Glossary of Diabetes

Acetone: A chemical formed in the blood when the body breaks down fat instead of sugar for energy; if acetone forms, it usually means the cells are starved. Commonly, the body’s production of acetone is known as “ketosis.” It occurs when there is an absolute or relative deficiency in insulin so sugars cannot get into cells for energy. The body then tries to use other energy sources like proteins from muscle and fat from fat cells. Acetone passes through the body into the urine.

Acidosis: Too much acid in the body, usually from the production of ketones like acetone, when cells are starved; for a person with diabetes, the most common type of acidosis is called “ketoacidosis.”

Acute: Abrupt onset that is usually severe; happens for a limited period of time.

Adrenal glands: Two endocrine glands that sit on top of the kidneys and make and release stress hormones, such as epinephrine (adrenaline), which stimulates carbohydrate metabolism; nor epinephrine, which raises heart rate and blood pressure; and corticosteroid hormones, which control how the body utilizes fat, protein, carbohydrates, and minerals, and helps reduce inflammation. They also produce sex hormones like testosterone and can produce DHEA and progesterone.

Adult-onset diabetes: A term for type 2 diabetes that is no longer used, because this type of diabetes is now commonly seen in children; “non-insulin dependent diabetes” is also considered an incorrect phrase in describing type 2 diabetes, because patients with this type of diabetes may at some point require insulin.

Antibodies: Proteins that the body produces to protect itself from foreign substances, such as bacteria or viruses.

Antidiabetic agent: A substance that helps people with diabetes control the level of sugar in their blood (see insulin, oral diabetes medication).

Antigens: Substances that cause an immune response in the body, identifying substances or markers on cells; the body produces antibodies to fight antigens, or harmful substances, and tries to eliminate them.

Blood glucose monitoring or testing: A method of testing how much sugar is in your blood; home blood-glucose monitoring involves pricking your finger with a lancing device, putting a drop of blood on a test strip and inserting the test strip into a blood-glucose-testing meter that displays your blood glucose level. Blood-sugar testing can also be done in the laboratory. Blood-glucose monitoring is recommended three or four times a day for people with insulin-dependent diabetes. Depending on the situation, glucose checks before meals, two hours after meals, at bedtime, in the middle of the night, and before and after exercise, may be recommended.

Blood pressure: The measurement of the pressure or force of blood against the blood vessels (arteries); blood pressure is written as two numbers. The first number or top number is called the systolic pressure and is the measure of pressure in the arteries when the heart beats and pushes more blood into the arteries. The second number, called the diastolic pressure, is the pressure in the arteries when the heart rests between beats. The ideal blood pressure for non-pregnant people with diabetes is 130/80 or less.

Carbohydrate: One of the three main classes of foods and a source of energy; carbohydrates are mainly sugars and starches that the body breaks down into glucose (a simple sugar that the body can use to feed its cells).

Cholesterol: A waxy, odorless substance made by the liver that is an essential part of cell walls and nerves; cholesterol plays an important role in body functions such as digestion and hormone production. In addition to being produced by the body, cholesterol comes from animal foods that we eat. Too much cholesterol in the blood causes an increase in particles called LDL (’‘bad’’ cholesterol), which increases the buildup of plaque in the artery walls and leads to atherosclerosis.

Diabetic ketoacidosis (DKA): A severe, life-threatening condition that results from hyperglycemia (high blood sugar), dehydration, and acid buildup that needs emergency fluid and insulin treatment; DKA happens when there is not enough insulin and cells become starved for sugars. An alternative source of energy called ketones becomes activated. The system creates a buildup of acids. Ketoacidosis can lead to coma and even death.

Fasting plasma glucose test (FPG): The preferred method of screening for diabetes; the FPG measures a person’s blood sugar level after fasting or not eating anything for at least 8 hours. Normal fasting blood glucose is less than 100 milligrams per deciliter or mg/dL. A fasting plasma glucose greater than 100 mg/dL and less than126 mg/dL implies that the person has an impaired fasting glucose level but may not have diabetes. A diagnosis of diabetes is made when the fasting blood glucose is greater than 126 mg/dL and when blood tests confirm abnormal results. These tests can be repeated on a subsequent day or by measuring glucose 2 hours after a meal. The results should show an elevated blood glucose of more than 200 mg/dL.

Fats: Substances that help the body use some vitamins and keep the skin healthy; they are also the main way the body stores energy. In food, there are many types of fats – saturated, unsaturated, polyunsaturated, monounsaturated, and trans fats. To maintain your blood cholesterol and triglyceride (lipid) levels as near the normal ranges as possible, the American Diabetes Association recommends limiting the amount of saturated fats and cholesterol in our diets. Saturated fats contribute to blood levels of LDL (’‘bad’’) cholesterol. The amount of saturated fats should be limited to less than 10% of total caloric intake, and the amount of dietary cholesterol should be limited to 300 mg/day.

