Guest guest Posted December 4, 2003 Report Share Posted December 4, 2003 A Acidosis Too much acid in the body. A person with diabetes whose disease is not properly controlled will tend to create acidic compounds called Ketone Bodies. If these cannot be removed from the body, they will build up to cause a metabolic acidosis called Diabetic Ketoacidosis. Adult-Onset Diabetes Former term for non-insulin-dependent diabetes mellitus, or type 2 diabetes. Angiopathy Disease of the blood vessels (arteries, veins and capillaries), which can result from having diabetes for a long time. Macroangiopathy and microangiopathy are the two types of angiopathy. In macroangiopathy, fat and blood clots build up in the large blood vessels, stick to the vessel walls, and block the flow of blood. In microangiopathy, the walls of the smaller blood vessels become so thick and weak that they bleed, leak protein and slow the flow of blood through the body. Top of Page B Beta Cell A type of cell in the pancreas in areas called the islets of Langerhans. Beta cells make and release insulin, a hormone that controls the level of glucose (sugar) in the blood. Blood Glucose The main sugar used by the body, glucose is a simple or hexose sugar (one of the smallest kinds of molecules which can be called a sugar). The glucose found in the bloodstream is mostly derived from the digestion of complex carbohydrates (starches and the more complex sugar compounds) but can also be made from fats and proteins. Glucose is the principal source of energy for living cells, and is carried to each cell through the bloodstream. Some populations of cells cannot properly absorb and use glucose except in the presence of insulin. Also called dextrose. Blood Sugar See Blood glucose Bolus In Greek, bolus means " lump. " In medical contexts, the word is used to describe a one-time dose of something, given orally or by injection. In the discussion of diabetes, " bolus " is usually used to mean a single injection of insulin given to " cover " an elevated level of blood glucose (sugar), such as the mealtime blood sugar spike that commonly occurs after eating. Commonly, the size of this bolus injection of insulin will be determined according to a sliding scale that " matches " the blood sugar level. Such sliding scales are generally individualized for each person. Top of Page C Chronic glucose toxicity A chronic exposure to levels of high levels of blood glucose. Hyperglycemia may not only be a consequence but also a cause of further impairment in glucose tolerance in the diabetic patient because hyperglycemia decreases insulin sensitivity in some target tissue populations and increases glucose production in the liver. Once a patient's metabolic control improves, the effects of chronic glucose toxicity tend to abate, and the dose of insulin or hypoglycemic drug can usually be lowered.3 Complications of Diabetes Harmful effects that may happen when a person has diabetes. Some effects, such as hypoglycemia, can happen any time, particularly with anti-diabetic medications that have long-lasting effects. Other complications of diabetes can occur when a person has had diabetes for a long time, and several organs can be affected and damaged. Damage to the retina of the eye (retinopathy), the blood vessels (angiopathy), the nervous system (neuropathy) and the kidneys (nephropathy) are often the consequence of chronic glucose toxicity. Studies show that keeping blood glucose levels as close to the normal range as possible may help prevent, slow, or delay harmful effects to the eyes, kidneys and nerves. Top of Page D Diabetes Insipidus A disease of the pituitary gland or kidney, not to be confused with diabetes mellitus. Diabetic Ketoacidosis (DKA) A severe consequence of out-of-control diabetes, particularly type 1 diabetes. See Ketoacidosis. DKA is characterized by severe dehydration, prostration, fever, hypotension, excessively rapid or very deep breathing. DKA is not caused by blood sugar going too high but by the effects of " starvation " as certain tissue populations take up abnormal metabolic processes because they're not being provided with the insulin they require to make proper use of glucose. DKA is almost always in need of prompt and appropriate treatment, and can require emergency care. Diabetic Retinopathy A disease of the small blood vessels of the retina of the eye that can lead to blindness. It is often seen as a complication of disease in diabetic patients with long-term disease or ineffective metabolic control. Top of Page E Euglycemia A normal level of glucose (sugar) in the blood. Early Phase Insulin Release Every time a meal is eaten, blood glucose (sugar) levels tend to rise. In order to quickly bring the harvest of new glucose into the cells that require it - and bring blood glucose levels down into the normal range as soon as possible - the beta cells in the normally-functioning body will produce an Early Phase Insulin Release which results in higher levels of blood insulin that " match " the increases in blood glucose following a meal. Top of Page F Fasting Plasma Glucose (FPG) Also known as fasting blood sugar, the measurement of plasma glucose generally taken after an overnight fast (the blood sample drawn early in the morning, with nothing by mouth except