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8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 164
National Diabetes Information Clearinghouse
The DiabetesDictionaryThe DiabetesDictionary
US Department
of Health and
Human Services
NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 264
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 364
The DiabetesDictionary
Some terms listed have many meanings only those meanings that relate todiabetes are included Words that appear in bold italic are listed elsewherein the dictionary
Information in this dictionary is not a substitute for a visit to your doctorTalk with a health professional if you have a problem with your diabetes
The US Government does not endorse or favor any specific commercialproduct or company Trade proprietary or company names appearing inthis document are used only because they are considered necessary in the
context of the information provided If a product is not mentioned theomission does not mean or imply that the product is unsatisfactory
US Department
of Health and
Human Services
NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 464
Pronunciation Guide
This pronunciation guide uses letters and letter combinations rather thanphonetic symbols to stand for the various sounds in the English language
Vowels
a cat batah f ather
air pear hairar parkay say came weigh
aw saw boughte bet set eh (used at the end of a syllable or when
standing alone)examples
meadow (MEH-doh)enemy (EH-nuh-mee) butdiet (DY-et)
ee f eet neati sit igloo ih (used at the end of a syllable or when
standing alone)
exampleschicken (CHIH-ken)miracle (MIHR-ih-kuhl) butpicnic (PIK-nik)
ihr near here
y f ire idol eye (used at the beginning of a syllable or
when standing alone)examplesiron (EYE-urn)chloride (KLOR-eyed) butsilent (S Y -luhnt)
o hot cotoh coat homeoo f ood rude
or tore soar f oroi soil boy
ou now couchu put f ootuh about sum china
ur hurt alert yoo use yoor cure
Consonantsb bat job
ch chop itch
d dig bed
f f ur tough calf
g grape bigh happy
j joke nudge
k k ite car tackl lip sell
m move jam
n not kneeng ring
p play hop
r rain fur
s set tips
ss bus guess fencesh sh y fish
t toy boat
th breath
v vine ha ve w w alk where y yesz zip jazz has
zh measure
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1
A acesulfame potassium ( AY-see-
SUHL-faym) (poh-TASS-ee-uhm) a dietary sweetener
with no calories and nonutritional value Also knownas acesulfame-K (Brand name Sunett)
Actoplus Met (AK-toh-pluhss)(met) the brand name of anoral medicine used to treat type 2 diabetes a combination of pioglitazone and metformin
Actos (AK-tohss) see pioglitazone
acute (uh-KYOOT) describessomething that happenssuddenly and for a short timeOpposite of chronic or long-lasting
acute renal failure (uh-KYOOT)(REE-nuhl) (FAYL-yoor)
sudden and temporary loss of kidney function See chronic
kidney disease
adhesive capsulitis (ad-HEE-siv)(KAP-soo-LY-tiss) a conditionof the shoulder associated with diabetes that results in pain andloss of the ability to move theshoulder in all directions
adult-onset diabetes (uh-DUHLT- AWN-set) (DY-uh-BEE-teez) former term for type 2 diabetes
acanthosis nigricans (ak-an-THOH-siss) (NIG-rih-kanz) askin condition characterizedby darkened skin patchescommon in people whose bodyis not responding correctly tothe insulin they make in their
pancreas a condition calledinsulin resistance This skincondition is also seen in people
who have prediabetes or type 2
diabetes
acarbose (A-kahr-bohss) an oralmedicine used to treat type 2
diabetes Acarbose slows downthe digestion of foods highin carbohydrate such as ricebread milk and fruit Theresult is a slower and lowerrise in blood glucose throughoutthe day especially right aftermeals Acarbose belongs to the
class of medicines called alpha- glucosidase inhibitors (Brandname Precose)
ACE inhibitor (ayss) (in-HIB-ih-tur)an oral medicine that lowers blood pressure ACE standsfor angiotensin-converting
enzyme For people with diabetes especially those who have protein (albumin) in the urine it alsohelps slow down kidney damage
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A
AGEs (AY-JEE-EEZ) standsfor advanced glycosylation endproducts AGEs are producedin the body when glucose links
with protein They play a role indamaging blood vessels which canlead to diabetes complications
albumin (al-BYOO-min) the main protein in blood Over several years people who are developingdiabetic kidney disease leaksmall amounts of albumininto the urine a conditioncalled microalbuminuria As
kidney disease progressesmore albumin leaks intothe urine a condition calledmacroalbuminuria or proteinuria
As the amount of albumin inthe urine increases the kidneysrsquo
ability to filter the blooddecreases
albuminuria (al-BYOO-min-YOOree-uh) a condition in whichthe urine has more than normalamounts of a protein called albumin Albuminuria may bea sign of nephropathy or kidney
disease See albumin
alpha cell (AL-fuh) (sel) a typeof cell in the pancreas Alphacells make and release a hormone
called glucagon The bodysends a signal to the alpha cellsto make glucagon when blood
glucose falls too low Then
glucagon reaches the liver whereit tells the liver to release glucose
into the blood for energy
alpha-glucosidase inhibitor
(AL-fuh-gloo-KOH-sih-dayss)(in-HIB-ih-tur) a class of oralmedicine for type 2 diabetes that
slows down the digestion offoods high in carbohydrate suchas rice bread milk and fruitThe result is a slower and lowerrise in blood glucose after meals(Generic namesBrand names acarbosePrecose miglitolGlyset)
alternative site testingusingareas of the body other than
the fingertips for blood glucose
monitoring
Amaryl (AM-uh-ril) see glimepiride
amputate (AM-pyoo-tayt) to cut
a part such as a foot from thebody
2
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A
amylin (AM-ih-lin) a hormone
formed by beta cells in the pancreas Amylin regulates thetiming of glucose release intothe bloodstream after eatingby slowing the emptying of thestomach
amylin mimetic (AM-ih-lin) (mihMET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of the hormone amylin This medicine helpsfood move more slowly throughthe stomach and helps keep
the liver from releasing stored glucose (Generic nameBrandname pramlintide acetate
Symlin)
amyotrophy (uh-my-OT-roh-fee)a type of neuropathy resulting inpain weakness or wasting in
the musclesanemia (uh-NEE-mee-uh) a
condition in which the numberof red blood cells is less thannormal resulting in less oxygencarried to the bodyrsquos cells
Anemia can cause extremefatigue
angiopathy (AN-jee-OP-uh-thee)any disease of the blood vessels
(arteries capillaries veins) or lymphatic vessels
antibodies (AN-tee-BOD-eez) proteins made by the body toprotect itself from foreignsubstances such as bacteriaor viruses People get type 1
diabetes when their bodies makeantibodies that destroy the
bodyrsquos own insulin-making beta cells
A1C (AY-WUHN-SEE) a test thatmeasures a personrsquos average blood glucose level over the past2 to 3 months Hemoglobin isthe part of a red blood cell that
carries oxygen to the cells andsometimes joins with the glucose
in the bloodstream Also called hemoglobin A1C or glycosylated
hemoglobin the test shows theamount of glucose that sticksto the red blood cell which isproportional to the amount of
glucose in the blood Results aregiven as a percentage or as anaverage glucose value called an estimated average glucose
Apidra (uh-PEE-druh) see insulin
glulisine
ARB (arb) an oral medicine that
lowers blood pressure ARBstands for angiotensin receptorblocker For people with diabetes especially those whohave protein (albumin) in the urine it also helps slow down kidney damage
3
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A
arteriosclerosis (ar-TIHRee-oh-sklur-OH-siss) see atherosclerosis
artery (AR-tur-ee) a large blood
vessel that carries blood withoxygen from the heart to all
parts of the bodyaspartame (ASS-par-taym) a
dietary sweetener with almost no calories and no nutritional value
atherosclerosis (ATH-ur-oh-sklurOH-siss) clogging narrowingand hardening of the bodyrsquos
large blood vessels also called arteries Atherosclerosis can leadto coronary heart disease heart
attacks peripheral arterial disease
strokes and transient ischemic
attacks It can also damage thearteries that go to the kidneys
A healthy blood vessel
A narrowed blood vessel
athletersquos foot (ATH-leets) (fut)a fungal infection of the skinon the foot also called tinea
pedis The fungus is common inpeople with diabetes the elderlyand people with an impairedimmune system The skin may
peel crack bleed or cause painSome people have no symptomsand do not know they have aninfection The affected skin isalso more vulnerable to bacteriathat cause cellulitis
Common Types of Athletersquos Foot
bull moccasin whichaffectsthesoles of the feet
bull interdigital whichaffectstheskin between the toes
bull inflammatoryorblistering which affects the soles and
sides of the feet
autoimmune disease (AW-toh-ih-MYOON) (dih-ZEEZ) adisorder of the bodyrsquos immune
system in which the immunesystem mistakenly attacks anddestroys body tissue it believes to
be foreign
4
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AndashB
autonomic neuropathy (AW-tohNOM-ik) (noo-ROP-uh-thee) atype of neuropathy affecting thelungs heart stomach intestinesbladder or genitals
Avandamet (uh-VAN-duh-met) the
brand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and metformin
Avandaryl (uh-VAN-duh-ril) thebrand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and glimepiride
Avandia (uh-VAN-dee-uh) see rosiglitazone
background retinopathy (BAKground) (RET-ih-NOP-uh-thee)a type of damage to the retina
of the eye marked by bleedingfluid accumulation andabnormal dilation of the blood
vessels Background retinopathy
is an early stage of diabetic retinopathy Also called simpleor nonproliferative retinopathy
basal rate (BAY-suhl) (rayt) acontinuous supply of low levelsof longer-acting insulin as usedin insulin pumps
beta cell (BAY-tuh) (sel) a cellthat makes insulin Beta cellsare located in the islets of the pancreas
biguanide (by-GWAH-nyd) aclass of oral medicine used totreat type 2 diabetes that lowers
blood glucose by reducing theamount of glucose produced bythe liver This type of medicinealso helps treat insulin resistance
a condition in which the bodydoesnrsquot use insulin the way itshould (Generic namesBrandnames metforminGlucophage
Glucophage XR Riomet)
5
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B
blood glucose (bluhd) (GLOOkohss) the main sugar found inthe blood and the bodyrsquos mainsource of energy Also called blood sugar
blood glucose level (bluhd)
(GLOO-kohss) (LEV-uhl) theamount of glucose in a givenamount of blood In the UnitedStates blood glucose levels arenoted in milligrams per deciliteror mgdL
blood glucose meter (bluhd)(GLOO-kohss) (MEE-tur) asmall portable machine usedby people with diabetes to checktheir blood glucose levels Afterpricking the skin with a lancet
one places a drop of blood on atest strip in the machine Themeter then displays the blood
glucosereading
Blood glucose meter
blood glucose monitoring (bluhd)(GLOO-kohss) (MON-ih-TURing) checking blood glucose levels
by using a blood glucose meter
or blood glucose test strips thatchange color when touched by ablood sample in order to manage
diabetes
blood pressure the force of bloodexerted on the inside walls of blood vessels Blood pressure isexpressed as two numbers Forexample a blood pressure resultof 12080 is said as ldquo120 over
80rdquo The first number is the systolic pressure or the pressure when the heart pushes blood intothe arteries The second numberis the diastolic pressure or thepressure when the heart rests
blood sugar see blood glucose
blood sugar level see blood glucose level
blood urea nitrogen (BUN) (bluhd)(yoo-REE-uh) (NY-troh-jen) a
waste product in the blood thatcomes from the breakdown of protein The kidneys filter blood
to remove urea As kidneyfunction decreases the BUNlevel increases
6
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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C
callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
8
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
9
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
10
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
11
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
12
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
13
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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The DiabetesDictionary
Some terms listed have many meanings only those meanings that relate todiabetes are included Words that appear in bold italic are listed elsewherein the dictionary
Information in this dictionary is not a substitute for a visit to your doctorTalk with a health professional if you have a problem with your diabetes
The US Government does not endorse or favor any specific commercialproduct or company Trade proprietary or company names appearing inthis document are used only because they are considered necessary in the
context of the information provided If a product is not mentioned theomission does not mean or imply that the product is unsatisfactory
US Department
of Health and
Human Services
NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse
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Pronunciation Guide
This pronunciation guide uses letters and letter combinations rather thanphonetic symbols to stand for the various sounds in the English language
Vowels
a cat batah f ather
air pear hairar parkay say came weigh
aw saw boughte bet set eh (used at the end of a syllable or when
standing alone)examples
meadow (MEH-doh)enemy (EH-nuh-mee) butdiet (DY-et)
ee f eet neati sit igloo ih (used at the end of a syllable or when
standing alone)
exampleschicken (CHIH-ken)miracle (MIHR-ih-kuhl) butpicnic (PIK-nik)
ihr near here
y f ire idol eye (used at the beginning of a syllable or
when standing alone)examplesiron (EYE-urn)chloride (KLOR-eyed) butsilent (S Y -luhnt)
o hot cotoh coat homeoo f ood rude
or tore soar f oroi soil boy
ou now couchu put f ootuh about sum china
ur hurt alert yoo use yoor cure
Consonantsb bat job
ch chop itch
d dig bed
f f ur tough calf
g grape bigh happy
j joke nudge
k k ite car tackl lip sell
m move jam
n not kneeng ring
p play hop
r rain fur
s set tips
ss bus guess fencesh sh y fish
t toy boat
th breath
v vine ha ve w w alk where y yesz zip jazz has
zh measure
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1
A acesulfame potassium ( AY-see-
SUHL-faym) (poh-TASS-ee-uhm) a dietary sweetener
with no calories and nonutritional value Also knownas acesulfame-K (Brand name Sunett)
Actoplus Met (AK-toh-pluhss)(met) the brand name of anoral medicine used to treat type 2 diabetes a combination of pioglitazone and metformin
Actos (AK-tohss) see pioglitazone
acute (uh-KYOOT) describessomething that happenssuddenly and for a short timeOpposite of chronic or long-lasting
acute renal failure (uh-KYOOT)(REE-nuhl) (FAYL-yoor)
sudden and temporary loss of kidney function See chronic
kidney disease
adhesive capsulitis (ad-HEE-siv)(KAP-soo-LY-tiss) a conditionof the shoulder associated with diabetes that results in pain andloss of the ability to move theshoulder in all directions
adult-onset diabetes (uh-DUHLT- AWN-set) (DY-uh-BEE-teez) former term for type 2 diabetes
acanthosis nigricans (ak-an-THOH-siss) (NIG-rih-kanz) askin condition characterizedby darkened skin patchescommon in people whose bodyis not responding correctly tothe insulin they make in their
pancreas a condition calledinsulin resistance This skincondition is also seen in people
who have prediabetes or type 2
diabetes
acarbose (A-kahr-bohss) an oralmedicine used to treat type 2
diabetes Acarbose slows downthe digestion of foods highin carbohydrate such as ricebread milk and fruit Theresult is a slower and lowerrise in blood glucose throughoutthe day especially right aftermeals Acarbose belongs to the
class of medicines called alpha- glucosidase inhibitors (Brandname Precose)
ACE inhibitor (ayss) (in-HIB-ih-tur)an oral medicine that lowers blood pressure ACE standsfor angiotensin-converting
enzyme For people with diabetes especially those who have protein (albumin) in the urine it alsohelps slow down kidney damage
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A
AGEs (AY-JEE-EEZ) standsfor advanced glycosylation endproducts AGEs are producedin the body when glucose links
with protein They play a role indamaging blood vessels which canlead to diabetes complications
albumin (al-BYOO-min) the main protein in blood Over several years people who are developingdiabetic kidney disease leaksmall amounts of albumininto the urine a conditioncalled microalbuminuria As
kidney disease progressesmore albumin leaks intothe urine a condition calledmacroalbuminuria or proteinuria
As the amount of albumin inthe urine increases the kidneysrsquo
ability to filter the blooddecreases
albuminuria (al-BYOO-min-YOOree-uh) a condition in whichthe urine has more than normalamounts of a protein called albumin Albuminuria may bea sign of nephropathy or kidney
disease See albumin
alpha cell (AL-fuh) (sel) a typeof cell in the pancreas Alphacells make and release a hormone
called glucagon The bodysends a signal to the alpha cellsto make glucagon when blood
glucose falls too low Then
glucagon reaches the liver whereit tells the liver to release glucose
into the blood for energy
alpha-glucosidase inhibitor
(AL-fuh-gloo-KOH-sih-dayss)(in-HIB-ih-tur) a class of oralmedicine for type 2 diabetes that
slows down the digestion offoods high in carbohydrate suchas rice bread milk and fruitThe result is a slower and lowerrise in blood glucose after meals(Generic namesBrand names acarbosePrecose miglitolGlyset)
alternative site testingusingareas of the body other than
the fingertips for blood glucose
monitoring
Amaryl (AM-uh-ril) see glimepiride
amputate (AM-pyoo-tayt) to cut
a part such as a foot from thebody
2
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A
amylin (AM-ih-lin) a hormone
formed by beta cells in the pancreas Amylin regulates thetiming of glucose release intothe bloodstream after eatingby slowing the emptying of thestomach
amylin mimetic (AM-ih-lin) (mihMET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of the hormone amylin This medicine helpsfood move more slowly throughthe stomach and helps keep
the liver from releasing stored glucose (Generic nameBrandname pramlintide acetate
Symlin)
amyotrophy (uh-my-OT-roh-fee)a type of neuropathy resulting inpain weakness or wasting in
the musclesanemia (uh-NEE-mee-uh) a
condition in which the numberof red blood cells is less thannormal resulting in less oxygencarried to the bodyrsquos cells
Anemia can cause extremefatigue
angiopathy (AN-jee-OP-uh-thee)any disease of the blood vessels
(arteries capillaries veins) or lymphatic vessels
antibodies (AN-tee-BOD-eez) proteins made by the body toprotect itself from foreignsubstances such as bacteriaor viruses People get type 1
diabetes when their bodies makeantibodies that destroy the
bodyrsquos own insulin-making beta cells
A1C (AY-WUHN-SEE) a test thatmeasures a personrsquos average blood glucose level over the past2 to 3 months Hemoglobin isthe part of a red blood cell that
carries oxygen to the cells andsometimes joins with the glucose
in the bloodstream Also called hemoglobin A1C or glycosylated
hemoglobin the test shows theamount of glucose that sticksto the red blood cell which isproportional to the amount of
glucose in the blood Results aregiven as a percentage or as anaverage glucose value called an estimated average glucose
Apidra (uh-PEE-druh) see insulin
glulisine
ARB (arb) an oral medicine that
lowers blood pressure ARBstands for angiotensin receptorblocker For people with diabetes especially those whohave protein (albumin) in the urine it also helps slow down kidney damage
3
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A
arteriosclerosis (ar-TIHRee-oh-sklur-OH-siss) see atherosclerosis
artery (AR-tur-ee) a large blood
vessel that carries blood withoxygen from the heart to all
parts of the bodyaspartame (ASS-par-taym) a
dietary sweetener with almost no calories and no nutritional value
atherosclerosis (ATH-ur-oh-sklurOH-siss) clogging narrowingand hardening of the bodyrsquos
large blood vessels also called arteries Atherosclerosis can leadto coronary heart disease heart
attacks peripheral arterial disease
strokes and transient ischemic
attacks It can also damage thearteries that go to the kidneys
A healthy blood vessel
A narrowed blood vessel
athletersquos foot (ATH-leets) (fut)a fungal infection of the skinon the foot also called tinea
pedis The fungus is common inpeople with diabetes the elderlyand people with an impairedimmune system The skin may
peel crack bleed or cause painSome people have no symptomsand do not know they have aninfection The affected skin isalso more vulnerable to bacteriathat cause cellulitis
Common Types of Athletersquos Foot
bull moccasin whichaffectsthesoles of the feet
bull interdigital whichaffectstheskin between the toes
bull inflammatoryorblistering which affects the soles and
sides of the feet
autoimmune disease (AW-toh-ih-MYOON) (dih-ZEEZ) adisorder of the bodyrsquos immune
system in which the immunesystem mistakenly attacks anddestroys body tissue it believes to
be foreign
4
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AndashB
autonomic neuropathy (AW-tohNOM-ik) (noo-ROP-uh-thee) atype of neuropathy affecting thelungs heart stomach intestinesbladder or genitals
Avandamet (uh-VAN-duh-met) the
brand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and metformin
Avandaryl (uh-VAN-duh-ril) thebrand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and glimepiride
Avandia (uh-VAN-dee-uh) see rosiglitazone
background retinopathy (BAKground) (RET-ih-NOP-uh-thee)a type of damage to the retina
of the eye marked by bleedingfluid accumulation andabnormal dilation of the blood
