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Glossary

This glossary aims to provide accurate definitions of key terms. Words in italics have their own explanations. If you feel there are terms that should be added to the glossary, please send an e-mail to info@excemed.org with your suggestion.

Click one of the letters above to advance the page to terms beginning with that letter.

5

50/50 insulin search for term

Premixed insulin formulation that comprises 50% of an intermediate-acting insulin and 50% of a short- or rapid-acting insulin

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A

Acanthosis nigricans search for term

Patches of darkened skin observed in some people with insulin resistance, pre-diabetes or type 2 diabetes mellitus

Acarbose search for term

Oral treatment for type 2 diabetes of the class called alpha-glucosidase inhibitors. Blocks enzymes that digest starch (carbohydrate), thereby slowing the time to postprandial blood glucose peak, and also lowering that peak

ACEi search for term

Angiotensin-converting enzyme inhibitors; oral antihypertensive treatments that prevent the synthesis of angiotensin II, thus allowing constricted blood vessels to expand and thereby lowering BP. ACEi therapy may help to reduce the progression of renal damage in diabetic patients with proteinuria

Acetohexamide search for term

Oral treatment for type 2 diabetes of the class called sulphonylureas. Reduces blood glucose by increasing the production of insulin in beta cells in the pancreas and also improving how insulin is used. Acetohexamide is not used in all countries

Acidosis search for term
Adherence search for term

Describes how patients follow (or have steady observance of) any therapeutic regimen agreed between themselves and their healthcare practitioners.

Adhesive capsulitis search for term

Commonly known as ‘frozen shoulder’. Common musculoskeletal condition that is substantially more common in people with diabetes than nondiabetics. This painful, restrictive condition limits the range of movement and causes substantial discomfort in the shoulder joint. It has been proposed that the incidence of frozen shoulder is heightened in people with diabetes because circulatory problems may result in abnormal collagen repair; in addition, factors such as microvascular disease, inflammation and heightened infection risk may speed up the degenerative process in the shoulder joint

AGEs search for term

Advanced glycosylation end-products, which are produced when glucose links with protein. AGEs contribute to blood-vessel damage

Albuminuria search for term

Excess of albumin in the urine that may indicate diabetic nephropathy; albuminuria affects nearly half of all people with a ≥10-year history of type 1 diabetes. In addition, small quantities of protein (microalbuminuria) may be present on diagnosis in people with type 2 diabetes mellitus (either due to damage caused by undiagnosed diabetes or due to the effects of concomitant cardiovascular disease, e.g. hypertension)

Aldosterone search for term

Hormone secreted by the adrenal gland to signal the kidneys to conserve sodium and water, which raises blood pressure.

Alpha cells search for term

Found in the islets of Langerhans, within the pancreas, alpha cells make and secrete the hormone glucagon when blood glucose levels are low; glucagon travels to the liver and releases glucose to provide energy

Alpha-glucosidase inhibitor search for term

Class of oral treatment for type 2 diabetes mellitus. Blocks enzymes that digest starch (carbohydrate), thereby slowing the time to postprandial blood glucose peak, and also lowering that peak.

Ambulatory blood pressure monitoring (ABPM) search for term

Ambulatory blood pressure monitoring, usually undertaken continuously for 24 h

Amylin search for term

Hormone made in the pancreas by beta cells that slows gastric emptying and thereby regulates the release of glucose into the bloodstream

Angioplasty (balloon) search for term

Cardiac catheterization procedure involving the inflation of a small balloon while the catheter is in situ in the artery, to increase blood flow and expand narrowed arterial tissue.

Angiotensin II search for term

Chemical that causes vasoconstriction, which may lead to elevations in BP.

Angiotensin receptor blocker (ARB) search for term

A class of oral antihypertensive medication

Antibodies search for term

Proteins that protect the body from pathogenic effects of foreign substances (e.g. viruses, bacteria); in people with conditions that have an autoimmune-mediated component, such as type 1 diabetes mellitus, antibodies are produced that may destroy beta cells (which produce insulin in the pancreas)

Arteriosclerosis search for term

Hardening of the arteries

Aspart insulin search for term

Fast-acting insulin analogue that lowers blood glucose. When injected subcutaneously in the abdominal wall, the onset of action will occur within 10–20 minutes after injection. The maximum effect is observed between 1 and 3 hours and the duration is 3–5 hours

Atherosclerosis search for term

Fat deposits that build up in arteries, leading to arterial wall stiffening and fat plaques that restrict or block arterial blood flow.

Autoimmune disease/disorder search for term

Condition in which the immune system attacks and destroys body tissue that it incorrectly believes to be pathogenic/foreign

Autonomic neuropathy search for term

Neuropathic condition that affects organs including the genitals, bladder, intestines and heart. A serious but relatively common complication of diabetes mellitus

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B

Background retinopathy search for term

Retinal damage that is an early sign of diabetic retinopathy. Indicated by bleeding, fluid accumulation and abnormal blood-vessel dilatation. Also known as simple (nonproliferative) retinopathy.