water from about midnight the night before). Fasting Blood Glucose Test A method for finding out how much glucose (sugar) is in the blood. The test can show if a person has diabetes. A blood sample is taken in a lab or doctor's office. The test is usually done in the morning before the person has eaten. Top of Page G Gestational Diabetes Mellitus (GDM) A type of diabetes mellitus that can occur when a woman is pregnant which disappears after the pregnancy ends. Women with GDM usually develop it during the second half of the pregnancy, but after the baby is born, the blood sugar goes back to normal levels in 95% of cases. Women who have had gestational diabetes are at increased risk for the later development of type 2 diabetes.4 Glucagon A hormone that raises the level of glucose (sugar) in the blood. The alpha cells of the pancreas (in areas called the islets of Langerhans) make glucagon when the body needs to put more sugar into the blood. An injectable form of glucagons is sometimes used to treat insulin shock. If a patient has insulin shock, the injection glucagon quickly raises blood glucose back to normal. Glucose A simple sugar found in the blood. Glucose is the body's main source of energy; also known as dextrose. Glucose Spikes High levels of blood glucose after meals. Over time, accumulation of both fasting and post-mealtime glucose spikes can lead to health complications. Glucose Tolerance Test See also Oral Glucose Tolerance Test A test to see if a person has diabetes. The test is given in a lab or doctor's office in the morning before the person has eaten. A first sample of blood is taken from the person. Then the person drinks a liquid that has glucose (sugar) in it [for an oral glucose tolerance test] or the patient is given an injection that has a given amount of glucose in it. After one hour, a second blood sample is drawn, and, after another hour, a third sample is taken. These tests mimic what happens during and after a normal meal and allows the doctor to tell if the patient is able to control the high levels of glucose that a person has after a meal. Top of Page H Hemoglobin A1C (HbA1C) Hemoglobin is the substance inside red blood cells that carries oxygen through the bloodstream to the tissues. If the blood levels of glucose are high, the glucose becomes permanently attached to the hemoglobin and the glycated (also called glycosylated) hemoglobin stays inside the red blood cells as long as they live (about 4 months). Because the HbA1c inside the red blood cells is stable for such a long time, a test to measure hemoglobin A1C shows what the person's average blood glucose level was for those 4 months. Hormone A chemical released by special cells that turns on, turns off or fine-tunes what another cell does. Hormones " give orders " to other cells. For instance, insulin is a hormone made by the beta cells in the pancreas. When released, insulin " turns on " everything the cell needs to be able to use glucose (sugar) for energy. Human Insulin Man-made insulin compounds that are chemically similar to insulin produced by the human body. Hyperglycemia Too high a level of glucose (sugar) in the blood; a sign that diabetes is out of control. Many things can cause hyperglycemia. It occurs when the body does not have enough insulin or cannot effectively use the insulin it has in order to turn glucose into energy. Signs of hyperglycemia are a great thirst, a dry mouth, and a need to urinate more often than usual. Hyperinsulinism Too high a level of insulin in the blood. This term most often refers to a condition in which the body produces too much insulin. Hypoglycemia Too low a level of glucose (sugar) in the blood. A person with hypoglycemia may feel nervous, shaky, weak, sweaty, hungry or may have a headache or blurred vision. Hypoglycemia occurs when a person with diabetes has injected too much insulin, taken too high a dose of an oral anti-diabetic agent, or taken a long-acting oral anti-diabetic. Hypoglycemia can also happen when a person with diabetes has eaten too little food or has exercised on an empty stomach. Impaired Glucose Tolerance (IGT) Blood glucose (sugar) levels measured from a sample of blood taken after fasting that are higher than normal but not high enough to be called diabetes. IGT may be a early warning sign of type 2 diabetes.5 Top of Page I Insulin A hormone that helps the body use glucose (sugar) for energy. The beta cells of the pancreas (in areas called the islets of Langerhans) make the insulin. When the body cannot make enough insulin on its own, a person with diabetes must take a medication that can stimulate insulin secretion, or improve the way the cells use insulin. Persons who do not make insulin must inject it into themselves. The insulin used to be made mostly from pork and beef; now it is more frequently made from human sources or in the laboratory by recombinant DNA. Insulin Reaction Too low a level of glucose (sugar) in the blood; also called hypoglycemia, caused by injected insulin. This occurs when a person with diabetes has injected too much insulin, eaten too little food, or exercised on an empty stomach. Insulin Receptors Areas on the outer part of a cell that allow the cell to join or bind with insulin that is in the blood. When the cell and insulin bind