vessels Background retinopathy
is an early stage of diabetic retinopathy Also called simpleor nonproliferative retinopathy
basal rate (BAY-suhl) (rayt) acontinuous supply of low levelsof longer-acting insulin as usedin insulin pumps
beta cell (BAY-tuh) (sel) a cellthat makes insulin Beta cellsare located in the islets of the pancreas
biguanide (by-GWAH-nyd) aclass of oral medicine used totreat type 2 diabetes that lowers
blood glucose by reducing theamount of glucose produced bythe liver This type of medicinealso helps treat insulin resistance
a condition in which the bodydoesnrsquot use insulin the way itshould (Generic namesBrandnames metforminGlucophage
Glucophage XR Riomet)
5
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B
blood glucose (bluhd) (GLOOkohss) the main sugar found inthe blood and the bodyrsquos mainsource of energy Also called blood sugar
blood glucose level (bluhd)
(GLOO-kohss) (LEV-uhl) theamount of glucose in a givenamount of blood In the UnitedStates blood glucose levels arenoted in milligrams per deciliteror mgdL
blood glucose meter (bluhd)(GLOO-kohss) (MEE-tur) asmall portable machine usedby people with diabetes to checktheir blood glucose levels Afterpricking the skin with a lancet
one places a drop of blood on atest strip in the machine Themeter then displays the blood
glucosereading
Blood glucose meter
blood glucose monitoring (bluhd)(GLOO-kohss) (MON-ih-TURing) checking blood glucose levels
by using a blood glucose meter
or blood glucose test strips thatchange color when touched by ablood sample in order to manage
diabetes
blood pressure the force of bloodexerted on the inside walls of blood vessels Blood pressure isexpressed as two numbers Forexample a blood pressure resultof 12080 is said as ldquo120 over
80rdquo The first number is the systolic pressure or the pressure when the heart pushes blood intothe arteries The second numberis the diastolic pressure or thepressure when the heart rests
blood sugar see blood glucose
blood sugar level see blood glucose level
blood urea nitrogen (BUN) (bluhd)(yoo-REE-uh) (NY-troh-jen) a
waste product in the blood thatcomes from the breakdown of protein The kidneys filter blood
to remove urea As kidneyfunction decreases the BUNlevel increases
6
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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C
callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
8
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
9
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
10
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
11
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
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dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
29
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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The DiabetesDictionary
Some terms listed have many meanings only those meanings that relate todiabetes are included Words that appear in bold italic are listed elsewherein the dictionary
Information in this dictionary is not a substitute for a visit to your doctorTalk with a health professional if you have a problem with your diabetes
The US Government does not endorse or favor any specific commercialproduct or company Trade proprietary or company names appearing inthis document are used only because they are considered necessary in the
context of the information provided If a product is not mentioned theomission does not mean or imply that the product is unsatisfactory
US Department
of Health and
Human Services
NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse
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Pronunciation Guide
This pronunciation guide uses letters and letter combinations rather thanphonetic symbols to stand for the various sounds in the English language
Vowels
a cat batah f ather
air pear hairar parkay say came weigh
aw saw boughte bet set eh (used at the end of a syllable or when
standing alone)examples
meadow (MEH-doh)enemy (EH-nuh-mee) butdiet (DY-et)
ee f eet neati sit igloo ih (used at the end of a syllable or when
standing alone)
exampleschicken (CHIH-ken)miracle (MIHR-ih-kuhl) butpicnic (PIK-nik)
ihr near here
y f ire idol eye (used at the beginning of a syllable or
when standing alone)examplesiron (EYE-urn)chloride (KLOR-eyed) butsilent (S Y -luhnt)
o hot cotoh coat homeoo f ood rude
or tore soar f oroi soil boy
ou now couchu put f ootuh about sum china
ur hurt alert yoo use yoor cure
Consonantsb bat job
ch chop itch
d dig bed
f f ur tough calf
g grape bigh happy
j joke nudge
k k ite car tackl lip sell
m move jam
n not kneeng ring
p play hop
r rain fur
s set tips
ss bus guess fencesh sh y fish
t toy boat
th breath
v vine ha ve w w alk where y yesz zip jazz has
zh measure
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1
A acesulfame potassium ( AY-see-
SUHL-faym) (poh-TASS-ee-uhm) a dietary sweetener
with no calories and nonutritional value Also knownas acesulfame-K (Brand name Sunett)
Actoplus Met (AK-toh-pluhss)(met) the brand name of anoral medicine used to treat type 2 diabetes a combination of pioglitazone and metformin
Actos (AK-tohss) see pioglitazone
acute (uh-KYOOT) describessomething that happenssuddenly and for a short timeOpposite of chronic or long-lasting
acute renal failure (uh-KYOOT)(REE-nuhl) (FAYL-yoor)
sudden and temporary loss of kidney function See chronic
kidney disease
adhesive capsulitis (ad-HEE-siv)(KAP-soo-LY-tiss) a conditionof the shoulder associated with diabetes that results in pain andloss of the ability to move theshoulder in all directions
adult-onset diabetes (uh-DUHLT- AWN-set) (DY-uh-BEE-teez) former term for type 2 diabetes
acanthosis nigricans (ak-an-THOH-siss) (NIG-rih-kanz) askin condition characterizedby darkened skin patchescommon in people whose bodyis not responding correctly tothe insulin they make in their
pancreas a condition calledinsulin resistance This skincondition is also seen in people
who have prediabetes or type 2
diabetes
acarbose (A-kahr-bohss) an oralmedicine used to treat type 2
diabetes Acarbose slows downthe digestion of foods highin carbohydrate such as ricebread milk and fruit Theresult is a slower and lowerrise in blood glucose throughoutthe day especially right aftermeals Acarbose belongs to the
class of medicines called alpha- glucosidase inhibitors (Brandname Precose)
ACE inhibitor (ayss) (in-HIB-ih-tur)an oral medicine that lowers blood pressure ACE standsfor angiotensin-converting
enzyme For people with diabetes especially those who have protein (albumin) in the urine it alsohelps slow down kidney damage
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A
AGEs (AY-JEE-EEZ) standsfor advanced glycosylation endproducts AGEs are producedin the body when glucose links
with protein They play a role indamaging blood vessels which canlead to diabetes complications
albumin (al-BYOO-min) the main protein in blood Over several years people who are developingdiabetic kidney disease leaksmall amounts of albumininto the urine a conditioncalled microalbuminuria As
kidney disease progressesmore albumin leaks intothe urine a condition calledmacroalbuminuria or proteinuria
As the amount of albumin inthe urine increases the kidneysrsquo
ability to filter the blooddecreases
albuminuria (al-BYOO-min-YOOree-uh) a condition in whichthe urine has more than normalamounts of a protein called albumin Albuminuria may bea sign of nephropathy or kidney
disease See albumin
alpha cell (AL-fuh) (sel) a typeof cell in the pancreas Alphacells make and release a hormone
called glucagon The bodysends a signal to the alpha cellsto make glucagon when blood
glucose falls too low Then
glucagon reaches the liver whereit tells the liver to release glucose
into the blood for energy
alpha-glucosidase inhibitor
(AL-fuh-gloo-KOH-sih-dayss)(in-HIB-ih-tur) a class of oralmedicine for type 2 diabetes that
slows down the digestion offoods high in carbohydrate suchas rice bread milk and fruitThe result is a slower and lowerrise in blood glucose after meals(Generic namesBrand names acarbosePrecose miglitolGlyset)
alternative site testingusingareas of the body other than
the fingertips for blood glucose
monitoring
Amaryl (AM-uh-ril) see glimepiride
amputate (AM-pyoo-tayt) to cut
a part such as a foot from thebody
2
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A
amylin (AM-ih-lin) a hormone
formed by beta cells in the pancreas Amylin regulates thetiming of glucose release intothe bloodstream after eatingby slowing the emptying of thestomach
amylin mimetic (AM-ih-lin) (mihMET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of the hormone amylin This medicine helpsfood move more slowly throughthe stomach and helps keep
the liver from releasing stored glucose (Generic nameBrandname pramlintide acetate
Symlin)
amyotrophy (uh-my-OT-roh-fee)a type of neuropathy resulting inpain weakness or wasting in
the musclesanemia (uh-NEE-mee-uh) a
condition in which the numberof red blood cells is less thannormal resulting in less oxygencarried to the bodyrsquos cells
Anemia can cause extremefatigue
angiopathy (AN-jee-OP-uh-thee)any disease of the blood vessels
(arteries capillaries veins) or lymphatic vessels
antibodies (AN-tee-BOD-eez) proteins made by the body toprotect itself from foreignsubstances such as bacteriaor viruses People get type 1
diabetes when their bodies makeantibodies that destroy the
bodyrsquos own insulin-making beta cells
A1C (AY-WUHN-SEE) a test thatmeasures a personrsquos average blood glucose level over the past2 to 3 months Hemoglobin isthe part of a red blood cell that
carries oxygen to the cells andsometimes joins with the glucose
in the bloodstream Also called hemoglobin A1C or glycosylated
hemoglobin the test shows theamount of glucose that sticksto the red blood cell which isproportional to the amount of
glucose in the blood Results aregiven as a percentage or as anaverage glucose value called an estimated average glucose
Apidra (uh-PEE-druh) see insulin
glulisine
ARB (arb) an oral medicine that
lowers blood pressure ARBstands for angiotensin receptorblocker For people with diabetes especially those whohave protein (albumin) in the urine it also helps slow down kidney damage
3
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A
arteriosclerosis (ar-TIHRee-oh-sklur-OH-siss) see atherosclerosis
artery (AR-tur-ee) a large blood
vessel that carries blood withoxygen from the heart to all
parts of the bodyaspartame (ASS-par-taym) a
dietary sweetener with almost no calories and no nutritional value
atherosclerosis (ATH-ur-oh-sklurOH-siss) clogging narrowingand hardening of the bodyrsquos
large blood vessels also called arteries Atherosclerosis can leadto coronary heart disease heart
attacks peripheral arterial disease
strokes and transient ischemic
attacks It can also damage thearteries that go to the kidneys
A healthy blood vessel
A narrowed blood vessel
athletersquos foot (ATH-leets) (fut)a fungal infection of the skinon the foot also called tinea
pedis The fungus is common inpeople with diabetes the elderlyand people with an impairedimmune system The skin may
peel crack bleed or cause painSome people have no symptomsand do not know they have aninfection The affected skin isalso more vulnerable to bacteriathat cause cellulitis
Common Types of Athletersquos Foot
bull moccasin whichaffectsthesoles of the feet
bull interdigital whichaffectstheskin between the toes
bull inflammatoryorblistering which affects the soles and
sides of the feet
autoimmune disease (AW-toh-ih-MYOON) (dih-ZEEZ) adisorder of the bodyrsquos immune
system in which the immunesystem mistakenly attacks anddestroys body tissue it believes to
be foreign
4
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AndashB
autonomic neuropathy (AW-tohNOM-ik) (noo-ROP-uh-thee) atype of neuropathy affecting thelungs heart stomach intestinesbladder or genitals
Avandamet (uh-VAN-duh-met) the
brand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and metformin
Avandaryl (uh-VAN-duh-ril) thebrand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and glimepiride
Avandia (uh-VAN-dee-uh) see rosiglitazone
background retinopathy (BAKground) (RET-ih-NOP-uh-thee)a type of damage to the retina
of the eye marked by bleedingfluid accumulation andabnormal dilation of the blood
vessels Background retinopathy
is an early stage of diabetic retinopathy Also called simpleor nonproliferative retinopathy
basal rate (BAY-suhl) (rayt) acontinuous supply of low levelsof longer-acting insulin as usedin insulin pumps
beta cell (BAY-tuh) (sel) a cellthat makes insulin Beta cellsare located in the islets of the pancreas
biguanide (by-GWAH-nyd) aclass of oral medicine used totreat type 2 diabetes that lowers
blood glucose by reducing theamount of glucose produced bythe liver This type of medicinealso helps treat insulin resistance
a condition in which the bodydoesnrsquot use insulin the way itshould (Generic namesBrandnames metforminGlucophage
Glucophage XR Riomet)
5
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B
blood glucose (bluhd) (GLOOkohss) the main sugar found inthe blood and the bodyrsquos mainsource of energy Also called blood sugar
blood glucose level (bluhd)
(GLOO-kohss) (LEV-uhl) theamount of glucose in a givenamount of blood In the UnitedStates blood glucose levels arenoted in milligrams per deciliteror mgdL
blood glucose meter (bluhd)(GLOO-kohss) (MEE-tur) asmall portable machine usedby people with diabetes to checktheir blood glucose levels Afterpricking the skin with a lancet
one places a drop of blood on atest strip in the machine Themeter then displays the blood
glucosereading
Blood glucose meter
blood glucose monitoring (bluhd)(GLOO-kohss) (MON-ih-TURing) checking blood glucose levels
by using a blood glucose meter
or blood glucose test strips thatchange color when touched by ablood sample in order to manage
diabetes
blood pressure the force of bloodexerted on the inside walls of blood vessels Blood pressure isexpressed as two numbers Forexample a blood pressure resultof 12080 is said as ldquo120 over
80rdquo The first number is the systolic pressure or the pressure when the heart pushes blood intothe arteries The second numberis the diastolic pressure or thepressure when the heart rests
blood sugar see blood glucose
blood sugar level see blood glucose level
blood urea nitrogen (BUN) (bluhd)(yoo-REE-uh) (NY-troh-jen) a
waste product in the blood thatcomes from the breakdown of protein The kidneys filter blood
to remove urea As kidneyfunction decreases the BUNlevel increases
6
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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C
callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
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carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
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certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
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coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
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conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
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dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
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diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
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dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
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the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
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dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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Pronunciation Guide
This pronunciation guide uses letters and letter combinations rather thanphonetic symbols to stand for the various sounds in the English language
Vowels
a cat batah f ather
air pear hairar parkay say came weigh
aw saw boughte bet set eh (used at the end of a syllable or when
standing alone)examples
meadow (MEH-doh)enemy (EH-nuh-mee) butdiet (DY-et)
ee f eet neati sit igloo ih (used at the end of a syllable or when
standing alone)
exampleschicken (CHIH-ken)miracle (MIHR-ih-kuhl) butpicnic (PIK-nik)
ihr near here
y f ire idol eye (used at the beginning of a syllable or
when standing alone)examplesiron (EYE-urn)chloride (KLOR-eyed) butsilent (S Y -luhnt)
o hot cotoh coat homeoo f ood rude
or tore soar f oroi soil boy
ou now couchu put f ootuh about sum china
ur hurt alert yoo use yoor cure
Consonantsb bat job
ch chop itch
d dig bed
f f ur tough calf
g grape bigh happy
j joke nudge
k k ite car tackl lip sell
m move jam
n not kneeng ring
p play hop
r rain fur
s set tips
ss bus guess fencesh sh y fish
t toy boat
th breath
v vine ha ve w w alk where y yesz zip jazz has
zh measure
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1
A acesulfame potassium ( AY-see-
SUHL-faym) (poh-TASS-ee-uhm) a dietary sweetener
with no calories and nonutritional value Also knownas acesulfame-K (Brand name Sunett)
Actoplus Met (AK-toh-pluhss)(met) the brand name of anoral medicine used to treat type 2 diabetes a combination of pioglitazone and metformin
Actos (AK-tohss) see pioglitazone
acute (uh-KYOOT) describessomething that happenssuddenly and for a short timeOpposite of chronic or long-lasting
acute renal failure (uh-KYOOT)(REE-nuhl) (FAYL-yoor)
sudden and temporary loss of kidney function See chronic
kidney disease
adhesive capsulitis (ad-HEE-siv)(KAP-soo-LY-tiss) a conditionof the shoulder associated with diabetes that results in pain andloss of the ability to move theshoulder in all directions
adult-onset diabetes (uh-DUHLT- AWN-set) (DY-uh-BEE-teez) former term for type 2 diabetes
acanthosis nigricans (ak-an-THOH-siss) (NIG-rih-kanz) askin condition characterizedby darkened skin patchescommon in people whose bodyis not responding correctly tothe insulin they make in their
pancreas a condition calledinsulin resistance This skincondition is also seen in people
who have prediabetes or type 2
diabetes
acarbose (A-kahr-bohss) an oralmedicine used to treat type 2
diabetes Acarbose slows downthe digestion of foods highin carbohydrate such as ricebread milk and fruit Theresult is a slower and lowerrise in blood glucose throughoutthe day especially right aftermeals Acarbose belongs to the
class of medicines called alpha- glucosidase inhibitors (Brandname Precose)
ACE inhibitor (ayss) (in-HIB-ih-tur)an oral medicine that lowers blood pressure ACE standsfor angiotensin-converting
enzyme For people with diabetes especially those who have protein (albumin) in the urine it alsohelps slow down kidney damage
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A
AGEs (AY-JEE-EEZ) standsfor advanced glycosylation endproducts AGEs are producedin the body when glucose links
with protein They play a role indamaging blood vessels which canlead to diabetes complications
albumin (al-BYOO-min) the main protein in blood Over several years people who are developingdiabetic kidney disease leaksmall amounts of albumininto the urine a conditioncalled microalbuminuria As
kidney disease progressesmore albumin leaks intothe urine a condition calledmacroalbuminuria or proteinuria
As the amount of albumin inthe urine increases the kidneysrsquo
ability to filter the blooddecreases
albuminuria (al-BYOO-min-YOOree-uh) a condition in whichthe urine has more than normalamounts of a protein called albumin Albuminuria may bea sign of nephropathy or kidney
disease See albumin
alpha cell (AL-fuh) (sel) a typeof cell in the pancreas Alphacells make and release a hormone
called glucagon The bodysends a signal to the alpha cellsto make glucagon when blood
glucose falls too low Then
glucagon reaches the liver whereit tells the liver to release glucose
into the blood for energy
alpha-glucosidase inhibitor
(AL-fuh-gloo-KOH-sih-dayss)(in-HIB-ih-tur) a class of oralmedicine for type 2 diabetes that
slows down the digestion offoods high in carbohydrate suchas rice bread milk and fruitThe result is a slower and lowerrise in blood glucose after meals(Generic namesBrand names acarbosePrecose miglitolGlyset)
alternative site testingusingareas of the body other than
the fingertips for blood glucose
monitoring
Amaryl (AM-uh-ril) see glimepiride
amputate (AM-pyoo-tayt) to cut
a part such as a foot from thebody
2
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A
amylin (AM-ih-lin) a hormone
formed by beta cells in the pancreas Amylin regulates thetiming of glucose release intothe bloodstream after eatingby slowing the emptying of thestomach
amylin mimetic (AM-ih-lin) (mihMET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of the hormone amylin This medicine helpsfood move more slowly throughthe stomach and helps keep
the liver from releasing stored glucose (Generic nameBrandname pramlintide acetate
Symlin)
amyotrophy (uh-my-OT-roh-fee)a type of neuropathy resulting inpain weakness or wasting in
the musclesanemia (uh-NEE-mee-uh) a
condition in which the numberof red blood cells is less thannormal resulting in less oxygencarried to the bodyrsquos cells
Anemia can cause extremefatigue
angiopathy (AN-jee-OP-uh-thee)any disease of the blood vessels
(arteries capillaries veins) or lymphatic vessels
antibodies (AN-tee-BOD-eez) proteins made by the body toprotect itself from foreignsubstances such as bacteriaor viruses People get type 1
diabetes when their bodies makeantibodies that destroy the
bodyrsquos own insulin-making beta cells
A1C (AY-WUHN-SEE) a test thatmeasures a personrsquos average blood glucose level over the past2 to 3 months Hemoglobin isthe part of a red blood cell that
carries oxygen to the cells andsometimes joins with the glucose
in the bloodstream Also called hemoglobin A1C or glycosylated
hemoglobin the test shows theamount of glucose that sticksto the red blood cell which isproportional to the amount of