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

Glucagon: A hormone that raises the level of glucose in the blood by releasing stored glucose from the liver; glucagon is sometimes injected when a person has lost consciousness (passed out) from low blood sugar levels. The injected glucagon helps raise the level of glucose in the blood.

Glucose: A simple sugar found in the blood; it is the body’s main source of energy; also known as “dextrose.”

Glucose tolerance test: A test to determine if a person has diabetes; the test is done in a lab or doctor’s office in the morning before the person has eaten. A period of at least 8 hours without any food is recommended prior to doing the test. First, a sample of blood is taken in the fasting state. Then the person drinks a liquid that has sugar in it. Two hours later, a second blood test is done. A fasting blood sugar equal to or greater than 126 mg/dl is considered diabetes. A fasting blood sugar between 100 mg/dl and 125 mg/dl is classified as impaired fasting glucose. If the two-hour test result shows a blood sugar equal to or greater than 200 mg/dl, the person is considered to have diabetes. A two-hour blood glucose between 140 mg/dl and 199 mg/dl is classified as impaired glucose tolerance.

Glycated hemoglobin test (HbA1c): This is an important blood test to determine how well you are managing your diabetes; hemoglobin is a substance in red blood cells that carries oxygen to tissues. It can also attach to sugar in the blood, forming a substance called glycated hemoglobin or a Hemoglobin A1C. The test provides an average blood sugar measurement over a 6- to 12-week period and is used in conjunction with home glucose monitoring to make treatment adjustments. The ideal range for people with diabetes is generally less than 7%. This test can also be used to diagnose diabetes when the HbA1c level is equal to or greater than 6.5%.

Human insulin: Bio-engineered insulin very similar to insulin made by the body; the DNA code for making human insulin is put into bacteria or yeast cells and the insulin made is purified and sold as human insulin.

Hyperglycemia: High blood sugar; this condition is fairly common in people with diabetes. Many things can cause hyperglycemia. It occurs when the body does not have enough insulin or cannot use the insulin it does have.

Hypoglycemia: Low blood sugar; the condition often occurs in people with diabetes. Most cases occur when there is too much insulin and not enough glucose in your body.

Impotence: Also called “erectile dysfunction;” persistent inability of the penis to become erect or stay erect. Some men may become impotent after having diabetes for a long time, because nerves and blood vessels in the penis become damaged. It is estimated that 50% of men diagnosed with type 2 diabetes experiences impotence.

Injection site rotation: Changing the areas on the body where a person injects insulin; by changing the area of injection, the injections will be easier, safer, and more comfortable. If the same injection site is used over and over again, hardened areas, lumps, or indentations can develop under the skin, which keep the insulin from being used properly. These lumps or indentations are called “lipodystrophies.”

Insulin: A hormone produced by the pancreas that helps the body use sugar for energy; the beta cells of the pancreas make insulin.

Insulin-dependent diabetes: Former term used for type 1 diabetes.

Insulin mixture: A mixture of insulin that contains short-, intermediate- or long-acting insulin; you can buy premixed insulin to eliminate the need for mixing insulin from two bottles.

Insulin pump: A small, computerized device – about the size of a small cell phone – that is worn on a belt or put in a pocket; insulin pumps have a small flexible tube with a fine needle on the end. The needle is inserted under the skin of the abdomen and taped in place. A carefully measured, steady flow of insulin is released into the body.

Insulin reaction: Another term for hypoglycemia in a person with diabetes; this occurs when a person with diabetes has injected too much insulin, eaten too little food, or has exercised without eating extra food.

Insulin receptors: Areas on the outer part of a cell that allow insulin in the blood to join or bind with the cell; when the cell and insulin bind together, the cell can take glucose from the blood and use it for energy.

Ketone bodies: Often simply called ketones, one of the products of fat burning in the body; when there is not enough insulin, your body is unable to use sugar (glucose) for energy and your body breaks down its own fat and protein. When fat is used, ketone bodies, an acid, appear in your urine and blood. A large amount of ketones in your system can lead to a serious condition called ketoacidosis. Ketones can be detected and monitored in your urine at home using products such as Ketostix, Chemstrips, and Acetest. When your blood sugar is consistently greater than 250 mg/dl, if you are ill or if you are pregnant and have diabetes, ketones should be checked regularly.

Lipid: Another term for a fat or fat-like substance in the blood; the body stores fat as energy for future use, just like a car that has a reserve fuel tank. When the body needs energy, it can break down lipids into fatty acids and burn them like glucose. Excess amounts of fats in the diet can cause fat buildup in the walls of the arteries – called “atherosclerosis.” Excess amounts of calories from fats or other nutrients can lead to an increase in weight gain.