Basal rate search for term

Steady infusion of longer-acting insulin, delivered by insulin pump over a 24-h period, to maintain a constant presence of insulin in the bloodstream in patients with diabetes mellitus

Basal secretion search for term

Also called basal insulin. Small quantity of insulin that is constantly present in the bloodstream in nondiabetic people

Beta blocker search for term

Oral treatment for people with hypertension that blocks the effects of adrenaline and reduces stress on cardiac tissue, thus reducing the workload on the heart and thereby lowering BP.

Beta cells search for term

Insulin-producing cells located in the islets of Langerhans in the pancreas

Biguanide search for term

Oral treatment for type 2 diabetes mellitus that helps to lower the blood glucose level by reducing glucose production in the liver and improving the physiological response to insulin secretion by the pancreas

Blood glucose search for term

The primary source of energy; also called blood sugar

Blood glucose level search for term

The quantity of glucose in a sample of blood, measured in milligrams per decilitre (mg/dl)

Blood glucose meter search for term

Discrete, portable electronic machine that people with diabetes use to monitor blood glucose on a daily basis. The user pricks the skin with a lancet to obtain a one-drop blood sample, which is placed directly on a test strip that is read by the machine; the blood glucose level is displayed numerically on a screen

Blood glucose monitoring search for term

Regular monitoring of the blood glucose level; a long-established aspect of daily diabetes management for patients with type 1 or type 2 diabetes mellitus; undertaken using test strips that change colour to give a visual indication of the blood glucose level; can be undertaken with a blood glucose meter

Blood sugar search for term
Blood sugar level search for term
Blood urea nitrogen (BUN) search for term

Analytical test to determine kidney function, by measuring levels of waste products that are produced following the breakdown of protein. With decreasing kidney function, the filtration of blood is impaired and the BUN level increases

Borderline diabetes search for term
Brittle diabetes search for term

Description of a situation when there are frequent fluctuations in the patient’s blood glucose level, from low to high, and high to low

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C

C-peptide search for term

Connecting peptide; substance released into the bloodstream by the pancreas, in equimolar quantities to insulin; testing the C-peptide level indicates the level of insulin production in the pancreas

Calcium channel blockers search for term

Class of antihypertensive treatment that reduces movement of calcium into arterial vessel walls and cardiac cells, thereby leading to arterial relaxation and reducing blood-vessel pressure.

Calorie search for term

Unit of measurement representing the energy provided by foods; carbohydrates and proteins contain 4 calories/g, alcohol has 7 calories/g and fat has 9 calories/g

Capillary search for term

The smallest type of blood vessel. Capillaries are important for the passage of oxygen and glucose between the bloodstream and the cells, and also for the passage of carbon dioxide and other waste products from cells into the bloodstream

Capsaicin search for term

Active ingredient in hot peppers that is included in topical preparations to relieve diabetic neuropathic pain

Carbohydrate search for term

Key nutrient found in starchy or sugary foods

Carbohydrate counting search for term

Dietetic method of meal planning, suitable for people with diabetes, in which the number of grams of carbohydrate in the food being served are counted

CHF search for term

Congestive heart failure; condition that describes inadequacies in the circulation of blood through the heart.

Chlorpropamide search for term

Oral treatment for type 2 diabetes mellitus in the class known as sulphonylureas; reduces the blood glucose level by augmenting insulin production and improving how the body uses the insulin that it produces

Cholesterol search for term

Type of fat produced in hepatic cells and found in certain foods; circulates in the bloodstream and is important for hormone synthesis and cellular development

Combination therapy search for term

Treatment strategy in which different types of medicine are used together to manage blood glucose levels in patients with type 2 diabetes mellitus; examples include the use of two or three different oral hypoglycaemic drugs, or the use of oral hypoglycaemic agents together with injected insulin

Compliance search for term

Describes how patients follow a treatment regimen in accordance with the advice given to them by their health care professional. Thus, people comply well or badly with things such as medication (e.g. taking the right tablets in the right numbers at the right times), or special diets (e.g. eating the right foods in the right amounts and avoiding other foods, etc.).

Creatinine search for term

Waste product originating from dietary protein and muscles that is removed from the bloodstream and excreted by the kidneys. Creatinine levels increase in the blood in people with kidney disease, with higher levels indicating more severe renal dysfunction

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D

DALY search for term

Disability-adjusted life year. The number of years of potential life lost because of ill health, disability or early death. DALYs are a measure of overall disease burden.

Dawn phenomenon search for term

Phenomenon recognised in people with diabetes mellitus in which a rise in blood glucose is observed between 4am and 8am

DBP search for term

Diastolic blood pressure; pressure of blood against arterial walls during cardiac relaxation phase (phase between heart beats).