glucose in the blood Results aregiven as a percentage or as anaverage glucose value called an estimated average glucose
Apidra (uh-PEE-druh) see insulin
glulisine
ARB (arb) an oral medicine that
lowers blood pressure ARBstands for angiotensin receptorblocker For people with diabetes especially those whohave protein (albumin) in the urine it also helps slow down kidney damage
3
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A
arteriosclerosis (ar-TIHRee-oh-sklur-OH-siss) see atherosclerosis
artery (AR-tur-ee) a large blood
vessel that carries blood withoxygen from the heart to all
parts of the bodyaspartame (ASS-par-taym) a
dietary sweetener with almost no calories and no nutritional value
atherosclerosis (ATH-ur-oh-sklurOH-siss) clogging narrowingand hardening of the bodyrsquos
large blood vessels also called arteries Atherosclerosis can leadto coronary heart disease heart
attacks peripheral arterial disease
strokes and transient ischemic
attacks It can also damage thearteries that go to the kidneys
A healthy blood vessel
A narrowed blood vessel
athletersquos foot (ATH-leets) (fut)a fungal infection of the skinon the foot also called tinea
pedis The fungus is common inpeople with diabetes the elderlyand people with an impairedimmune system The skin may
peel crack bleed or cause painSome people have no symptomsand do not know they have aninfection The affected skin isalso more vulnerable to bacteriathat cause cellulitis
Common Types of Athletersquos Foot
bull moccasin whichaffectsthesoles of the feet
bull interdigital whichaffectstheskin between the toes
bull inflammatoryorblistering which affects the soles and
sides of the feet
autoimmune disease (AW-toh-ih-MYOON) (dih-ZEEZ) adisorder of the bodyrsquos immune
system in which the immunesystem mistakenly attacks anddestroys body tissue it believes to
be foreign
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AndashB
autonomic neuropathy (AW-tohNOM-ik) (noo-ROP-uh-thee) atype of neuropathy affecting thelungs heart stomach intestinesbladder or genitals
Avandamet (uh-VAN-duh-met) the
brand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and metformin
Avandaryl (uh-VAN-duh-ril) thebrand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and glimepiride
Avandia (uh-VAN-dee-uh) see rosiglitazone
background retinopathy (BAKground) (RET-ih-NOP-uh-thee)a type of damage to the retina
of the eye marked by bleedingfluid accumulation andabnormal dilation of the blood
vessels Background retinopathy
is an early stage of diabetic retinopathy Also called simpleor nonproliferative retinopathy
basal rate (BAY-suhl) (rayt) acontinuous supply of low levelsof longer-acting insulin as usedin insulin pumps
beta cell (BAY-tuh) (sel) a cellthat makes insulin Beta cellsare located in the islets of the pancreas
biguanide (by-GWAH-nyd) aclass of oral medicine used totreat type 2 diabetes that lowers
blood glucose by reducing theamount of glucose produced bythe liver This type of medicinealso helps treat insulin resistance
a condition in which the bodydoesnrsquot use insulin the way itshould (Generic namesBrandnames metforminGlucophage
Glucophage XR Riomet)
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blood glucose (bluhd) (GLOOkohss) the main sugar found inthe blood and the bodyrsquos mainsource of energy Also called blood sugar
blood glucose level (bluhd)
(GLOO-kohss) (LEV-uhl) theamount of glucose in a givenamount of blood In the UnitedStates blood glucose levels arenoted in milligrams per deciliteror mgdL
blood glucose meter (bluhd)(GLOO-kohss) (MEE-tur) asmall portable machine usedby people with diabetes to checktheir blood glucose levels Afterpricking the skin with a lancet
one places a drop of blood on atest strip in the machine Themeter then displays the blood
glucosereading
Blood glucose meter
blood glucose monitoring (bluhd)(GLOO-kohss) (MON-ih-TURing) checking blood glucose levels
by using a blood glucose meter
or blood glucose test strips thatchange color when touched by ablood sample in order to manage
diabetes
blood pressure the force of bloodexerted on the inside walls of blood vessels Blood pressure isexpressed as two numbers Forexample a blood pressure resultof 12080 is said as ldquo120 over
80rdquo The first number is the systolic pressure or the pressure when the heart pushes blood intothe arteries The second numberis the diastolic pressure or thepressure when the heart rests
blood sugar see blood glucose
blood sugar level see blood glucose level
blood urea nitrogen (BUN) (bluhd)(yoo-REE-uh) (NY-troh-jen) a
waste product in the blood thatcomes from the breakdown of protein The kidneys filter blood
to remove urea As kidneyfunction decreases the BUNlevel increases
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
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carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
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certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
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coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
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conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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1
A acesulfame potassium ( AY-see-
SUHL-faym) (poh-TASS-ee-uhm) a dietary sweetener
with no calories and nonutritional value Also knownas acesulfame-K (Brand name Sunett)
Actoplus Met (AK-toh-pluhss)(met) the brand name of anoral medicine used to treat type 2 diabetes a combination of pioglitazone and metformin
Actos (AK-tohss) see pioglitazone
acute (uh-KYOOT) describessomething that happenssuddenly and for a short timeOpposite of chronic or long-lasting
acute renal failure (uh-KYOOT)(REE-nuhl) (FAYL-yoor)
sudden and temporary loss of kidney function See chronic
kidney disease
adhesive capsulitis (ad-HEE-siv)(KAP-soo-LY-tiss) a conditionof the shoulder associated with diabetes that results in pain andloss of the ability to move theshoulder in all directions
adult-onset diabetes (uh-DUHLT- AWN-set) (DY-uh-BEE-teez) former term for type 2 diabetes
acanthosis nigricans (ak-an-THOH-siss) (NIG-rih-kanz) askin condition characterizedby darkened skin patchescommon in people whose bodyis not responding correctly tothe insulin they make in their
pancreas a condition calledinsulin resistance This skincondition is also seen in people
who have prediabetes or type 2
diabetes
acarbose (A-kahr-bohss) an oralmedicine used to treat type 2
diabetes Acarbose slows downthe digestion of foods highin carbohydrate such as ricebread milk and fruit Theresult is a slower and lowerrise in blood glucose throughoutthe day especially right aftermeals Acarbose belongs to the
class of medicines called alpha- glucosidase inhibitors (Brandname Precose)
ACE inhibitor (ayss) (in-HIB-ih-tur)an oral medicine that lowers blood pressure ACE standsfor angiotensin-converting
enzyme For people with diabetes especially those who have protein (albumin) in the urine it alsohelps slow down kidney damage
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A
AGEs (AY-JEE-EEZ) standsfor advanced glycosylation endproducts AGEs are producedin the body when glucose links
with protein They play a role indamaging blood vessels which canlead to diabetes complications
albumin (al-BYOO-min) the main protein in blood Over several years people who are developingdiabetic kidney disease leaksmall amounts of albumininto the urine a conditioncalled microalbuminuria As
kidney disease progressesmore albumin leaks intothe urine a condition calledmacroalbuminuria or proteinuria
As the amount of albumin inthe urine increases the kidneysrsquo
ability to filter the blooddecreases
albuminuria (al-BYOO-min-YOOree-uh) a condition in whichthe urine has more than normalamounts of a protein called albumin Albuminuria may bea sign of nephropathy or kidney
disease See albumin
alpha cell (AL-fuh) (sel) a typeof cell in the pancreas Alphacells make and release a hormone
called glucagon The bodysends a signal to the alpha cellsto make glucagon when blood
glucose falls too low Then
glucagon reaches the liver whereit tells the liver to release glucose
into the blood for energy
alpha-glucosidase inhibitor
(AL-fuh-gloo-KOH-sih-dayss)(in-HIB-ih-tur) a class of oralmedicine for type 2 diabetes that
slows down the digestion offoods high in carbohydrate suchas rice bread milk and fruitThe result is a slower and lowerrise in blood glucose after meals(Generic namesBrand names acarbosePrecose miglitolGlyset)
alternative site testingusingareas of the body other than
the fingertips for blood glucose
monitoring
Amaryl (AM-uh-ril) see glimepiride
amputate (AM-pyoo-tayt) to cut
a part such as a foot from thebody
2
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amylin (AM-ih-lin) a hormone
formed by beta cells in the pancreas Amylin regulates thetiming of glucose release intothe bloodstream after eatingby slowing the emptying of thestomach
amylin mimetic (AM-ih-lin) (mihMET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of the hormone amylin This medicine helpsfood move more slowly throughthe stomach and helps keep
the liver from releasing stored glucose (Generic nameBrandname pramlintide acetate
Symlin)
amyotrophy (uh-my-OT-roh-fee)a type of neuropathy resulting inpain weakness or wasting in
the musclesanemia (uh-NEE-mee-uh) a
condition in which the numberof red blood cells is less thannormal resulting in less oxygencarried to the bodyrsquos cells
Anemia can cause extremefatigue
angiopathy (AN-jee-OP-uh-thee)any disease of the blood vessels
(arteries capillaries veins) or lymphatic vessels
antibodies (AN-tee-BOD-eez) proteins made by the body toprotect itself from foreignsubstances such as bacteriaor viruses People get type 1
diabetes when their bodies makeantibodies that destroy the
bodyrsquos own insulin-making beta cells
A1C (AY-WUHN-SEE) a test thatmeasures a personrsquos average blood glucose level over the past2 to 3 months Hemoglobin isthe part of a red blood cell that
carries oxygen to the cells andsometimes joins with the glucose
in the bloodstream Also called hemoglobin A1C or glycosylated
hemoglobin the test shows theamount of glucose that sticksto the red blood cell which isproportional to the amount of
glucose in the blood Results aregiven as a percentage or as anaverage glucose value called an estimated average glucose
Apidra (uh-PEE-druh) see insulin
glulisine
ARB (arb) an oral medicine that
lowers blood pressure ARBstands for angiotensin receptorblocker For people with diabetes especially those whohave protein (albumin) in the urine it also helps slow down kidney damage
3
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arteriosclerosis (ar-TIHRee-oh-sklur-OH-siss) see atherosclerosis
artery (AR-tur-ee) a large blood
vessel that carries blood withoxygen from the heart to all
parts of the bodyaspartame (ASS-par-taym) a
dietary sweetener with almost no calories and no nutritional value
atherosclerosis (ATH-ur-oh-sklurOH-siss) clogging narrowingand hardening of the bodyrsquos
large blood vessels also called arteries Atherosclerosis can leadto coronary heart disease heart
attacks peripheral arterial disease
strokes and transient ischemic
attacks It can also damage thearteries that go to the kidneys
A healthy blood vessel
A narrowed blood vessel
athletersquos foot (ATH-leets) (fut)a fungal infection of the skinon the foot also called tinea
pedis The fungus is common inpeople with diabetes the elderlyand people with an impairedimmune system The skin may
peel crack bleed or cause painSome people have no symptomsand do not know they have aninfection The affected skin isalso more vulnerable to bacteriathat cause cellulitis
Common Types of Athletersquos Foot
bull moccasin whichaffectsthesoles of the feet
bull interdigital whichaffectstheskin between the toes
bull inflammatoryorblistering which affects the soles and
sides of the feet
autoimmune disease (AW-toh-ih-MYOON) (dih-ZEEZ) adisorder of the bodyrsquos immune
system in which the immunesystem mistakenly attacks anddestroys body tissue it believes to
be foreign
4
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AndashB
autonomic neuropathy (AW-tohNOM-ik) (noo-ROP-uh-thee) atype of neuropathy affecting thelungs heart stomach intestinesbladder or genitals
Avandamet (uh-VAN-duh-met) the
brand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and metformin
Avandaryl (uh-VAN-duh-ril) thebrand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and glimepiride
Avandia (uh-VAN-dee-uh) see rosiglitazone
background retinopathy (BAKground) (RET-ih-NOP-uh-thee)a type of damage to the retina
of the eye marked by bleedingfluid accumulation andabnormal dilation of the blood
vessels Background retinopathy
is an early stage of diabetic retinopathy Also called simpleor nonproliferative retinopathy
basal rate (BAY-suhl) (rayt) acontinuous supply of low levelsof longer-acting insulin as usedin insulin pumps
beta cell (BAY-tuh) (sel) a cellthat makes insulin Beta cellsare located in the islets of the pancreas
biguanide (by-GWAH-nyd) aclass of oral medicine used totreat type 2 diabetes that lowers
blood glucose by reducing theamount of glucose produced bythe liver This type of medicinealso helps treat insulin resistance
a condition in which the bodydoesnrsquot use insulin the way itshould (Generic namesBrandnames metforminGlucophage
Glucophage XR Riomet)
5
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blood glucose (bluhd) (GLOOkohss) the main sugar found inthe blood and the bodyrsquos mainsource of energy Also called blood sugar
blood glucose level (bluhd)
(GLOO-kohss) (LEV-uhl) theamount of glucose in a givenamount of blood In the UnitedStates blood glucose levels arenoted in milligrams per deciliteror mgdL
blood glucose meter (bluhd)(GLOO-kohss) (MEE-tur) asmall portable machine usedby people with diabetes to checktheir blood glucose levels Afterpricking the skin with a lancet
one places a drop of blood on atest strip in the machine Themeter then displays the blood
glucosereading
Blood glucose meter
blood glucose monitoring (bluhd)(GLOO-kohss) (MON-ih-TURing) checking blood glucose levels
by using a blood glucose meter
or blood glucose test strips thatchange color when touched by ablood sample in order to manage
diabetes
blood pressure the force of bloodexerted on the inside walls of blood vessels Blood pressure isexpressed as two numbers Forexample a blood pressure resultof 12080 is said as ldquo120 over
80rdquo The first number is the systolic pressure or the pressure when the heart pushes blood intothe arteries The second numberis the diastolic pressure or thepressure when the heart rests
blood sugar see blood glucose
blood sugar level see blood glucose level
blood urea nitrogen (BUN) (bluhd)(yoo-REE-uh) (NY-troh-jen) a
waste product in the blood thatcomes from the breakdown of protein The kidneys filter blood
to remove urea As kidneyfunction decreases the BUNlevel increases
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
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conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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A
AGEs (AY-JEE-EEZ) standsfor advanced glycosylation endproducts AGEs are producedin the body when glucose links
with protein They play a role indamaging blood vessels which canlead to diabetes complications
albumin (al-BYOO-min) the main protein in blood Over several years people who are developingdiabetic kidney disease leaksmall amounts of albumininto the urine a conditioncalled microalbuminuria As
kidney disease progressesmore albumin leaks intothe urine a condition calledmacroalbuminuria or proteinuria
As the amount of albumin inthe urine increases the kidneysrsquo
ability to filter the blooddecreases
albuminuria (al-BYOO-min-YOOree-uh) a condition in whichthe urine has more than normalamounts of a protein called albumin Albuminuria may bea sign of nephropathy or kidney
disease See albumin
alpha cell (AL-fuh) (sel) a typeof cell in the pancreas Alphacells make and release a hormone
called glucagon The bodysends a signal to the alpha cellsto make glucagon when blood
glucose falls too low Then
glucagon reaches the liver whereit tells the liver to release glucose
into the blood for energy
alpha-glucosidase inhibitor
(AL-fuh-gloo-KOH-sih-dayss)(in-HIB-ih-tur) a class of oralmedicine for type 2 diabetes that
slows down the digestion offoods high in carbohydrate suchas rice bread milk and fruitThe result is a slower and lowerrise in blood glucose after meals(Generic namesBrand names acarbosePrecose miglitolGlyset)
alternative site testingusingareas of the body other than
the fingertips for blood glucose
monitoring
Amaryl (AM-uh-ril) see glimepiride
amputate (AM-pyoo-tayt) to cut
a part such as a foot from thebody
2
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A
amylin (AM-ih-lin) a hormone
formed by beta cells in the pancreas Amylin regulates thetiming of glucose release intothe bloodstream after eatingby slowing the emptying of thestomach
amylin mimetic (AM-ih-lin) (mihMET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of the hormone amylin This medicine helpsfood move more slowly throughthe stomach and helps keep
the liver from releasing stored glucose (Generic nameBrandname pramlintide acetate
Symlin)
amyotrophy (uh-my-OT-roh-fee)a type of neuropathy resulting inpain weakness or wasting in
the musclesanemia (uh-NEE-mee-uh) a
condition in which the numberof red blood cells is less thannormal resulting in less oxygencarried to the bodyrsquos cells
Anemia can cause extremefatigue
angiopathy (AN-jee-OP-uh-thee)any disease of the blood vessels
(arteries capillaries veins) or lymphatic vessels
antibodies (AN-tee-BOD-eez) proteins made by the body toprotect itself from foreignsubstances such as bacteriaor viruses People get type 1
diabetes when their bodies makeantibodies that destroy the
bodyrsquos own insulin-making beta cells
A1C (AY-WUHN-SEE) a test thatmeasures a personrsquos average blood glucose level over the past2 to 3 months Hemoglobin isthe part of a red blood cell that
carries oxygen to the cells andsometimes joins with the glucose
in the bloodstream Also called hemoglobin A1C or glycosylated
hemoglobin the test shows theamount of glucose that sticksto the red blood cell which isproportional to the amount of
glucose in the blood Results aregiven as a percentage or as anaverage glucose value called an estimated average glucose
Apidra (uh-PEE-druh) see insulin
glulisine
ARB (arb) an oral medicine that
lowers blood pressure ARBstands for angiotensin receptorblocker For people with diabetes especially those whohave protein (albumin) in the urine it also helps slow down kidney damage
3
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A
arteriosclerosis (ar-TIHRee-oh-sklur-OH-siss) see atherosclerosis
artery (AR-tur-ee) a large blood
vessel that carries blood withoxygen from the heart to all
parts of the bodyaspartame (ASS-par-taym) a
dietary sweetener with almost no calories and no nutritional value
atherosclerosis (ATH-ur-oh-sklurOH-siss) clogging narrowingand hardening of the bodyrsquos
large blood vessels also called arteries Atherosclerosis can leadto coronary heart disease heart
attacks peripheral arterial disease
strokes and transient ischemic
attacks It can also damage thearteries that go to the kidneys
A healthy blood vessel
A narrowed blood vessel
athletersquos foot (ATH-leets) (fut)a fungal infection of the skinon the foot also called tinea
pedis The fungus is common inpeople with diabetes the elderlyand people with an impairedimmune system The skin may
peel crack bleed or cause painSome people have no symptomsand do not know they have aninfection The affected skin isalso more vulnerable to bacteriathat cause cellulitis
Common Types of Athletersquos Foot
bull moccasin whichaffectsthesoles of the feet
bull interdigital whichaffectstheskin between the toes
bull inflammatoryorblistering which affects the soles and
sides of the feet
autoimmune disease (AW-toh-ih-MYOON) (dih-ZEEZ) adisorder of the bodyrsquos immune
system in which the immunesystem mistakenly attacks anddestroys body tissue it believes to
be foreign
4
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AndashB
autonomic neuropathy (AW-tohNOM-ik) (noo-ROP-uh-thee) atype of neuropathy affecting thelungs heart stomach intestinesbladder or genitals
Avandamet (uh-VAN-duh-met) the
brand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and metformin
Avandaryl (uh-VAN-duh-ril) thebrand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and glimepiride
Avandia (uh-VAN-dee-uh) see rosiglitazone
background retinopathy (BAKground) (RET-ih-NOP-uh-thee)a type of damage to the retina
of the eye marked by bleedingfluid accumulation andabnormal dilation of the blood
vessels Background retinopathy
is an early stage of diabetic retinopathy Also called simpleor nonproliferative retinopathy
basal rate (BAY-suhl) (rayt) acontinuous supply of low levelsof longer-acting insulin as usedin insulin pumps
beta cell (BAY-tuh) (sel) a cellthat makes insulin Beta cellsare located in the islets of the pancreas
biguanide (by-GWAH-nyd) aclass of oral medicine used totreat type 2 diabetes that lowers
blood glucose by reducing theamount of glucose produced bythe liver This type of medicinealso helps treat insulin resistance
a condition in which the bodydoesnrsquot use insulin the way itshould (Generic namesBrandnames metforminGlucophage
Glucophage XR Riomet)
5
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B
blood glucose (bluhd) (GLOOkohss) the main sugar found inthe blood and the bodyrsquos mainsource of energy Also called blood sugar
blood glucose level (bluhd)
(GLOO-kohss) (LEV-uhl) theamount of glucose in a givenamount of blood In the UnitedStates blood glucose levels arenoted in milligrams per deciliteror mgdL
blood glucose meter (bluhd)(GLOO-kohss) (MEE-tur) asmall portable machine usedby people with diabetes to checktheir blood glucose levels Afterpricking the skin with a lancet
