thiazolidinediones

One of several different classes of pills that lower the level of glucose in the blood. Used in Type 2 diabetes. There are several thiazolidinedione pills available. This class of medications is also called "glitazones."
See also: Oral hypoglycemic agents.

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.

Thyroid

An endocrine gland located in the neck, that makes two hormones (T4 or thyroxine and T3 or triiodothyronine, which are frequently simply called "thyroid hormone") that regulate the body's metabolic rate. Overactivity of the thyroid gland is called hyperthyroidism; underactivity is called hypothyroidism.

Both hyperthyroidism and hypothyroidism may have an autoimmune basis, and both are somewhat more common in people with Type 1 diabetes.

Tight Control

See Intensive Management.

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.

Transplantation of Pancreas

See Pancreas Transplant.

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.

Troglitazone

A drug formerly used as a treatment for Type 2 (noninsulin-dependent) diabetes ; belongs to a class of drugs called thiazolidinediones. Withdrawn from the market in March, 2000 because of rare liver problems.
See also: Oral hypoglycemic agents.

Twenty-Four Hour Urine

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

Type 1 Diabetes Mellitus

Type 1 diabetes has been subdivided into:

• Immune-mediated diabetes(Type 1A). This form of diabetes results from a cellular-mediated autoimmune destruction of the beta cells of the pancreas. Markers of the immune destruction of the beta cell include islet cell autoantibodies and other antibodies. One and usually more of these autoantibodies are present in 85 - 90% of individuals when fasting hyperglycemia is initially detected. Also, the disease has strong HLA associations.
• Idiopathic diabetes (Type 1B). Some forms of Type 1 diabetes have no known etiologies. Some of these patients have permanent insulin deficiency and are prone to ketoacidosis but have no evidence of autoimmunity. Although only a minority of patients with Type 1 diabetes fall into this category, of those who do, most are of African, Hispanic, or Asian origin. Individuals with this form of diabetes suffer from episodic ketoacidosis and exhibit varying degrees of insulin deficiency between episodes. This form of diabetes is strongly inherited, lacks immunological evidence for beta cell autoimmunity, and is not HLA associated. An absolute requirement for insulin replacement therapy in affected patients may come and go.

Type 1 diabetes used to be known as insulin-dependent diabetes mellitus, juvenile diabetes, juvenile-onset diabetes, and ketosis-prone diabetes. Contrast with Type 2 Diabetes Mellitus.

Type 2 Diabetes Mellitus

The most common form of diabetes mellitus; over 90 percent of people who have diabetes have Type 2 diabetes. The onset is usually in middle age and in most cases is thought to be due to some form of insensitivity to the action of insulin rather than to insulin deficiency. Many of the people who have this type of diabetes are overweight. Initial treatment is by weight reduction and excercise with the later addition of an increasing range of blood glucose lowering drugs.
Ultimately it may be neccessary to give insulin. Increasingly, geneticists are defining specific subgroups such as Maturity Onset Diabetes in the Young; but to date, this has not led to any change in treatment plans.

Type 2 diabetes used to be called noninsulin-dependent diabetes mellitus, adult-onset diabetes, maturity-onset diabetes, ketosis-resistant diabetes, and stable diabetes.
Contrast with Type 1 Diabetes Mellitus.

U-100

See: Unit of insulin.

Ulcer

A break in the skin; a deep sore. People with diabetes may get ulcers from minor scrapes on the feet or legs, from cuts that heal slowly, or from the rubbing of shoes that do not fit well. Ulcers can become infected.

Ultralente Insulin

A type of insulin that is long acting.

Ultrasound

Test used to monitor pregnancy and to diagnose neuropathy.

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.

Unsaturated Fats

A type of fat.
See also: Fats.

Unstable Diabetes

A type of diabetes when a person's blood glucose (sugar) level often swings quickly from high to low and from low to high. Also called "brittle diabetes" or "labile diabetes."

Urea

One of the chief waste products of the body. When the body breaks down food, it uses what it needs and throws the rest away as waste. The kidneys flush the waste from the body in the form of urea, which is in the urine.

Urine Testing

Checking urine to see if it contains glucose (sugar) and ketones. Special strips of paper or tablets (called reagents) are put into a small amount of urine or urine plus water. Changes in the color of the strip show the amount of glucose or ketones in the urine. Urine testing is the only way to check for the presence of ketones, a sign of serious illness. However, urine testing is less desirable then blood testing for monitoring the level of glucose in the body.
See also: Blood glucose monitoring; reagents.

Urologist

A doctor who sees men and women for treatment of the urinary tract and men for treatment of the genital organs.

Vaginitis

An infection of the vagina usually caused by a fungus. A woman with this condition may have itching or burning and may notice a discharge. Women who have diabetes may develop vaginitis more often than women who do not have diabetes.

Vascular

Relating to the body's blood vessels (arteries, veins, and capillaries).

Vein

A blood vessel that carries blood to the heart.
See also: Blood vessels.

Visceral Neuropathy

See: Autonomic neuropathy.

Vitrectomy

Removing the gel from the center of the eyeball because it has blood and scar tissue in it that blocks sight. An eye surgeon replaces the clouded gel with a clear fluid.
See also: Diabetic retinopathy.

Vitreous Humor

The clear jelly (gel) that fills the center of the eye.

Void

To empty the bladder in order to obtain a urine sample for testing.

Wolfram Syndrome

A syndrome comprising diabetes insipidus, a mild form of diabetes mellitus, optic atrophy, and deafness.
It is an autosomal recessive inherited disorder, with the chromosomal abnormality on the short arm of chromosome 4.
Also called DIDMOAD, for diabetes insipidus, diabetes mellitus, optic atrophy and deafness.

Xylitol

A sweetener found in plants and used as a substitute for sugar; it is called a nutritive sweetener because it provides calories, just like sugar.