Dextrose search for term
Diabetes Control and Complications Trial (DCCT) search for term

Study conducted in the 1980s and 1990s in people with type 1 diabetes mellitus, which showed the benefits of managing diabetes by an intensive regimen, involving multiple daily insulin injections/insulin pump administration, in conjunction with multiple daily measurements of the blood glucose level. Compared with previous treatment strategies, intensive therapy significantly reduced the occurrence of some of the main diabetes-associated complications. This approach also slowed the progression of any such complications when they occurred

Diabetes educator search for term

Healthcare professional who supports people with diabetes to help them to manage their health and wellbeing effectively by adopting good strategies for blood sugar, blood pressure and dietetic control

Diabetes insipidus search for term

Condition characterised by frequent micturition, polyuria, excessive thirst and weakness, but not abnormalities in blood glucose levels. Diabetes insipidus may be caused by pathologies relating to the kidney or the pituitary gland

Diabetes mellitus search for term

Condition characterized by hyperglycaemia, which develops because the body is unable to use blood glucose for energy. Type 1 diabetes develops when insulin production ceases in the pancreas; type 2 diabetes develops when the pancreas is unable to make enough insulin to meet physiological needs, or insulin is being made but is not being utilized properly

Diabetes Prevention Program (DPP) search for term

A study conducted between the late 1990s and early 2000s in which people with prediabetes who were also overweight/obese, who lost 5–7% of their body weight through basic exercise and dietary regimens, had a 58% lower risk of developing full-blown type 2 diabetes compared with those who did not follow a low-fat calorie-controlled diet that included 5 sessions of basic exercise (walking 30 minutes per day) per week. Participants who received metformin rather than lifestyle-focused interventions reduced their risk of developing type 2 diabetes by 31%

Diabetic amyotrophy search for term

Neuropathic condition associated with muscle wasting, pain and weakness. Although its overall prevalence is much lower than that of diabetic peripheral neuropathy, some people with diabetes (particularly type 2 diabetes) may present with acute, progressive, asymmetrical weakness and muscular pain in the proximal lower limbs. There are many alternative names for diabetic amyotrophy, such as diabetic lumbosacral radiculoplexus neuropathy or Bruns-Garland syndrome

Diabetic coma search for term

Life-threatening condition in which the diabetic patient is rendered unconscious following the development of hyperglycaemia or hypoglycaemia

Diabetic complications search for term

Undiagnosed or poorly controlled diabetes is associated with higher risk of developing chronic complications involving different organ systems, including: the ocular system (e.g. diabetic retinopathy, glaucoma); cardiovascular disease (e.g. coronary artery disease, stroke); peripheral vasculature (e.g. diabetic ulceration); neural pathways (e.g. diabetic neuropathy); renal disease (e.g. diabetic nephropathy); orthodontic disease (e.g. gingivitis). The development of acute complications may also occur, such as diabetic ketoacidosis, hyperosmolar non-ketotic coma, lactic acidosis and hypoglycaemia. The best way to avoid or reduce the development of these conditions is to maintain good lifetime control of blood glucose, blood pressure, cholesterol levels and body weight/fitness

Diabetic diarrhoea search for term

One of the manifestations of autonomic neuropathy of the gastrointestinal tract; the colonic motility disorders manifest as diarrhoea or constipation. Diabetic diarrhoea is generally nocturnal or postprandial and is often associated with fecal incontinence

Diabetic eye disease search for term
Diabetic retinopathy search for term

Ocular disease affecting people with type 1 or type 2 diabetes, caused by damage to the small blood vessels in the retina; may cause visual loss/disturbance

Diabetic ulcer search for term

Breakdown of skin tissue, typically on the leg or foot; often a secondary consequence of lost sensation due to peripheral neuropathy. The person has a decreased perception of any trauma to the affected area, together with musculoskeletal or motor weakness; some people experience issues with autonomic neuropathy (which may reduce perspiration, and lead to dry or cracked skin). In addition, peripheral arterial disease or atherosclerosis may be more common in some people with diabetes who have concomitant health issues or a history of smoking, compared with other diabetics. Finally, venous hypertension or insufficiency may lead to the development of ulcers of a venous origin; poorly controlled diabetes or concomitant health problems may affect the depth of ulceration and the speed of healing

Diabetogenic search for term

Having the capacity to cause diabetes; often used as a description for drugs that cause hyperglycaemia (e.g. thiazides, beta-blockers, statins)

Dupuytren's contracture search for term

A condition observed in some people with diabetes in which shortening and thickening of the fingers and the palm of the hand occur, and the fingers curve towards the palm

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E

Endocrine gland search for term

Gland containing specialist cells that release hormones into the bloodstream; the islets of Langerhans in the pancreas are endocrine glands that secrete insulin (beta cell), glucagon (alpha cell) and somatostatin (delta cell)

Enzyme search for term

Enzymes are proteins that act as catalysts for biochemical reactions essential to life.

Euglycaemia search for term

Normal blood glucose level

Exchange lists search for term

A method of meal planning used in diabetes management, where carbohydrates, meats/meat alternatives and fats are grouped according to their nutritional content. Guidance on portion size and how to substitute one food for another (in order to maintain appropriate nutrition) is given

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F

Fasting blood glucose testing search for term

A method of monitoring a person’s blood glucose level after an 8–12 h fast, to diagnose or monitor prediabetes or diabetes; usually undertaken in the morning

Fasting hyperglycaemia search for term

A blood glucose level that is deemed to be high after a period of fasting ≥8 h

Fluorescein angiography search for term

A method of examining ocular vasculature that is undertaken by injecting contrast media (dye) into a vein, then photographing the passage of the dye through the ocular blood vessels

Fructosamine test search for term

Blood test that analyses the number of blood glucose molecules that are linked to protein molecules and calculates the average glycaemic level over a 3-week period

Fructose search for term

A sugar, found in fruits and honey; energy value is 4 calories/g

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G

Gastroparesis search for term

A neuropathic condition that negatively affects the digestion of food, leading to gastric symptoms such as nausea, vomiting, bloating and discomfort; gastroparesis also complicates effective blood-glucose control

Gene search for term

A sequence of DNA that determines the structure of a particular protein.