one places a drop of blood on atest strip in the machine Themeter then displays the blood
glucosereading
Blood glucose meter
blood glucose monitoring (bluhd)(GLOO-kohss) (MON-ih-TURing) checking blood glucose levels
by using a blood glucose meter
or blood glucose test strips thatchange color when touched by ablood sample in order to manage
diabetes
blood pressure the force of bloodexerted on the inside walls of blood vessels Blood pressure isexpressed as two numbers Forexample a blood pressure resultof 12080 is said as ldquo120 over
80rdquo The first number is the systolic pressure or the pressure when the heart pushes blood intothe arteries The second numberis the diastolic pressure or thepressure when the heart rests
blood sugar see blood glucose
blood sugar level see blood glucose level
blood urea nitrogen (BUN) (bluhd)(yoo-REE-uh) (NY-troh-jen) a
waste product in the blood thatcomes from the breakdown of protein The kidneys filter blood
to remove urea As kidneyfunction decreases the BUNlevel increases
6
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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C
callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
8
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
9
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
10
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
11
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
12
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
13
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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A
amylin (AM-ih-lin) a hormone
formed by beta cells in the pancreas Amylin regulates thetiming of glucose release intothe bloodstream after eatingby slowing the emptying of thestomach
amylin mimetic (AM-ih-lin) (mihMET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of the hormone amylin This medicine helpsfood move more slowly throughthe stomach and helps keep
the liver from releasing stored glucose (Generic nameBrandname pramlintide acetate
Symlin)
amyotrophy (uh-my-OT-roh-fee)a type of neuropathy resulting inpain weakness or wasting in
the musclesanemia (uh-NEE-mee-uh) a
condition in which the numberof red blood cells is less thannormal resulting in less oxygencarried to the bodyrsquos cells
Anemia can cause extremefatigue
angiopathy (AN-jee-OP-uh-thee)any disease of the blood vessels
(arteries capillaries veins) or lymphatic vessels
antibodies (AN-tee-BOD-eez) proteins made by the body toprotect itself from foreignsubstances such as bacteriaor viruses People get type 1
diabetes when their bodies makeantibodies that destroy the
bodyrsquos own insulin-making beta cells
A1C (AY-WUHN-SEE) a test thatmeasures a personrsquos average blood glucose level over the past2 to 3 months Hemoglobin isthe part of a red blood cell that
carries oxygen to the cells andsometimes joins with the glucose
in the bloodstream Also called hemoglobin A1C or glycosylated
hemoglobin the test shows theamount of glucose that sticksto the red blood cell which isproportional to the amount of
glucose in the blood Results aregiven as a percentage or as anaverage glucose value called an estimated average glucose
Apidra (uh-PEE-druh) see insulin
glulisine
ARB (arb) an oral medicine that
lowers blood pressure ARBstands for angiotensin receptorblocker For people with diabetes especially those whohave protein (albumin) in the urine it also helps slow down kidney damage
3
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A
arteriosclerosis (ar-TIHRee-oh-sklur-OH-siss) see atherosclerosis
artery (AR-tur-ee) a large blood
vessel that carries blood withoxygen from the heart to all
parts of the bodyaspartame (ASS-par-taym) a
dietary sweetener with almost no calories and no nutritional value
atherosclerosis (ATH-ur-oh-sklurOH-siss) clogging narrowingand hardening of the bodyrsquos
large blood vessels also called arteries Atherosclerosis can leadto coronary heart disease heart
attacks peripheral arterial disease
strokes and transient ischemic
attacks It can also damage thearteries that go to the kidneys
A healthy blood vessel
A narrowed blood vessel
athletersquos foot (ATH-leets) (fut)a fungal infection of the skinon the foot also called tinea
pedis The fungus is common inpeople with diabetes the elderlyand people with an impairedimmune system The skin may
peel crack bleed or cause painSome people have no symptomsand do not know they have aninfection The affected skin isalso more vulnerable to bacteriathat cause cellulitis
Common Types of Athletersquos Foot
bull moccasin whichaffectsthesoles of the feet
bull interdigital whichaffectstheskin between the toes
bull inflammatoryorblistering which affects the soles and
sides of the feet
autoimmune disease (AW-toh-ih-MYOON) (dih-ZEEZ) adisorder of the bodyrsquos immune
system in which the immunesystem mistakenly attacks anddestroys body tissue it believes to
be foreign
4
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AndashB
autonomic neuropathy (AW-tohNOM-ik) (noo-ROP-uh-thee) atype of neuropathy affecting thelungs heart stomach intestinesbladder or genitals
Avandamet (uh-VAN-duh-met) the
brand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and metformin
Avandaryl (uh-VAN-duh-ril) thebrand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and glimepiride
Avandia (uh-VAN-dee-uh) see rosiglitazone
background retinopathy (BAKground) (RET-ih-NOP-uh-thee)a type of damage to the retina
of the eye marked by bleedingfluid accumulation andabnormal dilation of the blood
vessels Background retinopathy
is an early stage of diabetic retinopathy Also called simpleor nonproliferative retinopathy
basal rate (BAY-suhl) (rayt) acontinuous supply of low levelsof longer-acting insulin as usedin insulin pumps
beta cell (BAY-tuh) (sel) a cellthat makes insulin Beta cellsare located in the islets of the pancreas
biguanide (by-GWAH-nyd) aclass of oral medicine used totreat type 2 diabetes that lowers
blood glucose by reducing theamount of glucose produced bythe liver This type of medicinealso helps treat insulin resistance
a condition in which the bodydoesnrsquot use insulin the way itshould (Generic namesBrandnames metforminGlucophage
Glucophage XR Riomet)
5
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B
blood glucose (bluhd) (GLOOkohss) the main sugar found inthe blood and the bodyrsquos mainsource of energy Also called blood sugar
blood glucose level (bluhd)
(GLOO-kohss) (LEV-uhl) theamount of glucose in a givenamount of blood In the UnitedStates blood glucose levels arenoted in milligrams per deciliteror mgdL
blood glucose meter (bluhd)(GLOO-kohss) (MEE-tur) asmall portable machine usedby people with diabetes to checktheir blood glucose levels Afterpricking the skin with a lancet
one places a drop of blood on atest strip in the machine Themeter then displays the blood
glucosereading
Blood glucose meter
blood glucose monitoring (bluhd)(GLOO-kohss) (MON-ih-TURing) checking blood glucose levels
by using a blood glucose meter
or blood glucose test strips thatchange color when touched by ablood sample in order to manage
diabetes
blood pressure the force of bloodexerted on the inside walls of blood vessels Blood pressure isexpressed as two numbers Forexample a blood pressure resultof 12080 is said as ldquo120 over
80rdquo The first number is the systolic pressure or the pressure when the heart pushes blood intothe arteries The second numberis the diastolic pressure or thepressure when the heart rests
blood sugar see blood glucose
blood sugar level see blood glucose level
blood urea nitrogen (BUN) (bluhd)(yoo-REE-uh) (NY-troh-jen) a
waste product in the blood thatcomes from the breakdown of protein The kidneys filter blood
to remove urea As kidneyfunction decreases the BUNlevel increases
6
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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C
callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
8
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
9
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
10
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
11
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
12
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
13
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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A
arteriosclerosis (ar-TIHRee-oh-sklur-OH-siss) see atherosclerosis
artery (AR-tur-ee) a large blood
vessel that carries blood withoxygen from the heart to all
parts of the bodyaspartame (ASS-par-taym) a
dietary sweetener with almost no calories and no nutritional value
atherosclerosis (ATH-ur-oh-sklurOH-siss) clogging narrowingand hardening of the bodyrsquos
large blood vessels also called arteries Atherosclerosis can leadto coronary heart disease heart
attacks peripheral arterial disease
strokes and transient ischemic
attacks It can also damage thearteries that go to the kidneys
A healthy blood vessel
A narrowed blood vessel
athletersquos foot (ATH-leets) (fut)a fungal infection of the skinon the foot also called tinea
pedis The fungus is common inpeople with diabetes the elderlyand people with an impairedimmune system The skin may
peel crack bleed or cause painSome people have no symptomsand do not know they have aninfection The affected skin isalso more vulnerable to bacteriathat cause cellulitis
Common Types of Athletersquos Foot
bull moccasin whichaffectsthesoles of the feet
bull interdigital whichaffectstheskin between the toes
bull inflammatoryorblistering which affects the soles and
sides of the feet
autoimmune disease (AW-toh-ih-MYOON) (dih-ZEEZ) adisorder of the bodyrsquos immune
system in which the immunesystem mistakenly attacks anddestroys body tissue it believes to
be foreign
4
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AndashB
autonomic neuropathy (AW-tohNOM-ik) (noo-ROP-uh-thee) atype of neuropathy affecting thelungs heart stomach intestinesbladder or genitals
Avandamet (uh-VAN-duh-met) the
brand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and metformin
Avandaryl (uh-VAN-duh-ril) thebrand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and glimepiride
Avandia (uh-VAN-dee-uh) see rosiglitazone
background retinopathy (BAKground) (RET-ih-NOP-uh-thee)a type of damage to the retina
of the eye marked by bleedingfluid accumulation andabnormal dilation of the blood
vessels Background retinopathy
is an early stage of diabetic retinopathy Also called simpleor nonproliferative retinopathy
basal rate (BAY-suhl) (rayt) acontinuous supply of low levelsof longer-acting insulin as usedin insulin pumps
beta cell (BAY-tuh) (sel) a cellthat makes insulin Beta cellsare located in the islets of the pancreas
biguanide (by-GWAH-nyd) aclass of oral medicine used totreat type 2 diabetes that lowers
blood glucose by reducing theamount of glucose produced bythe liver This type of medicinealso helps treat insulin resistance
a condition in which the bodydoesnrsquot use insulin the way itshould (Generic namesBrandnames metforminGlucophage
Glucophage XR Riomet)
5
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B
blood glucose (bluhd) (GLOOkohss) the main sugar found inthe blood and the bodyrsquos mainsource of energy Also called blood sugar
blood glucose level (bluhd)
(GLOO-kohss) (LEV-uhl) theamount of glucose in a givenamount of blood In the UnitedStates blood glucose levels arenoted in milligrams per deciliteror mgdL
blood glucose meter (bluhd)(GLOO-kohss) (MEE-tur) asmall portable machine usedby people with diabetes to checktheir blood glucose levels Afterpricking the skin with a lancet
one places a drop of blood on atest strip in the machine Themeter then displays the blood
glucosereading
Blood glucose meter
blood glucose monitoring (bluhd)(GLOO-kohss) (MON-ih-TURing) checking blood glucose levels
by using a blood glucose meter
or blood glucose test strips thatchange color when touched by ablood sample in order to manage
diabetes
blood pressure the force of bloodexerted on the inside walls of blood vessels Blood pressure isexpressed as two numbers Forexample a blood pressure resultof 12080 is said as ldquo120 over
80rdquo The first number is the systolic pressure or the pressure when the heart pushes blood intothe arteries The second numberis the diastolic pressure or thepressure when the heart rests
blood sugar see blood glucose
blood sugar level see blood glucose level
blood urea nitrogen (BUN) (bluhd)(yoo-REE-uh) (NY-troh-jen) a
waste product in the blood thatcomes from the breakdown of protein The kidneys filter blood
to remove urea As kidneyfunction decreases the BUNlevel increases
6
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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C
callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
8
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
9
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
10
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
11
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
12
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
13
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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AndashB
autonomic neuropathy (AW-tohNOM-ik) (noo-ROP-uh-thee) atype of neuropathy affecting thelungs heart stomach intestinesbladder or genitals
Avandamet (uh-VAN-duh-met) the
brand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and metformin
Avandaryl (uh-VAN-duh-ril) thebrand name of an oral medicineused to treat type 2 diabetes acombination of rosiglitazone and glimepiride
Avandia (uh-VAN-dee-uh) see rosiglitazone
background retinopathy (BAKground) (RET-ih-NOP-uh-thee)a type of damage to the retina
of the eye marked by bleedingfluid accumulation andabnormal dilation of the blood
vessels Background retinopathy
is an early stage of diabetic retinopathy Also called simpleor nonproliferative retinopathy
basal rate (BAY-suhl) (rayt) acontinuous supply of low levelsof longer-acting insulin as usedin insulin pumps
beta cell (BAY-tuh) (sel) a cellthat makes insulin Beta cellsare located in the islets of the pancreas
biguanide (by-GWAH-nyd) aclass of oral medicine used totreat type 2 diabetes that lowers
blood glucose by reducing theamount of glucose produced bythe liver This type of medicinealso helps treat insulin resistance
a condition in which the bodydoesnrsquot use insulin the way itshould (Generic namesBrandnames metforminGlucophage
Glucophage XR Riomet)
5
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B
blood glucose (bluhd) (GLOOkohss) the main sugar found inthe blood and the bodyrsquos mainsource of energy Also called blood sugar
blood glucose level (bluhd)
(GLOO-kohss) (LEV-uhl) theamount of glucose in a givenamount of blood In the UnitedStates blood glucose levels arenoted in milligrams per deciliteror mgdL
blood glucose meter (bluhd)(GLOO-kohss) (MEE-tur) asmall portable machine usedby people with diabetes to checktheir blood glucose levels Afterpricking the skin with a lancet
one places a drop of blood on atest strip in the machine Themeter then displays the blood
glucosereading
Blood glucose meter
blood glucose monitoring (bluhd)(GLOO-kohss) (MON-ih-TURing) checking blood glucose levels
by using a blood glucose meter
or blood glucose test strips thatchange color when touched by ablood sample in order to manage
diabetes
blood pressure the force of bloodexerted on the inside walls of blood vessels Blood pressure isexpressed as two numbers Forexample a blood pressure resultof 12080 is said as ldquo120 over
80rdquo The first number is the systolic pressure or the pressure when the heart pushes blood intothe arteries The second numberis the diastolic pressure or thepressure when the heart rests
blood sugar see blood glucose
blood sugar level see blood glucose level
blood urea nitrogen (BUN) (bluhd)(yoo-REE-uh) (NY-troh-jen) a
waste product in the blood thatcomes from the breakdown of protein The kidneys filter blood
to remove urea As kidneyfunction decreases the BUNlevel increases
6
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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C
callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
8
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
9
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
11
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
12
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
13
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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B
blood glucose (bluhd) (GLOOkohss) the main sugar found inthe blood and the bodyrsquos mainsource of energy Also called blood sugar
blood glucose level (bluhd)
(GLOO-kohss) (LEV-uhl) theamount of glucose in a givenamount of blood In the UnitedStates blood glucose levels arenoted in milligrams per deciliteror mgdL
blood glucose meter (bluhd)(GLOO-kohss) (MEE-tur) asmall portable machine usedby people with diabetes to checktheir blood glucose levels Afterpricking the skin with a lancet
one places a drop of blood on atest strip in the machine Themeter then displays the blood
glucosereading
Blood glucose meter
blood glucose monitoring (bluhd)(GLOO-kohss) (MON-ih-TURing) checking blood glucose levels
by using a blood glucose meter
or blood glucose test strips thatchange color when touched by ablood sample in order to manage
diabetes
blood pressure the force of bloodexerted on the inside walls of blood vessels Blood pressure isexpressed as two numbers Forexample a blood pressure resultof 12080 is said as ldquo120 over
80rdquo The first number is the systolic pressure or the pressure when the heart pushes blood intothe arteries The second numberis the diastolic pressure or thepressure when the heart rests
blood sugar see blood glucose
blood sugar level see blood glucose level
blood urea nitrogen (BUN) (bluhd)(yoo-REE-uh) (NY-troh-jen) a
waste product in the blood thatcomes from the breakdown of protein The kidneys filter blood
to remove urea As kidneyfunction decreases the BUNlevel increases
6
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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C
callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
8
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
9
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
10
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
11
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
12
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
13
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
18
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
19
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
23
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
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Notes
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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7
Bblood vessels (bluhd) (VESS-uhlz)
tubes that carry blood to andfrom all parts of the body Thethree main types of blood vesselsare arteries capillaries and veins
BMI see body mass index
To find BMI Multiply body weight in pounds
by 703 Divide that number by height in
inches Divide that number by height in inches
again Find the resulting number below
18 and
below is
underweight
19 to 24 is
normal
25 to 29 is
overweight
30 and
above is
obese
body mass index (BMI) a measureused to evaluate body weight
relative to a personrsquos heightBMI is used to find out if aperson is underweight normal
weight overweight or obese
body tissue a group of cells in thebody that performs a specificfunction
bolus (BOH-luhss) an extraamount of insulin taken to coveran expected rise in blood glucose often related to a meal or snack
borderline diabetes (BOR-dur-lyn) (DY-uh-BEE-teez) aformer term for type 2 diabetes or prediabetes
brittle diabetes (BRIH-tuhl)(DY-uh-BEE-teez) a term used
when a personrsquos blood glucose level moves often from low tohigh and from high to low
BUN (BEE-YOO-EN) see blood
urea nitrogen
bunion (BUHN-yuhn) a bulgeon the first joint of the big toe
caused by the swelling of a fluidsac under the skin This spot canbecome red sore and infected
Byetta (by-YAY-tuh) see exenatide
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C
callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
8
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
9
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
10
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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C
callus (KAL-uhss) a small areaof skin usually on the foot thathas become thick and hard fromrubbing or pressure
calorie a unit representing theenergy provided by food
Carbohydrate fat protein andalcohol provide calories in thediet Carbohydrate and proteinhave 4 calories per gram fat has9 calories per gram and alcoholhas 7 calories per gram
Candida (KAN-did-uh) a fungusthat is normally found in thebody but commonly becomesovergrown in people with diabetes Overgrowth is due toincreased sugar in the body anda weakened immune system Useof antibiotics or birth controlpills also increases the risk of
candida overgrowthCandida
overgrowth can lead to infectioncausing itching skin lesions orrash Some common areas ofinfection are in or around themouth armpits groin vaginaand nails
CAPD (SEE-AY-PEE-DEE) see
continuous ambulatory peritoneal dialysis under dialysis
capillary (KAP-ih-lair-ee) thesmallest of the bodyrsquos blood
vessels Oxygen and glucose passthrough capillary walls and enterthe cells Waste products suchas carbon dioxide pass back fromthe cells into the blood through
capillaries
capsaicin (kap-SAY-ih-sin) aningredient in hot peppers thatcan be found in ointment formfor use on the skin to relievepain from diabetic neuropathy
carbohydrate (KAR-boh-HYdrayt) one of the three mainnutrients in food Foods thatprovide carbohydrate are starches vegetables fruits dairyproducts and sugars
Sources of carbohydrate
8
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
9
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