Metabolism: All of the physical and chemical processes in the body that occur when food is broken down, energy is created and wastes are produced.

Mg/dL (milligrams per deciliter): Measurement that indicates the amount of a particular substance such as glucose in a specific amount of blood.

Mixed dose: A prescribed dose of insulin in which two types of insulin are combined and injected at once; a mixed dose commonly combines a fast-acting and longer-acting insulin. A mixed dose can either come in a pre-mixed syringe or mixed at the time of injection. A mixed dose may be prescribed to provide better blood sugar control.

Nephropathy: Disease of the kidneys caused by damage to the small blood vessels or to the units in the kidneys that clean the blood; people who have had diabetes for a long time may develop nephropathy.

Non-insulin dependent diabetes: Former term for type 2 diabetes.

Obesity: A term uses to describe excess body fat; it is defined in terms of a person’s weight and height, or his/her body mass index (BMI). A BMI over 30 is classified as being obese. Obesity makes your body less sensitive to insulin’s action. Extra body fat is thought to be a risk factor for diabetes.

Polydipsia: Excessive thirst that lasts for long periods of time; may be a sign of diabetes.

Polyphagia: Excessive hunger and eating; may be a sign of diabetes. When insulin levels are decreased or there is insulin resistance, the cells of the body do not get enough sugar, and hunger develops. People with polyphagia often lose weight, even though they are eating more than normal, because the excess calories are lost in the urine as sugar (glucose).

Polyunsaturated fat: A type of fat that can be substituted for saturated fats in the diet and can reduce LDL ‘‘bad’’ cholesterol.

Polyuria: Increased need to urinate often; a common sign of diabetes.

Protein: One of three main classes of food; proteins are made of amino acids, which are called the “building blocks of the cells.” Cells need protein to grow and to mend them. Protein is found in many foods, like meat, fish, poultry, eggs, legumes, and dairy products.

Rapid-acting Insulin: Covers insulin needs for meals eaten at the same time as the injection; this type of insulin is used with longer-acting insulin. Includes Humalog, Novolog, and Apidra.

Sorbitol: A sugar – produced from fruits – that the body uses slowly; it is a sweetener used in diet foods and is called a “nutritive sweetener” because it has four calories in every gram, just like table sugar and starch. These compounds are used in many foods labeled as ‘‘sugar free’’ and ‘‘no sugar added’’ and can raise your blood glucose. Because a food is labeled ‘‘sugar free,’’ it doesn’t necessarily mean carbohydrate-free.

Stevia: A natural sugar substitute that has no calories; Truvia is the brand name for a sweetener made from the stevia leaf.

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

Sucralose: An artificial sweetener that is 600 times sweeter than sugar; can be used in cooking. Splenda is a brand name of sucralose.

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

Sulfonylureas: Pills or capsules that people take to lower the level of sugar in the blood; these oral diabetic medications work to lower your blood sugar by making your pancreas produce more insulin.

Triglyceride: Fats carried in the blood from the food we eat; most of the fats we eat, including butter, margarines, and oils, are in triglyceride form. Excess triglycerides are stored in fat cells throughout the body. The body needs insulin to remove this type of fat from the blood.

Type 1 diabetes: A type of diabetes in which the insulin-producing cells (called beta cells) of the pancreas are damaged; people with type 1 diabetes produce little or no insulin, so glucose cannot get into the body’s cells for use as energy. This causes blood sugar to rise. People with type 1 diabetes must use insulin injections to control their blood sugar.

Type 2 diabetes: A type of diabetes in which the insulin produced is either not enough or the person’s body does not respond normally to the amount present; therefore, glucose in the blood cannot get into the body’s cells for use as energy. This results in an increase in the level of glucose (sugar) in the blood.

Ultralente insulin: A type of insulin that is long-acting; usually, the action of this type of insulin works for 25-36 hours after injection. This type of insulin has an onset of action four to five hours after injecting and works most powerfully at eight to 14 hours after injection. Other types of long-acting insulin include insulin detemir (Levemir) and insulin (Lantus).

Unit of insulin: The basic measure of insulin; U-100 is the most common concentration of insulin. U-100 means that there are 100 units of insulin per milliliter (ml) of liquid. For the occasional patient who has severe insulin resistance, insulin is available as a U-500 form.

Urine testing: Checking urine to see if it contains ketones; if you have type 1 diabetes, are pregnant and have diabetes, or have gestational diabetes, your doctor may ask you to check your urine for ketones. This is an easy test done at home with a dipstick measure.

Vitrectomy: A procedure in which the gel from the center of the eyeball is removed because it has blood and scar tissue that blocks vision; an eye surgeon replaces the clouded gel with a clear fluid.

Xylitol: A nutritive sweetener used in dietary foods; it is a sugar alcohol that the body uses slowly, and contains fewer calories than table sugar.