Genotype search for term

The pattern of mutations present in particular genes, at the level of the DNA of an individual.

Gestational diabetes mellitus search for term

A form of diabetes mellitus that develops during pregnancy and usually resolves immediately on delivery (although affected women have an increased lifetime risk of developing type 2 diabetes in later life). Gestational diabetes is often managed with dietary control/meal planning and increased exercise, although some women require insulin therapy

Glargine insulin search for term

Long-acting insulin formulation that has a hypoglycaemic effect within 1 h postinjection and works continuously for a further 23 h

Glaucoma search for term

Increase in intraocular fluid pressure that may result in visual disturbance or loss

Glimepiride search for term

Oral treatment for type 2 diabetes in the class known as sulphonylureas; reduces the blood glucose level by augmenting insulin production and improving how the body uses the insulin that it produces

Glipizide search for term

Oral treatment for type 2 diabetes in the class known as sulphonylureas; reduces the blood glucose level by augmenting insulin production and improving how the body uses the insulin that it produces

Glomerular filtration rate search for term

Measurement that records the ability of the kidney to filter and remove waste products

Glomerulus/glomeruli search for term

Looped blood vessels in the kidney that filter waste products from the bloodstream

Glucagon search for term

Hormone produced in the pancreas, by alpha cells, that raises blood glucose levels. Glucagon injections can be used to treat severe cases of hypoglycaemia

Glucose search for term

A simple form of sugar that provides energy; energy value is 3.4 calories per g

Glyburide search for term

Oral treatment for type 2 diabetes in the class known as sulphonylureas; reduces the blood glucose level by augmenting insulin production and improving how the body uses the insulin that it produces

Glycaemic index search for term

System of ranking carbohydrate-rich foods by their effect on blood glucose levels; foods with a low glycaemic index (e.g. whole grain-based foods) have a slower impact on blood glucose than foods with a high glycaemic index (e.g. refined carbohydrates)

Glycogen search for term

Polysaccharide, stored in muscles and liver tissue, which forms glucose on hydrolysis

Glycosuria search for term

The presence of glucose in urine

Glycosylated haemoglobin search for term
GP search for term

General practitioner/family physician

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H

HbA1c search for term

Glycosylated haemoglobin

HCP search for term

Healthcare professional

Heart failure search for term

Chronic condition in which the heart cannot pump blood efficiently.

Heterozygous search for term

We each have two copies of each gene. A subject with a particular mutation of one gene, but not the other, is said to be heterozygous for that mutation.

High-density lipoprotein cholesterol search for term

Also known as HDL cholesterol. Blood lipid that transports excess cholesterol to the liver for excretion; sometimes referred to as ‘good cholesterol’, having a high HDL cholesterol level may be cardioprotective

Homozygous search for term

We each have two copies of each gene. A subject with an identical mutation of both genes is said to be homozygous for that mutation.

Honeymoon phase search for term

Phase in which insulin secretion resumes temporarily in people within a few weeks following a diagnosis of type 1 diabetes mellitus

Hormone search for term

Chemical compound produced in a specific gland and released into the bloodstream to regulate or trigger specific bodily functions. The hormone insulin, produced in the pancreas, controls glucose levels

HRQoL search for term

Health-related quality of life; describes the effect that a medical condition (and/or its therapy) has on a patient’s physical and occupational function, psychological state, level of social interaction and somatic sensation.

Hyperglycaemia search for term

An excessively high level of blood glucose

Hyperinsulinaemia search for term

A level of insulin in the blood that is abnormally high, due to an overproduction of insulin. See Insulin resistance

Hyperlipidaemia search for term

Abnormally high lipid (and cholesterol) levels in the blood

Hyperosmolar hyperglycaemic nonketotic syndrome search for term

Medical emergency characterised by a high blood glucose level that leads to high blood osmolarity without the presence of ketones in urine or blood. Without treatment, it can be fatal

Hypertension search for term

Persistently raised high blood pressure that, if untreated, may lead to organ damage (e.g. retinopathy, renal disease), arterial bleeding, cardiac disease, stroke or eclampsia in pregnant women. Normal adult blood pressure is 120 mmHg (systolic pressure; when the heart beats) and 80mmHg (diastolic pressure; when the heart relaxes). Hypertension is generally defined as when the person’s systolic blood pressure is ≥140 mmHg and/or their diastolic blood pressure is ≥90 mmHg. Where possible, repeated blood-pressure readings, ideally involving ≥24-h ambulatory monitoring, should be undertaken to assess levels throughout normal daily activities before a diagnosis of hypertension is made. Generally, hypertension is often asymptomatic, although some people describe experiencing headache, shortness of breath, chest pain, heart palpitations, nose bleeds and/or dizziness.