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coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
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conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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C
carbohydrate counting (KAR-bohHY-drayt) (KOUN-ting) amethod of meal planning forpeople with diabetes based oncounting the number of grams of carbohydrate in food
cardiologist (KAR-dee-OL-oh-jist)a doctor who treats people whohave heart problems
cardiovascular disease (KAR-deeoh-VASS-kyoo-lur) (dih-ZEEZ)disease of the heart and blood
vessels (arteries capillaries and veins)
carpal tunnel syndrome (KARpuhl) (TUHN-uhl) (SINdrohm) a common form of neuropathy occurring with diabetes Symptoms of carpaltunnel syndrome includenighttime hand tingling and pain
and numbness and weaknessin the hand and wrist thatsometimes radiates up the armCarpal tunnel syndrome oftenaffects both wrists and occursmore often in women than men
cataract (KAT-uh-rakt) clouding
of the lens of the eyeCCPD see continuous cycling
peritoneal dialysis under dialysis
CDE see certified diabetes educator
celiac disease (SEE-lee-ak) (dih-ZEEZ) the inability to digestand absorb proteins called glutenfound in wheat rye and barleyCeliac disease causes damage tothe lining of the small intestineand prevents absorption of
nutrients Also called celiacsprue gluten intolerance andnontropical sprue
cellulitis (SEL-yoo-LY-tiss) a skininfection caused by bacteriathat gets into the skin through a
wound Cellulitis may develop
from skin problems such as ulcers eczema psoriasis or afungal infection like athletersquos foot
People with diabetes peripheral
arterial disease or a weakenedimmune system may developcellulitis If not treated withantibiotics the infection can
spread to the blood or lymphnodes and cause death
cerebral vascular disease (sehREE-bruhl) (VASS-kyoo-lur)(dih-ZEEZ) damage to blood
vessels in the brain Vesselscan burst and bleed or become
clogged with fatty deposits A stroke results when blood flowis interrupted and brain cellsdie or are damaged
9
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
10
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
11
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
12
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
13
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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C
certified diabetes educator (CDE)
(SER-tih-fyd) (DY-uh-BEEteez) (EH-juh-KAY-tur) ahealth care professional withexpertise in diabetes education
who has met eligibilityrequirements and successfully
completed a certification examSee diabetes educator
CGMS see continuous glucose
monitoring system
Charcotrsquos foot (SHAHR-kohz)(fut) a condition resulting fromnerve damage in which the jointsand soft tissue in the foot aredestroyed
cheiroarthropathy (KY-roh-arTHROP-uh-thee) see limited
joint mobility
cheiropathy (ky-ROP-uh-thee)
see limited joint mobilitychlorpropamide (klor-PROH
puh-myd) an oral medicineused to treat type 2 diabetes
Chlorpropamide lowers blood
glucose levels by helping the pancreas make more insulin
and by helping the body betteruse the insulin it makesChlorpropamide belongs tothe class of medicines called sulfonylureas (Brand name Diabinese)
cholesterol (koh-LESS-tur-ol) atype of fat produced by the liver and found in the bloodCholesterol is also found in somefoods The body uses cholesterolto make hormones and build cell
walls
chronic (KRON-ik) describessomething that is long-lastingOpposite of acute
chronic kidney disease (CKD)
(KRON-ik) (KID-nee) (dih-ZEEZ) any condition thatcauses reduced kidney functionover a period of time CKDis present when a patientrsquos glomerular filtration rate remainsbelow 60 milliliters per minutefor more than 3 months CKDmay develop over many yearsand lead to endstage renal
disease
circulation (SUR-kyoo-LAYshuhn) the flow of bloodthrough the bodyrsquos blood vessels
and heart
CKD see chronic kidney disease
claudication (CLAW-dih-KAYshuhn) see intermittent
claudication
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
11
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
13
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
19
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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C
coma (KOH-muh) a sleeplikestate in which a person is notconscious A coma may becaused by hyperglycemia (high
blood glucose) or hypoglycemia
(low blood glucose) in people with diabetes
combination diabetes pill (KOMbih-NAY-shuhn) (DY-uh-BEEteez) (pil) a pill that includestwo different medicines
combination therapy the use ofdifferent medicines together tomanage blood glucose levels
complications (KOM-plih-KAYshuhnz) harmful effects of diabetes such as damage to theeyes heart blood vessels nervoussystem teeth and gums feet andskin or kidneys Studies showthat keeping blood glucose blood
pressure and LDL cholesterollevels close to normal can helpprevent or delay these problems
congenital defects (kon-JEN-ihtuhl) (DEE-fekts) problemsor conditions that are presentat birth
congestive heart failure (kon-JESStiv) (hart) (FAYL-yoor) thetype of heart failure in which lossof the heartrsquos pumping powercauses fluid to build up in thebody
constipation (KON-stih-PAYshuhn) a condition in whichthe stool becomes hard and dry
A person who is constipatedusually has fewer than threebowel movements in a weekBowel movements may be
painful
continuous ambulatory peritoneal
dialysis (kon-TIN-yoo-uhss)(AM-byoo-luh-TOR-ee) (PAIRih-toh-NEE-uhl) (dy-AL-ihsiss) see continuous ambulatory
peritoneal dialysis under dialysis
continuous cycling peritoneal
dialysis (kon-TIN-yoo-uhss)(SY-kling) (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see continuous cycling peritoneal
dialysis under dialysis
continuous glucose monitoring
system (CGMS) (kon-TIN-yoouhss) (GLOO-kohss) (MON-ihTUR-ing) (SISS-tuhm) a smallsensor inserted below the skinthat measures blood glucose levels
approximately 12 times an hour
continuous subcutaneous insulin
injection (kon-TIN-yoo-uhss)(SUHB-kyoo-TAY-nee-uhss)(IN-suh-lin) (in-JEK-shuhn)see insulin pump
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conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
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dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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C
conventional therapy a termused in clinical trials whereone group receives treatmentfor diabetes in which A1C and blood glucose levels are kept atlevels based on current practiceguidelines However the goal
is not to keep blood glucoselevels as close to normal aspossible as is done in intensive
therapy Conventional therapyincludes use of medication mealplanning and exercise along
with regular visits to health careproviders
coronary artery disease (KORuh-nair-ee) (AR-tur-ee) (dih-ZEEZ) see coronary heart
disease
coronary heart disease (KOR-uhnair-ee) (hart) (dih-ZEEZ)
heart disease caused bynarrowing of the arteries thatsupply blood to the heart If theblood supply is cut off the resultis a heart attack
C-peptide (SEE-PEP-tyd) asubstance the pancreas releasesinto the bloodstream in equal
amounts to insulin A test ofC-peptide levels shows howmuch insulin the body is making
C-reactive protein (SEE-ree-AKtiv) (PROH-teen) a substanceproduced in the liver in responseto injury or inflammationElevated levels of C-reactiveprotein are associated with ahigher risk of heart attack and
stroke
creatinine (kree-AT-ih-neen) a waste product from meat protein in the diet and fromthe muscles of the bodyCreatinine is removed from thebody by the kidneys as kidney
disease progresses the level ofcreatinine in the blood increases
creatinine clearance (kree-AT-ihneen) (KLIHR-ants) a testthat measures how efficientlythe kidneys remove creatinine
and other wastes from the
blood Low creatinine clearanceindicates impaired kidneyfunction
CSII (continuous subcutaneous
insulin injection) (SEE-ESSEYE-EYE) see insulin pump
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
13
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
18
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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D
dawn phenomenon (dawn) (fuhNOM-uh-non) the early-morning (4 am to 8 am) rise in blood glucose
DCCT see Diabetes Control and
Complications Trial
debridement (day-breed-MAW)removal of dead or infected tissuefrom a wound Debridementcan be done with enzymes
mechanically such as in a whirlpool or through surgery
dehydration (dee-hy-DRAY
shuhn) the loss of too muchbody fluid through frequenturinating sweating diarrhea or
vomiting
dermopathy (dur-MOP-uh-thee)disease of the skin
dextrose (DEKS-trohss) simple
sugar found in blood that servesas the bodyrsquos main source ofenergy Also called glucose
DiaBeta (dy-uh-BAY-tuh) see glyburide
diabetes (DY-uh-BEE-teez) acondition characterized by hyperglycemia (high blood glucose)
resulting from the bodyrsquosinability to use blood glucose
for energy In type 1 diabetes
the pancreas no longer makes
insulin therefore blood glucosecannot enter the cells to be usedfor energy In type 2 diabetes
either the pancreas does notmake enough insulin or the bodyis unable to use insulin correctly
Also called diabetes mellitus
Diabetes Control andComplications Trial (DCCT)
(DY-uh-BEE-teez) (kon-TROHL) (and) (KOM-plihKAY-shuhnz) (TRY-uhl) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted
from 1983 to 1993 in people with type 1 diabetes The studyshowed that intensive therapy
compared with conventional
therapy significantly helpedprevent or delay diabetic
retinopathy kidney disease and nerve disease Intensive therapy
included multiple daily injectionsof insulin or the use of an insulin
pump with multiple blood glucose
readings each day
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
19
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
21
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
22
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
24
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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14
diabetes educator (DY-uh-BEE-teez) (EH-juh-KAY-tur) ahealth care professional whoteaches people who have diabetes how to manage theircondition Some diabeteseducators are certified diabetes
educators (CDEs) Diabeteseducators are found in hospitalsphysician offices managed careorganizations home health careand other settings
diabetes insipidus (DY-uh-BEE-teez) (in-SIH-puh-duhss) a
condition characterized byfrequent and heavy urinationexcessive thirst and an overallfeeling of weakness Thiscondition may be caused by adefect in the pituitary gland orthe kidney In diabetes insipidus blood glucose levels are normal
diabetes mellitus (DY-uh-BEE-teez) (MEH-luh-tuhss) see diabetes
Diabetes Prevention Program
(DPP) (DY-uh-BEE-teez) (pree-VEN-shuhn) (PROH-gram) astudy by the National Instituteof Diabetes and Digestive andKidney Diseases conducted from1998 to 2001 in people at high
risk for type 2 diabetes All studyparticipants had impaired glucose
tolerance also called prediabetes and were overweight The studyshowed that people who lost5 to 7 percent of their body
weight through a low- fat low- calorie diet and moderate
physical activitymdashusually walkingfor 30 minutes 5 days a weekmdashreduced their risk of gettingtype 2 diabetes by 58 percentParticipants who receivedtreatment with the oral diabetesdrug metformin reduced theirrisk of getting type 2 diabetes by31 percent
diabetes self-management (DY-uh-BEE-teez) (self-MAN-uhj-ment) see self-management
D
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
18
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
19
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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D
diabetic diarrhea (DY-uh-BET-ik)(DY-uh-REE-uh) loose stoolsfecal incontinence or both thatresult from an overgrowth ofbacteria in the small intestineand diabetic neuropathy in theintestines This nerve damage
can also result in constipation
diabetic eye disease (DY-uhBET-ik) (eye) (dih-ZEEZ) see diabetic retinopathy
diabetic gastropathy (DY-uhBET-ik) (gass-TROP-uh-thee)see gastropathy
diabetic ketoacidosis (DKA)
(DY-uh-BET-ik) (KEE-toh-ASSih-DOH-siss) an emergencycondition in which extremelyhigh blood glucose levels along
with a severe lack of insulin
result in the breakdown of
body fat for energy and anaccumulation of ketones inthe blood and urine Signs ofDKA are nausea and vomitingstomach pain fruity breath odorand rapid breathing UntreatedDKA can lead to coma anddeath
diabetic myelopathy (DY-uhBET-ik) (MY-uh-LOP-uh-thee)damage to the spinal cord foundin some people with diabetes
diabetic nephropathy (DY-uhBET-ik) (neh-FROP-uh-thee)see nephropathy
diabetic neuropathy (DY-uhBET-ik) (noo-ROP-uh-thee)see neuropathy
diabetic retinopathy (DY-uhBET-ik) (RET-ih-NOP-uh-thee)damage to the small blood vessels
in the retina Loss of vision mayresult Also called diabetic eye
disease
diabetogenic (DY-uh-BET-oh
JEN-ik) causing diabetes Forexample some drugs cause blood
glucose levels to rise resulting indiabetes
diabetologist (DY-uh-beh-TOL-uh jist) a doctor who specializesin treating people who have
diabetesDiabinese (dy-AB-ih-neez) see
chlorpropamide
diagnosis (DY-ag-NOH-siss) thedetermination of a disease fromits signs and symptoms
15
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
21
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
24
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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D
dialysis (dy-AL-ih-siss) the
process of cleaning wastes fromthe blood artificially This jobis normally done by the kidneys
If the kidneys fail the bloodmust be cleaned artificially
with special equipment The
two major forms of dialysisare hemodialysis and peritoneal
dialysis
n hemodialysis (HEE-mohdy-AL-ih-siss) the use of amachine to clean wastes fromthe blood after the kidneys
have failed The blood travelsthrough tubes to a dialyzer amachine that removes wastesand extra fluid The cleanedblood then flows throughanother set of tubes back intothe body
Hemodialysis
n peritoneal dialysis (PAIR-ihtoh-NEE-uhl) (dy-AL-ih-siss)cleaning of the blood by usingthe lining of the abdominalcavity or belly as a filter Acleansing liquid called dialysis
solution is drained from a
bag into the abdomen Fluidand wastes flow throughthe lining of the abdominalcavity and remain ldquotrappedrdquoin the dialysis solution Thesolution is then drained fromthe abdomen removing theextra fluid and wastes from
the body The two maintypes of peritoneal dialysisare continuous ambulatory
peritoneal dialysis and continuous cycling peritoneal
dialysis
bullcontinuous ambulatory
peritoneal dialysis (CAPD)(kon-TIN-yoo-uhss) (AM-byoo-luh-TOR-ee)(PAIR-ih-toh-NEE-uhl)(dy-AL-ih-siss) a formof peritoneal dialysis thatneeds no machine WithCAPD the blood is always
being cleaned The dialysis solution passes from aplastic bag througha catheter and into theabdomen The dialysissolution stays in theabdomen with the cathetersealed After several hours
16
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
19
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
21
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
22
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
23
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
24
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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D
the person using CAPDdrains the solution back intoa disposable bag Then theperson refills the abdomen
with fresh solution throughthe same catheter to beginthe cleaning process again
bullcontinuous cycling
peritoneal dialysis (CCPD)
(kon-TIN-yoo-uhss) (SYkling) (PAIR-ih-toh-NEEuhl) (dy-AL-ih-siss) a formof peritoneal dialysis thatuses a machine This
machine automatically fillsand drains the dialysis
solution from the abdomen A typical CCPD scheduleinvolves three to fiveexchanges during thenight while the personsleeps During the day
the person using CCPDperforms one exchangedraining the dialysissolution after an entire day
dialysis solution (dy-AL-ih-siss)(suh-LOO-shuhn) a cleansingliquid used in the two major
forms of dialysismdashhemodialysisand peritoneal dialysis Dialysissolution contains dextrose a sugar and other chemicalssimilar to those in the bodyDextrose draws wastes and extrafluid from the body into thedialysis solution
diastolic pressure (DY-uh-STOL-ik) (PRESH-ur)the blood pressure when theheart rests
dietitian (DY-uh-TISH-uhn) ahealth care professional who
advises people about mealplanning weight controland diabetes management Aregistered dietitian (RD) hasmet certain requirements
dilated eye exam (DY-lay-ted) (eye)(ek-ZAM) a test done by aneye care specialist in which thepupilmdashthe black centermdashof theeye is temporarily enlarged witheyedrops to allow the specialistto see the inside of the eye moreeasily
Dilated eye
Undilated eye
17
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
18
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
19
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
21
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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D
dipeptidyl peptidase-4 inhibitor
(dy-PEP-tih-dil) (PEP-tih-dayss-FOR) (in-HIB-ih-tur) see DPP4 inhibitor
DKA see diabetic ketoacidosis
D-phenylalanine derivative (DEEFEN-il-AL-uh-neen) (duh-RIVuh-tiv) a type of oral medicinefor type 2 diabetes that lowers blood glucose levels by helping the pancreas make more insulin rightafter meals (Generic nameBrand name nateglinideStarlix)
DPP see Diabetes Prevention Program
DPP-4 inhibitor (DEE-PEE-PEEFOR) (in-HIB-ih-tur) a class oforal medicine used to treat type 2
diabetes that lowers blood glucose
by helping the body make more
insulin when itrsquos needed Thistype of medicine also helps keepthe liver from putting storedblood glucose into the blood(Generic nameBrand name sitagliptin phosphateJanuvia)
Duetact (DOO-uh-tak) the brandname of an oral medicineused to treat type 2 diabetes acombination of pioglitazone
and glimepiride
Dupuytrenrsquos contracture (doo-
pwee-TRENZ) (kon-TRAKchur) a condition associated
with diabetes in which the fingersand the palm of the hand thickenand shorten causing the fingersto curve inward
duration in referring to insulin
the length of time during which insulin keeps lowering blood glucose levels Durationmay also refer to the length oftime a person has had diabetes
which determines a personrsquosrisk of developing diabetescomplications
18
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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E
eAG see estimated average glucose
edema (eh-DEE-muh) swellingcaused by too much fluid in thebody
electromyography (EMG) (ee-LEKtroh-my-OG-ruh-fee) a testused to detect nerve functionElectromyography measures theelectrical activity generated bymuscles
EMG see electromyography
endocrine gland (EN-doh-krin)
(gland) a group of specializedcells that releases hormones
into the blood For examplethe islets in the pancreas whichsecrete insulin are endocrineglands
endocrinologist (EN-doh-krihNOL-uh-jist) a doctor who
treats people who have endocrine gland problems such as diabetes
end-stage renal disease (ESRD)
(END-STAYJ) (REE-nuhl) (dih-ZEEZ) total and permanent kidney failure When the kidneys fail the body retains
fluid Harmful wastes buildup A person with ESRD needstreatment to replace the work ofthe failed kidneys
enzyme (EN-zym) protein madeby the body that brings about achemical reactionmdashfor examplethe enzymes produced by the gutto aid digestion
erectile dysfunction (ee-REK-tyl)
(diss-FUHNK-shuhn) theinability to get or maintain anerection for satisfactory sexualintercourse Also called impotence
ESRD see endstage renal disease
estimated average glucose (ESStuh-may-ted) (AV-ur-ij) (GLOO
kohss) also called eAG oraverage glucose another way toreport the results of an A1C testThe A1C test measures averageglucose levels over the past 2 to3 months In the past results
were reported as a percentageResults reported as an eAG are
given as mgdL the same unitsused for self-monitoring of bloodglucose with a blood glucose
meter For example results ofan A1C test can be reported asan eAG of 126 mgdL which isequal to 6 percent
euglycemia (YOO-gly-SEEmee-uh) a normal level of glucose in the blood
19
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
21
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
22
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
23
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
24
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
29
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
30
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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20
exchange lists one of severalapproaches for diabetes mealplanning Foods are categorizedinto three groups based ontheir nutritional content Listsprovide the serving sizes for carbohydrates meat and meat
substitutes and fats Theselists allow for substitution fordifferent groups to keep thenutritional content fixed
exenatide (eks-EN-uh-tyd) aninjectable medicine for diabetes that mimics the effect of
incretin hormones a type of gastrointestinal hormone Thismedicine helps food move moreslowly through the stomachand helps keep the liver fromreleasing stored glucose (Brandname Byetta)
Ffasting blood glucose test (FASS-
ting) (bluhd) (GLOO-kohss)(test) a check of a personrsquos blood glucose level after theperson has not eaten for 8 to12 hoursmdashusually overnightThis test is used to diagnose
prediabetes and diabetes it isalso used to see whether people
with diabetes are keeping bloodglucose levels on target
fat 1 one of the three mainnutrients in food Foodsthat provide fat are butter
margarine salad dressing oilnuts meat poultry fish andsome dairy products 2 excess calories are stored as body fatproviding the body with a reservesupply of energy and otherfunctions
Endash
Sources of fat
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
21
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
22
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
23
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
24
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
29
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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Fndashfluorescein angiography (flor-ESSee-in) (AN-jee-OG-ruh-fee) atest to examine blood vessels inthe eye that is done by injectingdye into an arm vein and thentaking photos as the dye goesthrough the eyersquos blood vessels
focal neuropathy (FOH-kuhl)(noo-ROP-uh-thee) a type of neuropathy in which a singlenerve or a group of nerves isaffected producing sudden
weakness or pain
fructosamine test (frook-TOHSSuh-meen) (test) measuresthe number of blood glucose
molecules linked to protein
molecules in the blood Thetest provides information abouta personrsquos average blood glucose
level for the previous 3 weeks
fructose (FROOK-tohss) a sugarthat occurs naturally in fruits andhoney Fructose has 4 calories
per gram
G
GAD65 (GAD-SIKS-tee-FYV) seeislet cell autoantibodies
gangrene (GANG-green) thedeath of body tissue most oftencaused by a lack of blood flowand infection Gangrene can
lead to amputationgastrointestinal (GASS-troh-in
TESS-tin-uhl) related to thestomach and intestines
gastroparesis (GASS-troh-puhREE-siss) a form of neuropathy
that affects the stomach
Digestion of food may beincomplete or delayed resultingin nausea vomiting or bloatingmaking blood glucose controldifficult
gastropathy (gass-TROP-uh-thee)a form of neuropathy that affects
the stomach Symptoms mayinclude nausea discomfort afeeling of fullness and vomitingThe stomach may be delayed inemptying called gastroparesis
GDM see gestational diabetes
mellitus
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
22
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
23
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
24
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
29
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
30
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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G
gestational diabetes mellitus
(GDM) (jess-TAY-shuhn-uhl)(DY-uh-BEE-teez) (MEH-luhtuhss) a type of diabetes thatdevelops only during pregnancyand usually disappears upondelivery but increases the
motherrsquos risk of developingdiabetes later in life GDM ismanaged with meal planningphysical activity and in somecases medication
GFR see glomerular filtration rate
gingivitis (JIN-jih-VY-tiss)a condition of the gumscharacterized by inflammationand bleeding
gland a group of cells that secretesubstances Endocrine glands
secrete hormones Exocrineglands secrete salt enzymes and
water
glaucoma (glaw-KOH-muh) anincrease in fluid pressure insidethe eye that may lead to visionloss
glimepiride (gly-MEP-ih-ryd) anoral medicine used to treat type 2 diabetes Glimepiridelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Glimepiride belongs to the classof medicines called sulfonylureas
(Brand name Amaryl)
glipizide (GLIP-ih-zyd) an oralmedicine used to treat type 2
diabetes Glipizide lowers blood
glucose by helping the pancreas
make more insulin and byhelping the body better usethe insulin it makes Glipizidebelongs to the class of medicinescalled sulfonylureas (Brandnames Glucotrol Glucotrol XL)
glomerular filtration rate (GFR)
(gloh-MAIR-yoo-lur) (fil-TRAYshuhn) (rayt) the rate at whichthe kidneys filter wastes and extrafluid from the blood measuredin milliliters per minute
glomeruli (gloh-MAIR-yoo-ly)plural of glomerulus
glomerulus (gloh-MAIR-yoo-luhss)a tiny set of looping blood vessels
where the blood is filtered in the kidney
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
23
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
24
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
29
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
30
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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G
glucagon (GLOO-kuh-gon) a hormone produced by the alpha
cells in the pancreas Glucagonraises blood glucose Aninjectable form of glucagonavailable by prescriptionmay be used to treat severe
hypoglycemia
Glucophage Glucophage XR
(GLOO-koh-fahj) see metformin
glucose (GLOO-kohss) one of thesimplest forms of sugar
glucose gel (GLOO-kohss) (jel)pure glucose in gel form used fortreating hypoglycemia
glucose tablets (GLOO-kohss)(TAB-lets) chewable tabletsmade of pure glucose used fortreating hypoglycemia
Glucose tablets
glucose tolerance test (GLOOkohss) (TOL-ur-uhnss) (test)see oral glucose tolerance test
Glucotrol Glucotrol XL (GLOOkuh-trohl) see glipizide
Glucovance (GLOO-koh-vanss)the brand name of an oralmedicine used to treat type 2
diabetes a combination of glyburide and metformin
glyburide (GLY-buh-ryd) an oralmedicine used to treat type 2
diabetes Glyburide lowers blood
glucose by helping the pancreasmake more insulin and byhelping the body better use theinsulin it makes Glyburidebelongs to the class of medicinescalled sulfonylureas (Brandnames DiaBeta Glynase
PresTab Micronase)
glycemic index (gly-SEE-mik)(IN-deks) a ranking of a carbohydrate-containing foodbased on the foodrsquos effect on blood glucose compared with astandard reference food
glycemic load (gly-SEE-mik) (lohd)a ranking of a carbohydrate
containing food based on thefoodrsquos glycemic index and theamount of carbohydrate in atypical serving
23
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
24
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
29
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
30
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
31
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
33
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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GndashH
glycogen (GLY-koh-jen) the formof glucose found in the liver andmuscles the main source ofstored fuel in the body
glycosuria (GLY-koh-SYOOree-uh) the presence of glucose
in the urine
glycosylated hemoglobin (GLY-kohSY-lay-ted) (HEE-moh-GLOHbin) see A1C
Glynase PresTab (GLY-nayz)(PRESS-TAB) see glyburide
Glyset (GLY-set) see miglitolgram a unit of weight in the
metric system An ounce equals28 grams In some meal plansfor people with diabetes thesuggested amounts of food aregiven in grams
One slice of bread has15 grams of carbohydrate
HDL cholesterol (AYCH-DEE-EL)(koh-LESS-tur-ol) standsfor highdensity lipoprotein
cholesterol which is a fat foundin the blood that takes extra cholesterol from the blood to the liver for removal Sometimes
called ldquogoodrdquo cholesterol
heart attack a condition in whichthe blood vessels to the heartbecome totally or partiallyblocked by fatty depositsWhen the blood supply is cutoff or reduced oxygen and
other needed supplies canrsquot getthrough Then heart muscle candie Also called a myocardial
infarction
heart failure a chronic conditionin which the heart cannot pumpblood properly
hemodialysis (HEE-moh-dy-AL-ihsiss) see dialysis
hemoglobin A1C test (HEE-mohGLOH-bin) (AY-WUHN-SEE)(test) see A1C
heredity (huh-RED-ih-tee) thepassing of a trait from parentto child
HHNS see hyperosmolar
hyperglycemic nonketotic
syndrome
24
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
29
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
30
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
31
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
32
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
33
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
36
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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H
high blood glucose (hy) (bluhd)(GLOO-kohss) see hyperglycemia
high blood pressure see hypertension
high-density lipoprotein cholesterol
(HY-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see HDL cholesterol
HLA see human leukocyte antigens
home glucose monitor (hohm)(GLOO-kohss) (MON-ih-tur)
see blood glucose meterhoneymoon phase temporary
remission of hyperglycemia thatoccurs in some people newlydiagnosed with type 1 diabetes
when some insulin secretionresumes for a short timemdashforexample a few monthsmdashbefore
stopping again
hormone a chemical producedin one part of the body andreleased into the blood to triggeror regulate particular functionsof the body For exampleinsulin is a hormone made in
the pancreas that tells other cells when to use glucose for energySynthetic hormones made foruse as medicines can be thesame or different from thosemade in the body
Humalog (YOO-muh-lawg) seeinsulin lispro
Humalog Mix 5050 (YOO-muhlawg) (mix) see premixed
insulin
Humalog Mix 7525 (YOO-muhlawg) (mix) see premixed
insulin
human leukocyte antigens (HLA)
(HYOO-man) (LOO-koh-syt)(AN-tih-jens) proteins locatedon the surface of the cell thathelp the immune system identify
the cell either as one belongingto the body or as one fromoutside the body Some patternsof these proteins may meanincreased risk of developing type 1 diabetes
Humulin (YOO-myoo-lin)
see premixed insulinHumulin 7030 (YOO-myoo-lin)
see premixed insulin
Humulin N (YOO-myoo-lin)see NPH insulin
Humulin R (YOO-myoo-lin)see regular insulin
25
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
29
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
30
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
31
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
32
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
33
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
36
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
37
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
38
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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H
hyperglycemia (HY-pur-glySEE-mee-uh) higher thannormal blood glucose Fastinghyperglycemia is blood glucoseabove a desirable level aftera person has fasted for atleast 8 hours Postprandial
hyperglycemia is blood glucoseabove a desirable level 1 to2 hours after a person has eaten
hyperinsulinemia (HY-pur-IN-suhlin-EE-mee-uh) a conditionin which the level of insulin inthe blood is higher than normal
Caused by overproduction ofinsulin by the body Related toinsulin resistance
hyperlipidemia (HY-pur-LIP-ihDEE-mee-uh) higher thannormal fat and cholesterol levelsin the blood
hyperosmolar hyperglycemicnonketotic syndrome (HHNS)
(HY-pur-oz-MOH-lur)(HY-pur-gly-SEE-mik) (nonkee-TOT-ik) (SIN-drohm) anemergency condition in whichonersquos blood glucose level is veryhigh and ketones are not present
in the blood or urine If HHNSis not treated it can lead to coma
or death
hypertension (HY-pur-TENshuhn) a condition present
when blood flows through the blood vessels with a force greaterthan normal Also called high
blood pressure Hypertensioncan strain the heart damage
blood vessels and increase therisk of heart attack stroke kidney
problems and death
Checking blood pressure
hypoglycemia (HY-poh-glySEE-mee-uh) also called low blood glucose a conditionthat occurs when onersquos blood
glucose is lower than normalusually below 70 mgdL Signsinclude hunger nervousness
shakiness perspirationdizziness or light-headednesssleepiness and confusion Ifleft untreated hypoglycemiamay lead to unconsciousnessHypoglycemia is treated by
26
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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HndashI
consuming a carbohydrate-richfood such as glucose tablets or
juice Hypoglycemia may alsobe treated with an injection
of glucagon if the person isunconscious or unable toswallow Also called an insulin
reaction
hypoglycemia unawareness
(HY-poh-gly-SEE-mee-uh)(uhn-uh-WAIR-ness) a statein which a person does not feelor recognize the symptomsof hypoglycemia People who
have frequent episodes ofhypoglycemia may no longerexperience hypoglycemiarsquostypical warning signs
hypotension (HY-poh-TENshuhn) low blood pressure or asudden drop in blood pressure
Hypotension may occur whena person rises quickly from asitting or reclining positioncausing dizziness or fainting
IA-2A (EYE-AY-TOO-AY) seeislet cell autoantibodies
IAA (EYE-AY-AY) see islet cell
autoantibodies
ICA512 (EYE-SEE-AY-FYVWUHN-TOO) see islet cell
autoantibodies
ICA (EYE-SEE-AY) see islet cell
autoantibodies
IDDM (EYE-DEE-DEE-EM)see insulindependent diabetes
mellitus
IFG (EYE-EF-JEE) see impaired fasting glucose
IGT (EYE-JEE-TEE) see impaired
glucose tolerance
immune system (ih-MYOON)(SISS-tuhm) the bodyrsquos systemfor protecting itself from virusesand bacteria or any foreignsubstances
immunosuppressant (IM-yoo-nohsoo-PRESS-uhnt) a drug givento stop the natural responsesof the bodyrsquos immune system
Immunosuppressants are given
to prevent organ rejection inpeople who have received organ transplants and to patients with autoimmune diseases
27
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
29
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
30
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
31
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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28
impaired fasting glucose (IFG) (im-PAIRD) (FASS-ting)(GLOO-kohss) a condition in
which a fasting blood glucose test shows a level of glucose higherthan normal but not high enoughfor a diagnosis of diabetes IFG
also called prediabetes is a levelof 100 to 125 mgdL People withprediabetes are at increased riskfor developing type 2 diabetes heart disease and stroke
impaired glucose tolerance (IGT) (im-PAIRD) (GLOO-kohss)
(TOL-ur-uhnss) a conditionin which blood glucose levels arehigher than normal but are nothigh enough for a diagnosisof diabetes IGT also called prediabetes is a level of 140 to199 mgdL 2 hours after the startof an oral glucose tolerance test
People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forIGT that are no longer usedare ldquoborderlinerdquo ldquosubclinicalrdquoldquochemicalrdquo or ldquolatentrdquo diabetes
implantable insulin pump (im-PLANT-uh-buhl) (IN-suh-lin) (puhmp) a small pumpplaced inside the body to deliverinsulin in response to remote-control commands from the user
impotence (IM-puh-tenss) see erectile dysfunction
incidence (IN-sih-denss) ameasure of how often a diseaseoccurs the number of new casesof a disease among a certain
group of people for a certainperiod of time
incontinence (in-KON-tih-nenss)loss of bladder or bowel controlthe accidental loss of urine orfeces
incretin mimetic (IN-krit-in) (mih-
MET-ik) a type of injectablemedicine for diabetes that mimicsthe effect of incretin hormones atype of gastrointestinal hormoneThis medicine helps foodmove more slowly through thestomach and helps keep the liver from releasing stored glucose
(Generic nameBrand name exenatideByetta)
inhaled insulin (in-HAYLD)(IN-suh-lin) a type of insulin
under development taken witha special device that enablesthe user to breathe in insulin
through the mouthinjection (in-JEK-shuhn) inserting
liquid medication or nutrientsinto the body with a syringe
I
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
29
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
31
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
33
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
34
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
36
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
37
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
38
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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I
injection site rotation (in-JEKshuhn) (syt) (roh-TAY-shuhn)changing the places on thebody where insulin is injectedRotation prevents the formationof lipodystrophies
injection sites (in-JEK-shuhn)(syts) places on the body whereinsulin is injected
insulin (IN-suh-lin) a hormone
that helps the body use glucose
for energy The beta cells of the pancreas make insulin Whenthe body cannot make enoughinsulin insulin must be taken byinjection or other means
insulin adjustment (IN-suh-lin)(uh-JUHST-ment) a change inthe amount of insulin a person
with diabetes takes based onfactors such as meal planning
physical activity and blood glucose levels
insulin aspart (IN-suh-lin) (ASSpart) a rapid-acting insulin withan onset of 15 minutes a peak at30 to 90 minutes and a duration
of 3 to 5 hours (Brand name
NovoLog)insulin-dependent diabetes mellitus
(IDDM) (IN-suh-lin-duhPEN-dent) (DY-uh-BEE-teez)(MEH-luh-tuhss) former termfor type 1 diabetes
insulin detemir (IN-suh-lin) (DETih-mihr) a long-acting insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hours(Brand name Levemir)
insulin glargine (IN-suh-lin)
(GLAR-jeen) a type of long-acting insulin with an onset of1 hour no peak and a duration
of 20 to 26 hours (Brand name Lantus)
insulin glulisine (IN-suh-lin)(gloo-LY-seen) a type ofrapid-acting insulin with an onset
of 15 minutes a peak at 30 to90 minutes and a duration of 3 to5 hours (Brand name Apidra)
insulin infuser (IN-suh-lin)(in-FYOO-zur) a device fortaking insulin in which a smalltube is inserted just below the
skin and remains in place forseveral days Insulin is injectedinto the end of the tube
insulin lispro (IN-suh-lin) (LISSproh) a type of rapid-actinginsulin with an onset of15 minutes a peak at 30 to
90 minutes and a duration of 3 to5 hours (Brand name Humalog)
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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I
insulinoma (IN-suh-lih-NOHmuh) a tumor of the beta
cells in the pancreas Aninsulinoma may cause the bodyto make extra insulin leading to hypoglycemia
insulin pen (IN-suh-lin) (pen) adevice for injecting insulin thatlooks like a fountain pen andholds replaceable cartridgesof insulin Also available indisposable form
insulin pump (IN-suh-lin) (puhmp)an insulin-delivering deviceabout the size of a deck of cardsthat can be worn on a belt orkept in a pocket An insulinpump connects to narrowflexible plastic tubing that ends
with a needle inserted just underthe skin Users set the pump
to give a steady trickle or basalamount of insulin continuouslythroughout the day Pumpsrelease bolus doses of insulin atmeals and at times when blood
glucose is too high based ondoses set by the user
insulin reaction (IN-suh-lin) (ree AK-shuhn) when the level of glucose in the blood is too low(below 70 mgdL) Also called hypoglycemia
insulin receptors (IN-suh-lin) (ree
SEP-turz) areas on the outerpart of a cell that allow the cellto bind with insulin in the bloodWhen the cell and insulin bindthe cell can take glucose from theblood and use it for energy
insulin resistance (IN-suh-lin)(ree-ZISS-tuhnss) the bodyrsquosinability to respond to and usethe insulin it produces Insulinresistance may be linked to obesity hypertension and highlevels of fat in the blood
insulin shock (IN-suh-lin) (shok)see hypoglycemia
intensive therapy a treatment for diabetes in which blood glucose
is kept as close to normal aspossible Optimal blood glucose
levels are reached throughfrequent injections of insulin
or use of an insulin pump
meal planning adjustment ofmedicines and physical activityPeople undergoing intensivetherapy work closely with theirhealth care team
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
31
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
32
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
33
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
34
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
36
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
37
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
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Notes
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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I
intermediate-acting insulin
(IN-tur-MEE-dee-uht-AKT-ing)(IN-suh-lin) a type of insulin
with an onset of 1 to 3 hours a peak at 8 hours and a duration of12 to 16 hours See NPH insulin
intermittent claudication (IN-turMIT-ent) (CLAW-dih-KAYshuhn) pain that comes andgoes in the muscles of the legThis pain results from a lackof blood supply to the legs andusually happens when walking orexercising
intramuscular injection (IN-truhMUHSS-kyoo-lur) (in-JEKshuhn) inserting liquidmedication into a muscle with a syringe Glucagon may be givenby intramuscular or subcutaneous
injection for hypoglycemia
islet cell autoantibodies (ICAs)(EYE-let) (sel) (AW-toh-AN-tihbod-eez) proteins found in theblood of people newly diagnosed
with type 1 diabetes They arealso found in people who maybe developing type 1 diabetesThe presence of ICAs indicates
the bodyrsquos immune system hasbeen damaging beta cells in the pancreas The antibodies thatare routinely tested for include IAA IA2A ICA512 and GAD65
(also called GAD or GADA)
islets (EYE-lets) groups of cellslocated in the pancreas thatmake hormones that help thebody break down and use foodFor example alpha cells make glucagon and beta cells makeinsulin Also called islets of
Langerhans
islets of Langerhans (EYE-lets)(uhv) (LAHNG-ur-hahnz)see islets
islet transplantation (EYE-let)(TRANZ-plan-TAY-shuhn)moving the islets from a donor pancreas into a person whosepancreas has stopped producinginsulin Beta cells in the isletsmake the insulin that the bodyneeds for using blood glucose
31
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
32
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
33
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
36
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
37
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
38
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
39
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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JndashK
Janumet (JAN-yoo-met) thebrand name of an oral medicineused to treat type 2 diabetes
a combination of sitagliptin
phosphate and metformin
Januvia (juh-NOO-vee-uh) see