Hypoglycaemia search for term

Abnormally low blood glucose level (usually ≤70 mg/dl in diabetes patients or

Hypoglycaemia unawareness search for term

Inability to recognize the warning signs of hypoglycaemia, such as shakiness, perspiration or hunger; may occur if hypoglycaemic episodes occur frequently

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I

Impaired fasting glucose search for term

A condition in which a fasting blood glucose analysis reveals a blood-glucose level that is abnormally high (100 mg/dl to 125 mg/dl) but not at a level that confirms a diagnosis of diabetes. Impaired fasting glucose is one of the conditions known as prediabetes. People with an impaired fasting glucose are at a heightened risk of developing type 2 diabetes mellitus

Impaired glucose tolerance search for term

A condition in which blood glucose levels are abnormally high (between 140 mg/dl and 199 mg/dl, 2 h after the start of an oral glucose tolerance test) but not at a level that confirms a diagnosis of diabetes mellitus. Impaired glucose tolerance is one of the conditions known as prediabetes. People with impaired glucose tolerance are at heightened risk of developing type 2 diabetes mellitus. Former names for impaired glucose tolerance include ‘subclinical’, ‘latent’ or ‘borderline’ diabetes

Inhaled insulin search for term

Powdered formulation of insulin that is delivered via a nebulizer; efficacy is believed to be equivalent to rapid-acting injectable insulin

Injection site rotation search for term

Consecutive insulin injections are administered in different places, to prevent lipodystrophy

Insulin search for term

A hormone made by beta cells in the pancreas and secreted into the bloodstream to allow use of glucose for energy. Insulin is administered via injection, insulin pump or inhaled formulations, in people who are unable to make adequate quantities of insulin (i.e. people with diabetes)

Insulin adjustment search for term

Changing the insulin dose to account for the size and nutritional composition of a meal, the level of activity, the presence of certain illnesses or the blood glucose level

Insulin lispro search for term

Insulin lispro is a fast-acting insulin analogue. It has one primary advantage over regular insulin for postprandial glucose control: it has a shortened delay of onset, allowing slightly more flexibility than regular insulin

Insulin pen search for term

Device that is the size and shape of an ink pen that contains cartridges of insulin, for injecting insulin and transporting it discreetly

Insulin pump search for term

Electronic device similar in shape to a mobile phone that is programmed to administer continuous small doses of insulin, and higher bolus doses (e.g. at mealtimes or due to hyperglycaemia), via a flexible plastic tube connected to a small subcutaneous needle

Insulin reaction search for term
Insulin receptors search for term

Transmembrane receptors on cells (in the large class of tyrosine kinase receptors), activated by insulin, insulin-like growth factor (IGF)-I and IGF-II. Insulin receptors permit a cell to bind insulin in the blood, thereby allowing glucose uptake for energy provision

Insulin resistance search for term

Inability to use insulin effectively. May be linked to hypertension, obesity or hypercholesterolaemia

Insulin shock search for term

An acute hypoglycaemic episode that typically occurs after an insulin overdose, characterized by dizziness, weakness, trembling and sweating. If untreated, insulin shock may lead to convulsions and/or coma

Insulin-dependent diabetes mellitus search for term

Former name for type 1 diabetes mellitus

Synonyms: IDDM

Insulinoma search for term

Pancreatic tumour confined to the beta cells; often associated with excess insulin production and the development of hypoglycaemia

Intensive therapy search for term

Method of managing diabetes by maintaining euglycaemia by frequent insulin administration (injection or insulin pump), meal planning, regular blood glucose monitoring and close partnership between the person with diabetes and their healthcare team. Previously known as tight control

Intermediate-acting insulin search for term

Insulin formulation that begins to lower blood glucose within 2 h postinjection, with its peak effect 6–12 h postinjection; continues to work up to 16–24 h post injection. Also called lente and NPH insulin

Intermittent claudication search for term

Periodic pain in the leg muscles, often occurring during periods of activity (e.g. walking). Typically caused by obstructions in arterial circulation

Ischaemic heart disease search for term

Abbreviated as IHD; also known as coronary heart disease (CHD) or coronary artery disease (CAD). The leading cause of death globally. Occurs when blood flow to the heart muscle is decreased by a partial or complete blockage of the coronary arteries. People with diabetes may be at increased risk of developing IHD.

Islet transplantation search for term

Novel procedure in which islet cells from a nondiabetic donor pancreas are transplanted into a person with diabetes, to restore insulin production by beta cells in the islets

Islet-cell autoantibodies search for term

Detected by blood analysis, these are proteins that are found in people who may be developing (or recently diagnosed with) type 1 diabetes. Islet-cell autoantibodies indicate autoimmune damage to beta cells in the pancreas

Islets search for term

Tiny clusters of pancreatic cells that produce the hormones necessary to support the release of energy in the body. Islet cells include alpha cells (which make glucagon) and beta cells (which make insulin)

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K

Ketoacidosis search for term

Potentially fatal emergency condition in the diabetic patient, in which an extremely high blood glucose level and a severe lack of insulin cause adipose cells to break down, to provide energy. Ketones accumulate in urine and blood; the patient presents with nausea/vomiting, upper gastrointestinal pain, ‘pear drops’ breath (fruity, sweet breath), and shallow, rapid, laboured breathing (Kussmaul breathing)

Ketone search for term

A chemical produced when physiological insulin production is inadequate and the body breaks down adipose cells in order to fulfil energy requirements. High levels of ketones may result in diabetic ketoacidosis or coma