sitagliptin phosphate
jet injector (jet) (in-JEK-tur) adevice that uses high pressureinstead of a needle to propelinsulin through the skin and intothe body
juvenile diabetes (JOO-vuh-nyl)
(DY-uh-BEE-teez) formerterm for insulindependent
diabetes mellitus (IDDM) or type 1 diabetes
ketoacidosis (KEE-toh-ASSih-DOH-siss) see diabetic
ketoacidosis
ketone (KEE-tohn) a chemicalproduced when there is a shortageof insulin in the blood and the
body breaks down body fat forenergy High levels of ketones canlead to diabetic ketoacidosis and coma Sometimes referred to asketone bodies
ketonuria (KEE-toh-NYOO-ree-uh)a condition occurring when ketones
are present in the urine a warningsign of diabetic ketoacidosis
ketosis (kee-TOH-siss) a ketone
buildup in the body that may leadto diabetic ketoacidosis Signs ofketosis are nausea vomiting andstomach pain
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
33
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
34
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
36
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
37
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
38
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
39
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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KndashL
kidney one of the two bean-shapedorgans that filter wastes from theblood The kidneys are locatednear the middle of the back oneon each side of the spine Theycreate urine which is deliveredto the bladder
Kidneys
Kidneys
kidney disease see nephropathy
kidney failure loss of kidney
function See acute renal failure
chronic kidney disease and end
stage renal disease
Kussmaul breathing (KOOS-moul)(BREE-thing) the rapid deep
and labored breathing of people who have diabetic ketoacidosis
lactic acidosis (LAK-tik) (ASS-ihDOH-siss) a serious conditionin which there is a buildup oflactic acid in the body Lacticacidosis can result from diabetic
ketoacidosis liver disease or kidney disease
LADA (LAH-DUH) see latent
autoimmune diabetes in adults
lancet (LAN-set) a spring-loadeddevice used to prick the skin
with a small needle to obtain adrop of blood for blood glucose
monitoring
Lantus (LAN-tuhss) see insulin
glargine
laser treatment a type of therapythat uses a strong beam of lightto treat a damaged area Thebeam of light is called a laser
A laser is sometimes used toseal blood vessels in the eye ofa person with diabetes See photocoagulation
33
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
34
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
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macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
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mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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L
latent autoimmune diabetes in
adults (LADA) (LAY-tent)(AW-toh-ih-MYOON) (DY-uhBEE-teez) (in) (uh-DUHLTS)a type of diabetes usually firstdiagnosed after age 30 in whichpeople show signs of both type 1
diabetes and type 2 diabetes Mostpeople with LADA still producetheir own insulin when firstdiagnosed and do not requireinsulin injections Some expertsbelieve that LADA is a slowlydeveloping kind of type 1diabetes because patients have
antibodies against the insulin-producing beta cells in the pancreas Several years afterdiagnosis people with LADAmust take insulin to control blood
glucose levels
LDL cholesterol (EL-DEE-EL)
(koh-LESS-tur-ol) standsfor low-density lipoprotein cholesterol a fat found in theblood that takes cholesterolaround the body to where it isneeded for cell repair and alsodeposits it on the inside of artery
walls Sometimes called ldquobadrdquo
cholesterol
Levemir (LEV-uh-mihr) seeinsulin detemir
limited joint mobility a conditionin which the joints swell and theskin of the hand becomes thicktight and waxy making the
joints less able to move It mayaffect the fingers and arms as
well as other joints in the body
lipid (LIP-id) a term for fat inthe body Lipids can be brokendown by the body and used forenergy
lipid profile (LIP-id) (PROH-fyl)a blood test that measures total cholesterol triglycerides and HDL
cholesterol LDL cholesterol isthen calculated from the results
A lipid profile is one measure ofa personrsquos risk of cardiovascular
disease
lipoatrophy (LIP-oh-AT-rohfee) loss of fat under theskin resulting in small dentsLipoatrophy may be caused byrepeated injections of insulin inthe same spot
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
36
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
37
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
38
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
39
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
41
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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L lipodystrophy (LIP-oh-DISS-troh
fee) a defect in the breakingdown or building up of fat belowthe surface of the skin resultingin lumps or small dents in theskin surface Lipodystrophy maybe caused by repeated injections
of insulin in the same spot See lipoatrophy and lipohypertrophy
lipohypertrophy (LIP-oh-hy-PURtroh-fee) buildup of fat belowthe surface of the skin causinglumps Lipohypertrophy may becaused by repeated injections of
insulin in the same spot
liver an organ in the body thatchanges food into energyremoves alcohol and poisonsfrom the blood and makes bilea substance that breaks down fats
and helps rid the body of wastes
Liver
Liver
long-acting insulin (long-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 1 hour no peak
and a duration of 20 to 26 hoursSee insulin detemir and insulin
glargine
low blood glucose (loh) (bluhd)(GLOO-kohss) see hypoglycemia
low blood pressure see hypotension
low-density lipoprotein cholesterol
(LOH-DEN-sih-tee) (LIP-oh
PROH-teen) (koh-LESS-tur-ol)see LDL cholesterol
lymphatic vessels (lim-FAT-ik)(VESS-uhlz) thin tubes in thebody that carry white blood cellsand lymphatic fluid Lymphaticfluid has cells that fight
infection
35
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
36
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
37
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
38
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
39
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
41
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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M
macrosomia (MAK-roh-SOHmee-uh) abnormally large in diabetes refers to abnormallylarge babies that may be born to
women with diabetes
Macrosomia
macrovascular disease (MAK-rohVASS-kyoo-lur) (dih-ZEEZ)disease of the large blood vessels
such as those found in the heart Lipids and blood clots build
up in the large blood vesselsand can cause atherosclerosis
coronary heart disease stroke and peripheral arterial disease
macula (MAK-yoo-luh) the partof the retina in the eye used forreading and seeing fine detail
macular edema (MAK-yoo-lur)(eh-DEE-muh) swelling of the macula
maturity-onset diabetes of the
young (MODY) (muh-CHURih-tee-AWN-set) (DY-uh-BEEteez) (uhv) (thuh) (yuhng) a monogenic form of diabetes
that usually first occurs duringadolescence or early adulthood
meglitinide (meh-GLIH-tih-nyd)a type of oral medicine for type 2 diabetes that lowers blood
glucose by helping the pancreas
make more insulin right aftermeals (Generic nameBrandname repaglinidePrandin)
metabolic syndrome (MET-uhBOL-ik) (SIN-drohm) agrouping of health conditionsassociated with an increasedrisk for heart disease and type 2 diabetes Conditionsinclude hypertension a large
waist high triglyceride levelslow HDL cholesterol levels andabove-normal blood glucose
levels Metabolic syndrome waspreviously called Syndrome X
metabolism (meh-TAB-ohlizm) all of the chemical andphysical processes in the body
necessary for life Processesinclude breaking down food forenergy and producing neededsubstances
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
37
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
38
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
39
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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M
Metaglip (MET-uh-glip) thebrand name of an oral medicineused to treat type 2 diabetes acombination of glipizide and metformin
metformin (met-FOR-min) an
oral medicine used to treat type 2 diabetes Metforminlowers blood glucose by reducingthe amount of glucose producedby the liver and helping thebody respond better to theinsulin made in the pancreas
Metformin belongs to the class
of medicines called biguanides(Brand names Glucophage
Glucophage XR Riomet)
mgdL milligrams per deciliter(MIL-ih-gramz) (pur) (DESSih-lee-tur) a unit of measurethat shows the concentration of a
substance in a specific amount offluid In the United States blood
glucose test results are reportedas mgdL Medical journals andother countries use millimolesper liter (mmolL) To convertto mgdL from mmolL multiplymmolL by 18 Example
10 mmolL times 18 = 180 mgdLmicroalbumin (MY-kroh-al-BYOO
min) small amounts of the protein called albumin in the urine detectable with a speciallaboratory test See albumin
microaneurysm (MY-kroh-AN yoo-rizm) a small swelling thatforms on the side of tiny blood
vessels These small swellingsmay break and allow bloodto leak into nearby tissuePeople with diabetes may get
microaneurysms in the retina ofthe eye
Micronase (MY-kroh-nayz) see glyburide
microvascular disease (MY-krohVASS-kyoo-lur) (dih-ZEEZ)disease of the smallest blood
vessels such as those found inthe eyes nerves and kidneys
The walls of the vessels becomeabnormally thick but weakThen they bleed leak protein
and slow the flow of blood tothe cells
miglitol (MIG-lih-tol) an oralmedicine used to treat type 2
diabetes Miglitol slows downthe digestion of foods high in carbohydrate such as rice breadmilk and fruit The result is aslower and lower rise in blood
glucose after meals Miglitol
belongs to the class of medicinescalled alphaglucosidase inhibitors
(Brand name Glyset)
37
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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M
mixed dose a combination of twotypes of insulin in one injection
Usually a rapid or shortacting
insulin is combined with alonger-acting insulin to provideboth short- and long-termcontrol of blood glucose levels
mmolL millimoles per liter (MILih-mohlz) (pur) (LEE-tur) aunit of measure that shows theconcentration of a substance ina specific amount of fluid Inmost of the world except for theUnited States blood glucose test
results are reported as mmolLIn the United States milligramsper deciliter (mgdL) is used Toconvert to mmolL from mgdLdivide mgdL by 18 Example180 mgdL divide 18 = 10 mmolL
MODY (MOH-dee) see maturity
onset diabetes of the young
monitor see blood glucose meter
monofilament (MON-oh-FIL-uhment) a short piece of nylonlike a hairbrush bristle mountedon a wand To check sensitivityof the nerves in the foot thedoctor touches the filament tothe bottom of the foot
monogenic (MON-oh-JEN-ik)related to a single gene Somerare forms of diabetes aremonogenic including neonatal
diabetes mellitus and maturity
onset diabetes of the young
(MODY)
mononeuropathy (MON-ohnoo-ROP-uh-thee) a type of neuropathy affecting a singlenerve
myocardial infarction (MY-ohKAR-dee-uhl) (in-FARK-shuhn)see heart attack
38
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
39
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
41
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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N
NAFLD (EN-AY-EF-EL-DEE)see nonalcoholic fatty liver disease
NASH (nuhsh) see nonalcoholic
steatohepatitis
nateglinide (nuh-TEG-lih-nyd)an oral medicine used to treat type 2 diabetes Nateglinidelowers blood glucose levels byhelping the pancreas makemore insulin right after mealsNateglinide belongs to theclass of medicines called Dphenylalanine derivatives
(Brand name Starlix)
NDM see neonatal diabetes mellitus
necrobiosis lipoidica diabeticorum
(NEK-roh-by-OH-siss) (lihPOY-dih-kuh) (DY-uh-bet-ihKOR-uhm) a skin conditionusually on the lower part of the
legs Lesions can be small orextend over a large area Theyare usually raised yellow and
waxy in appearance and oftenhave a purple border
neonatal diabetes mellitus (NDM)
(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life In about half of those
with NDM the condition islifelong and is called permanent
neonatal diabetes mellitus (PNDM)
In the rest of those with NDMthe condition is transient anddisappears during infancy butcan reappear later in life thistype of NDM is called transient
neonatal diabetes mellitus
(TNDM)
neotame (NEE-oh-taym) a dietarysweetener with no calories andno nutritional value
neovascularization (NEE-ohVASS-kyoo-lar-ih-ZAY-shuhn)the growth of new small blood
vessels In the retina this maylead to vision loss or blindness
nephrologist (neh-FROL-uh-jist)a doctor who treats people whohave kidney problems
nephropathy (neh-FROP-uhthee) disease of the kidneys
Hyperglycemia and hypertensioncan damage the kidneysrsquo glomeruli When the kidneysare damaged protein leaks outof the kidneys into the urine
Damaged kidneys can no longerremove wastes and extra fluidfrom the bloodstream
nerve conduction studies testsused to measure for nervedamage one way to diagnose neuropathy
nerve disease see neuropathy
39
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
41
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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N
neurogenic bladder (NOO-rohJEN-ik) (BLAD-ur) lossof bladder control caused bydamage to the nerves controllingthe bladder
neurologist (noo-ROL-uh-jist)
a doctor who specializes inproblems of the nervous systemsuch as neuropathy
neuropathy (noo-ROP-uhthee) disease of the nervoussystem The three major formsin people with diabetes are peripheral neuropathy autonomic
neuropathy and mononeuropathy
The most common form isperipheral neuropathy whichaffects the legs and feet
NIDDM (EN-EYE-DEEDEE-EM) see noninsulin-
dependent diabetes mellitus
nonalcoholic fatty liver disease
(NAFLD) (NON-al-kohHOL-ik) (FAT-ee) (LIV-ur)(dih-ZEEZ) fat in the liver
NAFLD can lead to nonalcoholic
steatohepatitis (NASH) and chronic liver disease NAFLD
can be a complication of insulin resistance and diabetes
nonalcoholic steatohepatitis
(NASH) (NON-al-koh-HOL-ik)(STEE-uh-toh-HEP-uh-TYtiss) a common liver diseaseoften without symptoms thatresembles alcoholic liver diseasebut occurs in people who
drink little or no alcohol Themajor characteristic of NASHis fat in the liver along withinflammation and damageNASH can be a complication ofinsulin resistance and diabetes
noninsulin-dependent diabetes
mellitus (NIDDM) (NON-INsuh-lin-duh-PEN-dent) (DY-uhBEE-teez) (MEH-luh-tuhss)former term for type 2 diabetes
noninvasive blood glucose
monitoring (NON-in-VAY-siv)(bluhd) (GLOO-kohss) (MON
ih-TUR-ing) measuring blood
glucose without pricking thefinger to obtain a blood sample
40
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
41
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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NndashNovolin 7030 (NOH-voh-lin)see premixed insulin
Novolin N (NOH-voh-lin)see NPH insulin
Novolin R (NOH-voh-lin)see regular insulin
NovoLog (NOH-voh-lawg)see insulin aspart
NovoLog Mix 7030 (NOH-vohlawg) (mix) see premixed
insulin
NPH insulin (EN-PEE-AYCH)
(IN-suh-lin) an intermediate-acting insulin with an onset of1 to 3 hours a peak at 8 hoursand a duration of 12 to 16 hours
Also called N insulin (Brandnames Humulin N Novolin N)
nutritionist (noo-TRISH-uh
nist) a person with trainingin nutrition may or may nothave specialized training andqualifications See dietitian
O
obesity (oh-BEE-sih-tee) acondition in which a greaterthan normal amount of fat isin the body more severe than overweight having a body mass
index of 30 or more
obstetrician (OB-stuh-TRISH-uhn)a doctor who treats pregnant
women and delivers babies
OGTT see oral glucose tolerance
test
onset in referring to insulin howsoon the insulin starts to lower
blood glucose levels after it istaken Onset may also refer tothe time when a personrsquos diabetes
began
ophthalmologist (AHF-thal-MOLuh-jist) a medical doctor whodiagnoses and treats all eye
diseases and eye disordersOphthalmologists can alsoprescribe glasses and contactlenses
Ophthalmologist
41
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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42
optician (op-TISH-uhn) a healthcare professional who dispensesglasses and lenses An opticianalso makes and fits contactlenses
optometrist (op-TOM-uh-trist) a
primary eye care provider whoprescribes glasses and contactlenses Optometrists candiagnose and treat certain eyeconditions and diseases
oral glucose tolerance test (OGTT) (OR-uhl) (GLOO-kohss)(TOL-ur-uhnss) (test) a test todiagnose prediabetes and diabetes The oral glucose tolerancetest is given by a health careprofessional after an overnightfast A blood sample is takenand then the patient drinks ahigh- glucose beverage Blood
samples are taken at hourlyintervals for 2 to 3 hours Testresults are compared with astandard and show how the bodyuses glucose over time
oral hypoglycemic agents (OR-uhl) (HY-poh-gly-SEE-mik) (AY-jents) medicinestaken by mouth by people
with type 2 diabetes to keep blood glucose levels as close tonormal as possible Types of
oral hypoglycemic agents are alpha-glucosidase inhibitors
biguanides D-phenylalanine
derivatives DPP-4 inhibitors
meglitinides sulfonylureas and thiazolidinediones
overweight an above-normal body
weight having a body mass indexof 25 to 29
O
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
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short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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P
PAD (PEE-AY-DEE) see
peripheral arterial disease
pancreas (PAN-kree-uhss) anorgan that makes insulin and enzymes for digestion Thepancreas is located behind the
lower part of the stomach and isabout the size of a hand
Pancreas
Pancreas
pancreas transplantation (PANkree-uhss) (TRANZ-plan-TAYshuhn) a surgical procedure totake a healthy whole or partial pancreas from a donor and placeit into a person with diabetes
pancreatitis (PAN-kree-uh-TYtiss) an irritation of the pancreas that can cause it tostop working Pancreatitis canbe acute or chronic Diabetes
may develop when pancreatictissue is destroyed from chronic
pancreatitis and the insulin-producing cells of the pancreascalled beta cells have beendamaged Pancreatitis can alsooccur as a side effect of thediabetes medication exenatide
(Byetta)
PCOS (PEE-SEE-OH-ESS) see polycystic ovary syndrome
peak in referring to insulin speedsthe length of time the insulin is
working hardest to lower blood
glucose levels
pediatric endocrinologist (PEE
dee-AT-rik) (en-doh-krih-NAHluh-jist) a doctor who treatschildren who have endocrine
gland problems such as diabetes
pedorthist (ped-OR-thist) a healthcare professional who specializesin fitting shoes for people with
disabilities or deformities Apedorthist can custom-makeshoes or orthotics (special insertsfor shoes)
43
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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P
pen injector (pen) (in-JEK-tur)a penlike device for injectinginsulin contains a needle and acartridge of insulin
periodontal disease (PAIR-ee-ohDON-tuhl) (dih-ZEEZ) disease
of the gumsperiodontist (PAIR-ee-oh-DON
tist) a dentist who specializesin treating people who have gumdiseases
peripheral arterial disease (PAD)
(puh-RIF-ur-uhl) (ar-TEE
ree-uhl) (dih-ZEEZ) alsocalled peripheral vascular
disease a condition in whichthe large blood vessels of thelegs are narrowed or blockedby fatty deposits decreasingblood flow to the legs and feetPAD increases the chances of
amputation heart attack and stroke
peripheral neuropathy (puh-RIFur-uhl) (noo-ROP-uh-thee)nerve damage that affects thefeet legs or hands Peripheralneuropathy causes pain
numbness or a tingling feelingperipheral vascular disease (PVD)
(puh-RIF-ur-uhl) (VASS-kyoolur) (dih-ZEEZ) see peripheral
arterial disease
peritoneal dialysis (PAIR-ih-tohNEE-uhl) (dy-AL-ih-siss) see dialysis
permanent neonatal diabetes
mellitus (PNDM) (PUR-muhnent) (NEE-oh-NAY-tuhl)
(DY-uh-BEE-teez) (MEH-luhtuhss) a rare monogenic formof diabetes that first occurs inthe first 6 months of life and is apermanent condition
pharmacist (FAR-muh-sist) ahealth care professional whoprepares and distributesmedicine to people Pharmacistsalso give information aboutmedicines
Pharmacist
44
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P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
8122019 Dictionary 508
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 4964
P
photocoagulation (FOH-tohkoh-AG-yoo-LAY-shuhn) atreatment for diabetic retinopathy
A lasermdasha strong beam oflightmdashis used to seal off bleeding blood vessels in the eye and toburn away extra blood vessels
that should not have grownthere
pioglitazone (py-oh-GLIH-tuhzohn) an oral medicine used totreat type 2 diabetes Pioglitazonehelps treat insulin resistance thecondition in which your body
doesnrsquot use insulin the way itshould Pioglitazone belongsto the class of medicines called thiazolidinediones (Brand name Actos)
PNDM see permanent neonatal
diabetes mellitus
podiatrist (poh-DY-uh-trist) adoctor who treats people whohave foot problems Podiatristsalso help people keep their feethealthy by providing regular footexaminations and treatment
podiatry (poh-DY-uh-tree) the
care and treatment of feetpoint system a meal-planning
system that uses points to ratethe caloric content of foods
polycystic ovary syndrome (PCOS)
(POL-ee-SISS-tik) (OH-vuhree) (SIN-drohm) a conditionin which women have high levelsof male hormones increasingthe risk of irregular or absentmenstrual cycles infertility
obesity ovarian cysts heartdisease and diabetes PCOS isassociated with insulin resistance
polydipsia (POL-ee-DIP-see-uh)excessive thirst may be a sign of diabetes
polyphagia (POL-ee-FAY-jee-uh)excessive hunger may be a signof diabetes
polyuria (POL-ee-YOO-ree-uh)excessive urination may be asign of diabetes
postprandial blood glucose
(pohst-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level 1 to 2 hours aftereating
pramlintide acetate (PRAMlin-tyd) (ASS-ih-tayt) aninjectable medicine used totreat diabetes Pramlintide helpsfood move more slowly throughthe stomach and helps keepthe liver from releasing stored glucose Pramlintide belongsto the class of medicines called amylin mimetics (Brand name Symlin)
45
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46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
8122019 Dictionary 508
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
8122019 Dictionary 508
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5064
46
Prandin (PRAN-din) see repaglinide
Precose (PREE-kohss) see acarbose
prediabetes (PREE-dy-uh-BEE-teez) a condition in which blood
glucose levels are higher thannormal but are not high enoughfor a diagnosis of diabetes People with prediabetes are atincreased risk for developing type 2 diabetes heart diseaseand stroke Other names forprediabetes are impaired glucose
tolerance and impaired fasting
glucose
pre-mixed insulin (PREE-MIKSD)(IN-suh-lin) a commerciallyproduced combination oftwo different types of insulin Several types are available
983150 Pre-mixed NPH and regular
insulin
bull 70 percent NPH and30 percent regular (Brandnames Humulin 7030 Novolin 7030 )
bull 50 percent NPH and50 percent regular (Brandname Humulin 5050 )
983150 Pre-mixed insulin lispro suspension and insulin lispro
bull 75 percent insulin lisproprotamine and 25 percentinsulin lispro (Brand name Humalog Mix 7525 )
bull 50 percent insulin lisproprotamine and 50 percentinsulin lispro (Brand name Humalog Mix 5050 )
983150 Pre-mixed insulin aspart
protamine suspension andinsulin aspart
bull 70 percent insulin aspartprotamine and 30 percentinsulin aspart (Brand name NovoLog Mix 7030 )
preprandial blood glucose (pree-PRAN-dee-uhl) (bluhd)(GLOO-kohss) the blood
glucose level before eating
prevalence (PREV-uh-luhnss) the number of people in a givengroup or population who arereported to have a disease
P
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
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WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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Notes
58
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National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
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US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
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P
proinsulin (proh-IN-suh-lin)the substance made first in the pancreas and then broken intoseveral pieces to become insulin
proliferative retinopathy (prohLIF-ur-uh-tiv) (RET-ih-NOP
uh-thee) a condition in whichfragile new blood vessels growalong the retina and in the vitreous humor of the eye
prosthesis (pross-THEE-siss)a man-made substitute for amissing body part such as an armor a leg
protein (PROH-teen) 1 one ofthe three main nutrientsin food Foods that provideprotein include meat poultryfish cheese milk dairy products eggs and dried beans2 proteins are also used in the
body for cell structure hormonessuch as insulin and otherfunctions
Sources of protein
47
proteinuria (proh-teen-YOOree-uh) a condition in whichthe urine contains large amountsof protein a sign that the kidneys
are not working properly
proximal neuropathy (PROK-sih
muhl) (noo-ROP-uh-thee) atype of neuropathy that causespain in the thighs hips orbuttocks and leads to weaknessin the legs
pump see insulin pump
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R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
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httpslidepdfcomreaderfulldictionary-508 5464
S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
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S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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httpslidepdfcomreaderfulldictionary-508 5664
T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
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T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
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httpslidepdfcomreaderfulldictionary-508 5864
U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
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V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6064
WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
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httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5264
R
rapid-acting insulin (RA-pid-AKting) (IN-suh-lin) a type ofinsulin with an onset of15 minutes a peak at 30 to90 minutes and a duration of3 to 5 hours See insulin aspart
insulin glulisine and insulin
lispro
rebound hyperglycemia (REEbound) (HY-pur-gly-SEEmee-uh) see Somogyi effect
receptors (ree-SEP-turz) seeinsulin receptors
Recognized Diabetes EducationPrograms (REH-kig-NYZD)(DY-uh-BEE-teez) (EH-juhKAY-shuhn) (PROH-gramz) diabetes selfmanagement
education programs that areapproved by the AmericanDiabetes Association
regular insulin (REH-gyuh-lur)(IN-suh-lin) a short-actinginsulin with an onset of 30 to60 minutes a peak of 2 to 4 hoursand a duration of 5 to 8 hours
Also called R insulin (Brandnames Humulin R Novolin R)
renal (REE-nuhl) of or relating tothe kidneys A renal disease isa disease of the kidneys Renalfailure means the kidneys havestopped working
renal threshold of glucose (REE
nuhl) (THRESH-ohld) (uhv)(GLOO-kohss) the blood
glucose concentration at whichthe kidneys start to excrete glucose into the urine
repaglinide (ruh-PAG-luh-nyd)an oral medicine used to treat type 2 diabetes Repaglinidelowers blood glucose by helpingthe pancreas make more insulin
right after meals Repaglinidebelongs to the class of medicinescalled meglitinides (Brandname Prandin)
retina (RET-ih-nuh) the light-
sensitive layer of tissue thatlines the back of the eye
retinal hemorrhages (RET-ih-nuhl)(HEM-uh-ruhj-ez) bleeding blood vessels in the retina whichcan cause protein deposits orexudates in the retina Laser
surgery is required to preventblindness Retinal hemorrhageis a common form of diabetic
retinopathy
48
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RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5464
S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5564
S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
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T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5764
T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5864
U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5964
V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6064
WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5364
RndashS
retinopathy (RET-ih-NOPuh-thee) see background
retinopathy proliferative
retinopathy and diabetic
retinopathy
R insulin (AR) (IN-suh-lin) see
regular insulin
Riomet (RY-oh-met) see metformin
risk factor anything that raises thechances of a person developing adisease
rosiglitazone (rohss-ih-GLIHtuh-zohn) an oral medicineused to treat type 2 diabetes
Rosiglitazone helps treat insulin
resistance the condition in which your body doesnrsquot use insulin
the way it should Rosiglitazonebelongs to the class of medicines
called thiazolidinediones (Brandname Avandia)
saccharin (SAK-uh-rin) a dietarysweetener with no calories andno nutritional value
saturated fat a type of dietary fat that can increase the riskof heart disease Saturated fat
is found in meat poultry skinbutter lard shortening and allmilk and dairy products exceptfat-free versions
secondary diabetes (SEK-uhn-DAIR-ee) (DY-uh-BEE-teez)a type of diabetes caused byanother disease or certain drugsor chemicals
self-management the ongoingprocess of managing diabetes
Includes meal planning plannedphysical activity blood glucose
monitoring taking diabetesmedicines handling episodes of
illness and of low blood glucoseand high blood glucose managingdiabetes when traveling andmore The person with diabetesdesigns his or her own self-management treatment plan inconsultation with a variety ofhealth care professionals such
as doctors nurses dietitians pharmacists and others
sharps container a container forthe disposal of used needlesand syringes often made ofhard plastic so needles cannotpenetrate the container
49
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5464
S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5564
S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5664
T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5764
T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5864
U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5964
V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6064
WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5464
S
short-acting insulin (short-AK-ting)(IN-suh-lin) a type of insulin
with an onset of 30 to 60 minutesa peak at 2 to 4 hours and a duration of 5 to 8 hours See regular insulin
side effects the unintendedaction(s) of a drug
sitagliptin phosphate (sih-tuhGLIP-tin) (FOSS-fayt) an oralmedicine used to treat type 2
diabetes Sitagliptin lowers blood
glucose by helping the body makemore insulin when itrsquos neededIt also helps keep the liver fromputting stored glucose into theblood Sitagliptin belongs tothe class of medicines called DPP4 inhibitors (Brand name Januvia)
sliding scale a set of instructions
for adjusting insulin on the basisof blood glucose test resultsmeals or activity levels
Somogyi effect (soh-MOH jee) (uh-FEKT) when the blood glucose level swings highfollowing low blood glucose or
hypoglycemia The Somogyieffect may follow an untreatedhypoglycemic episode duringthe night and is caused by therelease of stress hormones Alsocalled rebound hyperglycemia
sorbitol (SOR-bih-tol) 1 a sugar
alcohol mdasha sweetenermdashwith4 calories per gram 2 asubstance produced by thebody in people with diabetes
that can cause damage to theeyes and nerves
split mixed dose division of aprescribed daily dose of insulin
into two or more injections givenover the course of the day
starch another name for carbohydrate one of the threemain nutrients in food
Starlix (STAR-liks) see nateglinide
stroke a condition in which theblood supply to the brain issuddenly cut off caused by ablockage or the bursting ofa blood vessel in the brain or
neck Then brain tissue can bedamaged A stroke can causea person to lose the ability tospeak or move parts of the body
subcutaneous injection (SUHBkyoo-TAY-nee-uhss) (in-JEKshuhn) putting a fluid intothe tissue under the skin with aneedle and syringe
sucralose (SOO-kruh-LOHSS) adietary sweetener made from sugar but with no calories and nonutritional value
50
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5564
S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5664
T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5764
T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5864
U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5964
V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6064
WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5564
S
sucrose (SOO-krohss) a two-part sugar made of glucose and fructose Known as table sugar or white sugar it is found naturallyin sugar cane and beets
sugar 1 a class of carbohydrates
with a sweet taste includes glucose fructose and sucrose
2 a term used to refer to blood
glucose
sugar alcohols sweeteners thatproduce a smaller rise in blood
glucose than other carbohydrates
Their calorie content is about2 calories per gram Includeserythritol hydrogenated starchhydrolysates isomalt lactitolmaltitol mannitol sorbitol and xylitol Also known as polyols
sugar diabetes (SHU-gur) (DY-uhBEE-teez) former term for
diabetes mellitus
sulfonylurea (SUHL-foh-nil yoo-REE-uh) a class of oralmedicine for type 2 diabetes
that lowers blood glucose byhelping the pancreas make moreinsulin and by helping the body
better use the insulin it makes(Generic namesBrand names chlorpropamideDiabinese
glimepirideAmaryl glipizide
Glucotrol Glucotrol XL glyburide
DiaBeta Glynase PresTab
Micronase tolazamide [genericonly] tolbutamide [generic only])
Sunett (SOO-net) see acesulfame
potassium
Symlin (SIM-lin) see pramlintide
acetate
Syndrome X see insulin resistance
and metabolic syndrome
syringe (suh-RINJ) a device usedto inject medications or otherliquids into body tissues Thesyringe for insulin has a hollowplastic tube with a plunger insideand a needle on the end
Syringe
systolic pressure (siss-TOL-ik)(PRESH-ur) the blood pressure
when the heart pushes blood outinto the arteries
51
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5664
T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5764
T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5864
U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5964
V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6064
WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5664
T
team management a diabetes
treatment approach in whichmedical care is provided by ateam of health care professionalsincluding a doctor dietitian
nurse diabetes educator andothers The team provides
information and advises theperson with diabetes
thiazolidinedione (THY-uhZOHL-ih-deen-DY-ohn) aclass of oral medicine for type 2
diabetes that helps insulin take glucose from the blood into
the cells for energy by makingcells more sensitive to insulin(Generic namesBrand names pioglitazoneActos rosiglitazone
Avandia)
TIA (TEE-EYE-AY) see transient
ischemic attack
tight control see intensive therapy
tinea pedis (TIN-ee-uh) (PEEdiss) see athletersquos foot
TNDM see transient neonatal
diabetes mellitus
tolazamide (tol-AZ-uh-myd)
an oral medicine used to treat type 2 diabetes Tolazamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makesTolazamide belongs to the classof medicines called sulfonylureas
(Available only in generic form) 52
tolbutamide (tol-BYOO-tuh-myd)an oral medicine used to treat type 2 diabetes Tolbutamidelowers blood glucose by helpingthe pancreas make moreinsulin and by helping the bodybetter use the insulin it makes
Tolbutamide belongs to the classof medicines called sulfonylureas
(Available only in generic form)
trans fat a type of dietary fat
that increases the risk of heartdisease Trans fat is produced
when liquid oils are turned
into solids through a processcalled hydrogenation Foods
with trans fat include thoselisting hydrogenated or partiallyhydrogenated fat on thelabel such as crackers snackfoods commercially producedbaked goods and some stick
margarines
transient ischemic attack (TIA)
(TRANZ-see-uhnt) (iss-KEEmik) (uh-TAK) a condition in
which blood flow to the brain istemporarily blocked TIAs cancause temporary weakness or
numbness sudden confusiondizziness vision problems orsevere headache
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5764
T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5864
U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5964
V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6064
WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5764
T
transient neonatal diabetes mellitus
(TNDM) (TRANZ-see-uhnt)(NEE-oh-NAY-tuhl) (DY-uhBEE-teez) (MEH-luh-tuhss) arare monogenic form of diabetes
that occurs in the first 6 monthsof life TNDM disappears
during infancy but can reappearlater in life
transplant (TRANZ-plant)replacement of a damaged ordiseased organ with a healthyone
triglyceride (try-GLISS-ur-eyed)the storage form of fat in thebody High triglyceride levelsmay occur when diabetes is outof control
type 1 diabetes (typ) (whuhn)(DY-uh-BEE-teez) a conditioncharacterized by high blood
glucose levels caused by a totallack of insulin Occurs whenthe bodyrsquos immune system attacksthe insulin-producing beta cells
in the pancreas and destroysthem The pancreas thenproduces little or no insulinType 1 diabetes develops most
often in young people but canappear in adults
type 2 diabetes (typ) (too) (DY-uhBEE-teez) a conditioncharacterized by high blood
glucose levels caused by eithera lack of insulin or the bodyrsquosinability to use insulin efficientlyType 2 diabetes develops most
often in middle-aged andolder adults but can appearin children teens and youngpeople
type I diabetes (typ) (whuhn)(DY-uh-BEE-teez) formerterm for type 1 diabetes
type II diabetes (typ) (too) (DY-uhBEE-teez) former term for type 2 diabetes
53
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5864
U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5964
V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6064
WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5864
U
U-100 (YOO-whuhn-HUHN-dred)see unit of insulin
UKPDS see United Kingdom
Prospective Diabetes Study
ulcer (UHL-sur) a deep opensore or break in the skin
United Kingdom Prospective
Diabetes Study (UKPDS)
(yoo-NY-ted) (KING-duhm)(pruh-SPEK-tiv) (STUHD-ee)a British study conducted from1977 to 1997 in people with type 2 diabetes The study
showed that if people loweredtheir blood glucose they loweredtheir risk of eye disease and kidney damage In additionthose with type 2 diabetes and hypertension who lowered their blood pressure also reducedtheir risk of stroke eye damage
and death from long-term complications
unit of insulin (YOO-nit) (uhv)(IN-suh-lin) the basic measureof insulin U100 insulin means100 units of insulin per milliliter(mL) or cubic centimeter (cc)
of solution Most insulin madetoday in the United States isU-100
urea (yoo-REE-uh) a wasteproduct found in the bloodthat results from the normal
breakdown of protein in the liver
Urea is normally removed fromthe blood by the kidneys andthen excreted in the urine
uremia (yoo-REE-mee-uh) theillness associated with the
buildup of urea in the bloodbecause the kidneys are not
working effectively Symptomsinclude nausea vomiting loss ofappetite weakness and mentalconfusion
urinalysis (YOOR-ih-NAL-ih-siss)a test of a urine sample that canreveal many problems of theurinary tract and other bodysystems The sample may beobserved for color cloudinessconcentration signs of drug usechemical composition including glucose the presence of protein
blood cells or germs or othersigns of disease
urine (YOOR-in) liquid wasteproduct filtered from the bloodby the kidneys stored in thebladder and expelled from thebody by the act of urinating
urologist (yoo-ROL-uh-jist) adoctor who treats people whohave urinary tract problems
A urologist also cares for men who have problems with theirgenital organs such as erectile
dysfunction
54
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5964
V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6064
WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 5964
V
vaginal yeast (VAJ-ih-nuhl) (yeest)see Candida
vascular (VASS-kyoo-lur) relatingto the bodyrsquos blood vessels
Vascular system
vein (vayn) a blood vessel thatcarries blood to the heart
very-low-density lipoprotein
(VLDL) cholesterol (VAIR
ee-loh-DEN-sih-tee) (LIP-ohPROH-teen) (koh-LESS-tur-ol)see VLDL cholesterol
vitrectomy (vih-TREK-tuh-mee)surgery to restore sight in whichthe surgeon removes the cloudy vitreous humor in the eye andreplaces it with a salt solution
vitreous humor (VIT-ree-uhss)
(HYOO-mur) the clear gel thatlies behind the eyersquos lens and infront of the retina
VLDL cholesterol (VEE-ELDEE-EL) (koh-LESS-tur-ol)stands for very-low-densitylipoprotein cholesterol A formof cholesterol in the bloodHigh levels may be related to cardiovascular disease
void (voyd) to urinate to emptythe bladder
55
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6064
WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6064
WndashX
wound care steps taken to ensure a wound such as a foot ulcer healscorrectly People with diabetes
need to take special precautionsso wounds do not becomeinfected
xylitol (ZY-lih-tol) a carbohydratebased sweetener found in plantsand used as a substitute for sugar provides calories Foundin some mints and chewing gum
56
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6164
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6264
Notes
58
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6364
National Diabetes
Information Clearinghouse
1 Information WayBethesda MD 20892ndash3560Phone 1ndash800ndash860ndash8747TTY 1ndash866ndash569ndash1162Fax 703ndash738ndash4929Email ndicinfoniddknihgov Internet wwwdiabetesniddknihgov
The National Diabetes Information Clearinghouse (NDIC) is a serviceof the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) The NIDDK is part of the National Institutes of Healthof the US Department of Health and Human Services Establishedin 1978 the Clearinghouse provides information about diabetes topeople with diabetes and to their families health care professionalsand the public The NDIC answers inquiries develops and distributes
publications and works closely with professional and patientorganizations and Government agencies to coordinate resources aboutdiabetes
Publications produced by the Clearinghouse are carefully reviewed byboth NIDDK scientists and outside experts
This publication is not copyrighted The Clearinghouse encouragesusers of this publication to duplicate and distribute as many copies asdesired
This publication is available at wwwdiabetesniddknihgov
This publication may contain information about medications Whenprepared this publication included the most current information availableFor updates or for questions about any medications contact the US Foodand Drug Administration toll-free at 1ndash888ndashINFOndashFDA (1ndash888ndash463ndash6332)or visit wwwfdagov Consult your doctor for more information
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
8122019 Dictionary 508
httpslidepdfcomreaderfulldictionary-508 6464
US DEPARTMENT OF HEALTH
AND HUMAN SERVICES
Recommended