Ketonuria search for term

Presence of ketones in the urine; potential sign of diabetic ketoacidosis

Ketosis search for term

Condition indicated by high levels of ketones together with gastrointestinal pain, nausea and vomiting. Potential sign of diabetic ketoacidosis

Kussmaul breathing search for term

Shallow, rapid and laboured breathing associated with diabetic ketoacidosis

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L

Latent autoimmune diabetes in adults search for term

LADA; latent autoimmune diabetes in adults, or late-onset autoimmune diabetes of adulthood, is a form of diabetes that has a slower onset than the typical form of type 1 diabetes. LADA is sometimes described as type 1.5 diabetes

Lente insulin search for term

L-insulin. See Intermediate-acting insulin

Lipid profile search for term

Battery of blood tests that assess cardiovascular disease risk by measuring total cholesterol, triglycerides and HDL cholesterol levels, thereby allowing the LDL cholesterol level to be calculated

Lipoatrophy search for term

Loss of subcutaneous adipose tissue characterized by small indentations; may be caused by failure to rotate insulin injection sites adequately

Lipodystrophy search for term

Medical condition characterized by abnormal or degenerative conditions of the body's adipose tissue

Lipohypertrophy search for term

Subcutaneous accumulation of abnormalities in adipose tissue characterized by lumps, nodes and tough skin; may be caused by failure to rotate insulin injection sites adequately and may reduce insulin absorption

Low-density lipoprotein cholesterol search for term

LDL cholesterol. A blood lipid that transports cholesterol, to facilitate cell repair. However, LDL is also deposited in arteries, forming plaques on arterial walls. Referred to as ‘bad’ cholesterol

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M

Maturity-onset diabetes of the young search for term

Also known as MODY; refers to any of several hereditary forms of diabetes caused by mutations in an autosomal dominant gene disrupting insulin production

Meglitinide search for term

A class of oral treatment for type 2 diabetes that lowers blood glucose by improving postprandial insulin secretion in the pancreas

Metabolic syndrome search for term

A clustering of at least three of the following medical conditions: abdominal (central) obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides and low high-density lipoprotein (HDL) levels

Metabolism search for term

Chemical processes necessary for maintaining life, such as the cellular processes that change food into proteins, fats and sugars to provide functions such as growth, repair and energy

Metformin search for term

Oral treatment for type 2 diabetes in the class known as biguanides; lowers blood glucose by reducing glucose production in the liver and improving the physiological response to insulin produced in beta cells in the pancreas

Microalbumin search for term

Small quantities of protein (albumin) in the urine, detected by laboratory analysis. May be present on diagnosis in people with type 2 diabetes (either due to damage caused by undiagnosed diabetes or due to the effects of concomitant cardiovascular disease, e.g. hypertension)

Microvascular disease search for term

Or small vessel disease. It is an angiopathy affecting small blood vessels in the body, including those in the renal, neurological and vascular systems that cause pathologic changes associated with bleeding, slow blood flow or protein leakage

Miglitol search for term

Oral treatment for type 2 diabetes in the class known as alpha-glucosidase inhibitors; its action blocks enzymes that digest starches, leading to a slower, lower rise in the blood glucose level (particularly the postprandial rise)

Mixed dose search for term

Two types of insulin, administered in a single injection; mixed-dose formulations typically include a rapid- or short-acting insulin and a longer (intermediate)-acting insulin. The aim of mixed-dose insulin formulations is to provide short- and long-term blood glucose control

Myelopathy search for term

Damage to the myelin sheath in the spinal cord; a fairly rare complication in people with diabetes mellitus

Myocardial infarction (MI) search for term

Or acute myocardial infarction (AMI). Commonly known as a heart attack, occurs when blood flow stops to a part of the heart, causing damage to the heart muscle.

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N

Nateglinide search for term

Oral treatment for type 2 diabetes in the class known as D-phenylalanine derivatives; aims to lower blood glucose by improving postprandial insulin production in the pancreas

Necrobiosis lipoidica diabeticorum search for term

Abbreviated as NLD. This is a necrotizing skin condition that usually occurs in patients with diabetes mellitus but can also be associated with rheumatoid arthritis. NLD most frequently appears on the patient's shins, often on both legs, although it may also occur on forearms, hands and trunk. The centre of the affected area usually has a yellowish tint while the area surrounding it is a dark pink

Neovascularization search for term

Growth of small blood vessels, which are often abnormally formed. In people with diabetes, neovascularization may occur in the retina, where it causes visual disturbance or blindness

Nephropathy search for term

This kidney disease may develop in people with inadequately controlled diabetes or concomitant cardiometabolic diseases. Over time, hyperglycaemia and hypertension may damage the glomeruli, causing proteinuria and inhibiting the ability of the kidneys to filter and excrete waste or excess fluid

NPH insulin search for term

See Intermediate-acting insulin; NPH stands for neutral protamine Hagedorn

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O

Oral glucose tolerance test search for term

Abbreviated as OGTT. A medical test in which glucose is given and then blood samples taken to determine how quickly it is cleared from the blood. It is usually used to test for diabetes, insulin resistance, impaired beta cell function, and sometimes reactive hypoglycaemia and acromegaly, or rarer disorders of carbohydrate metabolism. Many variations of the OGTT have been devised over the years for varying purposes, with different standard doses of glucose, routes of administration, and intervals and durations of sampling, and various substances measured in addition to blood glucose

Oral hypoglycaemic agents search for term

Treatments administered by mouth to improve blood glucose levels in people with type 2 diabetes. There are numerous classes of oral hypoglycaemic agent, including alpha-glucosidase inhibitors, biguanides, D-phenylalanine derivatives, meglitinides, sulphonylureas and thiazolidinediones

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P

Pancreas search for term

Organ of the endocrine and digestive systems that produces and secretes enzymes to digest food and also produces the hormone insulin, to control blood sugar levels

Pancreatic transplantation search for term

Novel surgical procedure in which donor pancreatic tissue is transplanted into a person with diabetes, to re-instate normal pancreatic function (i.e. insulin production)

Peripheral neuropathy search for term

Damage to the body's peripheral nervous system. This can cause muscle weakness, numbness and tingling, burning pain and a loss of coordination

Peripheral vascular disease search for term

Abbreviated as PVD. Disease of the large blood vessels in the limbs, occurring as a result of impairment of blood flow. PVD symptoms are typically aching of the affected limbs or ulcerated tissue that fails to heal (or heals very slowly)

Peroxisome proliferator-activated receptor-gamma search for term

Also known as PPAR-γ, PPARG, glitazone receptor and NR1C3. Type II nuclear receptor, encoded by the PPARG gene, that is part of a key superfamily of transcription regulators involved in gene expression and the development of diseases such as diabetes

Photocoagulation search for term

Laser treatment for diabetic retinopathy in which leaking blood vessels and neovascular tissue are sealed off/removed

Pioglitazone search for term

Oral treatment for type 2 diabetes in the class known as thiazolidinediones; improves glucose uptake in the bloodstream and in cells by improving insulin sensitivity and reducing insulin resistance. Thiazolidinediones bind avidly to peroxisome proliferator-activated receptor-gamma in adipocytes, thereby promoting adipogenesis and fatty acid uptake in peripheral adipose tissue

Polydipsia search for term

Excessive thirst; a common sign of type 1 or type 2 diabetes mellitus

Polyphagia search for term

Excessive hunger; a potential sign of type 1 or type 2 diabetes

Polyuria search for term

Excessive urination; may be a sign of type 1 or type 2 diabetes

Postprandial blood glucose search for term

The blood glucose level at 1–2 h after eating

Postprandial hyperglycaemia search for term

A blood glucose level that is high 1–2 h after eating

Prediabetes search for term

A condition in which a person presents with a blood glucose level that is higher than normal but does not meet the criteria for a diabetes diagnosis. Prediabetes confers a heightened risk of type 2 diabetes, but also of other cardiovascular diseases (e.g. cardiac disease, stroke). Also known as impaired glucose tolerance and impaired fasting glucose

Prehypertension search for term

Prehypertensive state indicated by a systolic BP ranging between 120 and 139 mmHg or a diastolic BP ranging between 80 and 89 mmHg; prehypertension can be treated by lifestyle measures such as reducing weight and increasing levels of exercise.

Premixed insulin search for term

Commercial insulin preparation that includes two types of insulin: 50/50 insulin and 70/30 insulin

Preprandial blood glucose search for term

The blood glucose level before the person eats

Proinsulin search for term

Substance made in the pancreas that ultimately becomes insulin

Proliferative retinopathy search for term

Condition characterized by fragile neovasculature along the retina and in the vitreous humor

Proteinuria search for term

The presence of protein in the urine; in people with type 2 diabetes mellitus, this may indicate a reduction in kidney function

Proximal diabetic neuropathy search for term
Pulse pressure search for term

Difference between SBP and DPB. May be a predictor of heart disease risk.

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R

Rapid-acting insulin search for term

Insulin formulation that begins to lower blood glucose levels 5–10 min postinjection, with its strongest effect evident between 30 min to 3 h postinjection

RCT search for term

Randomized clinical trial.

Rebound hyperglycaemia search for term

A swing towards hyperglycaemia immediately after being hypoglycaemic or euglycaemic

Regular insulin search for term

Insulin formulation with a short action that starts to lower blood glucose, often in ≤30 min postinjection with a peak effect within 2–4 h; effect diminishes within 6 h postinjection

Repaglinide search for term

Oral treatment for type 2 diabetes in the class known as meglitinides; lowers blood glucose by improving postprandial insulin production in the pancreas

Retinopathy search for term
Rosiglitazone search for term

Oral treatment for type 2 diabetes in the class known as thiazolidinediones; improves glucose uptake in the bloodstream and in cells by improving insulin sensitivity and reducing insulin resistance. Thiazolidinediones bind avidly to peroxisome proliferator-activated receptor-gamma in adipocytes, thereby promoting adipogenesis and fatty acid uptake in peripheral adipose tissue

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S

SBP search for term

Systolic blood pressure. Highest force of blood against arterial walls during the contraction phase of cardiac muscle.

Sulphonylurea search for term

Also spelt as sulfonylurea. Class of oral diabetic drugs used to treat type 2 diabetes mellitus, predominantly by increasing the secretion of insulin from the pancreas. There are two generations of sulphonylurea: the first generation compounds usually require more frequent administration than the second-generation sulphonylureas; the second-generation agents may be more appropriate for patients with impaired renal function

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T

Team management search for term

Diabetes is often managed using a multidisciplinary approach whereby specialist care is available to advise and support the person with diabetes, as required, in addition to monitoring their overall health and wellbeing. The team management approach typically involves specialist members of the medical and nursing profession (including those involved in cardiovascular and metabolic health), dietetic services, diabetes educators, podiatrists and ophthalmologists, as required

Thiazolidinediones search for term

Class of oral treatments for type 2 diabetes that improve glucose uptake in the bloodstream and in cells by improving insulin sensitivity and reducing insulin resistance. Thiazolidinediones bind avidly to peroxisome proliferator-activated receptor-gamma in adipocytes, thereby promoting adipogenesis and fatty acid uptake in peripheral adipose tissue

Tight control search for term
Tolazamide search for term

Oral treatment for type 2 diabetes in the class known as sulphonlyureas; reduces the blood glucose level by augmenting insulin production and improving how the body uses the insulin that it produces

Tolbutamide search for term

Oral treatment for type 2 diabetes in the class known as sulphonylureas; reduces the blood glucose level by augmenting insulin production and improving how the body uses the insulin that it produces

Triglyceride search for term

Main form in which fat is stored in the body; comprises three fatty acid chains and a glycerol molecule. In people with poorly controlled diabetes, high triglyceride levels may be observed

Type 1 diabetes mellitus search for term

Sometimes abbreviated as T1DM. Occurs as a result of injury or attack to the insulin-producing beta cells in the pancreas, which causes the body to produce little or no insulin. Often occurs as a result of autoimmune attack. Irreversible without pancreatic tissue transplantation. Characterized by hyperglycaemia, glycosuria and symptoms such as rapid weight loss, excessive thirst and polyuria, ketotic breath; typically emerges in infancy, childhood, adolescence or early adulthood but may present in later adulthood. See also Diabetes mellitus. Must be managed with insulin replacement, using injected and/or inhaled insulin formulations and (usually in experimental situations) pancreatic/islet cell transplantation from unaffected donors

Type 2 diabetes mellitus search for term

Sometimes abbreviated as T2DM. Occurs when the pancreas is unable to make adequate levels of insulin to meet physiological needs, or when insulin is being made but is not properly utilized. Typically develops in mid-to-late adulthood, although lifestyle factors such as increasing rates of obesity and metabolic syndrome have seen increasing rates of type 2 diabetes development in much younger people. In early stages, type 2 diabetes may be managed through dietary control and increasing levels of physical activity, although oral treatments that target different pathophysiological mechanisms associated with type 2 diabetes, and injectable insulin regimens and metformin, are also widely used

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U

Ulcer search for term

A breakdown of skin tissue, often as a result of simple injury, that develops into a deep open lesion that may extend beyond the epidermal layer. In people with diabetes, ulcers may develop for a range of reasons, although the presence of peripheral neuropathy is the major factor.

Ultralente insulin search for term

Long-acting insulin (U insulin). Typically starts to lower blood sugar 4–6 h postinjection, with its peak effect at between 10 and 18 h and some continued effect on blood sugar for approximately 24–28 h

Unit of insulin search for term

Basic, standard, measure of insulin. U-100 insulin is the most common measure and equates to 100 units of insulin per ml or cc of solution

United Kingdom Prospective Diabetes Study (UKPDS) search for term

Long-term study conducted in the UK between 1977 and 1997, which reported a reduction in risk of renal or ocular complications in people with type 2 diabetes who reduced their levels of hyperglycaemia. Improvements in blood pressure in subjects with concomitant hypertension were also associated with a lower risk of stroke. Diabetes complication-associated mortality was also reduced in people who improved their health (i.e. reductions in blood glucose and better hypertension control)

Uraemia search for term

Condition that develops due to the build-up of urea in the bloodstream due to kidney dysfunction. Symptoms of uraemia include anorexia, weakness, nausea/vomiting and mental confusion

Urea search for term

Waste product found in blood, following the normal hepatic-mediated breakdown of protein. Usually removed by the kidneys and excreted in the urine

Urinalysis search for term

The procedure in which a urine sample is tested to look for the presence of abnormalities. Urinalysis may be undertaken with a simple test strip at the point of care, to monitor for the presence of abnormalities that may or may not be associated with diabetes (e.g. the absence, presence and likely level of glucose, protein or white blood cells in the urine, as indicators of diabetes control, kidney function and urinary tract infection, respectively). The presence of ketones may also be tested, as an indication of diabetic ketoacidosis. Urinalysis can also involve 24-h urine collection and bacterial culturing, although these are secondary to the standard point-of-care urinalysis undertaken routinely and regularly in people with diabetes

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V

Very long-acting insulin search for term
Very-low-density lipoprotein cholesterol (VLDL-cholesterol) search for term

A form of cholesterol found in blood that, at high levels, is associated with the development of cardiovascular disease

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W

White coat hypertension search for term

BP readings taken in clinical settings that indicate hypertension that is not present in normal daily life.

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