together, the cell can take glucose (sugar) from the blood and use it for energy. Insulin Resistance The inability of body tissue populations (such as the fatty cells of the adipose tissue within the abdomen) to respond to insulin even if there is plenty around. This is a common development in patients with type 2 diabetes, and it can grow worse as the disease persists for a long time, particularly when there has been poor metabolic control. Insulin Secretion Insulin is created in the beta cells of the islets of Langerhans scattered through the pancreas. These beta cells are part of the endocrine (or " ductless gland " ) system of the body, releasing the hormone insulin directly into the bloodstream. In the normal human body, elevated blood levels of glucose stimulate insulin secretion. In patients with type 1 diabetes the beta cells have been destroyed, and the pancreas produces little or no insulin at all. In patients with type 2 diabetes, the beta cells usually can manufacture insulin, but the ability of the beta cells to respond to high " spikes " in blood glucose levels is impaired. Thus, the majority of people with type 2 diabetes have the ability to make insulin, which could and should be secreted to help control blood sugar elevations, but that insulin simply is not appropriately released into the bloodstream. Insulin Shock A severe condition resulting from rapid drops in the level of blood glucose (sugar). The signs are shaking, sweating, dizziness, double vision, convulsions and collapse. Insulin shock can result when an insulin reaction is not treated quickly enough. Islets of Langerhans The islets of Langerhans are clusters of cells scattered throughout the abdominal digestive gland called the pancreas. Although they are in the pancreas and depend upon the pancreas for circulation and nutrition, they have little to do with the digestive functions of the pancreas. These " islands " of tissue consist of three cell types: alpha, beta, and delta. The most abundant cells produce insulin: the beta cells. The alpha cells make and secrete the hormone glucagons. The delta cells manufacture the hormone somatostatin. Top of Page K Ketone Bodies Chemicals that the body makes when metabolism is disturbed, such as during starvation, acute alcoholism, or uncontrolled diabetes mellitus. It happens when insulin is so low or so poorly utilized that glucose is not used as the main energy source and the body resorts to breakdown of fats for energy. Ketoacidosis When certain tissue populations in the body can no longer use glucose for fuel because there's not enough insulin (or insulin isn't effective enough) to permit them to absorb glucose from the bloodstream, these " starved " cells begin to create their own fuel by lipid oxidation, breaking down fat molecules to make energy. Ketone Bodies (see above) are created as a byproduct. High levels of ketone chemicals in the bloodstream will cause the blood to become excessively (even dangerously) acidic and can cause a person to go into a coma. Ketonuria Having ketone bodies in the urine; a warning sign of diabetic ketoacidosis. Ketosis A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting and stomach pain. Ketosis can lead to ketoacidosis if the ketone chemicals can't be eliminated from the body. Top of Page L Lente Insulin A type of insulin with intermediate length of action, compared to standard or long-acting insulins. Top of Page M Macrovascular Disease A disease of the large blood vessels that sometimes occurs when a person has had diabetes for a long time. Fat and blood clots build up in the large blood vessels and stick to the vessel walls. Three kinds of macrovascular disease are coronary disease, cerebrovascular disease and peripheral vascular disease. Microvascular Disease Disease of the smallest blood vessels that sometimes occurs when a person has had diabetes for a long time. The walls of the vessels become abnormally thick but weak, and therefore they bleed, leak protein and slow the flow of blood through the body. Top of Page N Nephropathy Disease of the kidneys caused by damage to the small blood vessels or to the units in the kidneys that clean the blood. Neuropathy Disease of the nervous system. Frequently a person who has had diabetes for a while may have some signs of nerve damage. The three major forms of nerve damage are: peripheral neuropathy, autonomic neuropathy and mononeuropathy. NPH Insulin A type of insulin that has an duration of action that is intermediate compared to standard or long-acting insulins. Top of Page O Oral Antidiabetic Agents See Oral Hypoglycemic Agents Oral Glucose Tolerance Test (OGTT) A test to see if a person has diabetes. The test is given in a lab or doctor's office in the morning before the person has eaten. A first sample of blood is taken. Then the person drinks a liquid that has glucose (sugar) in it. After one hour, a second blood sample is drawn, and, after another hour, a third sample is taken. This test allows the doctor to tell if the patient is able to control the high levels of glucose that usually follow eating a meal. Oral Hypoglycemic Agents7 Pills or capsules that people take by mouth to lower the level of glucose (sugar) in the blood. The pills work for some people whose pancreas still makes some insulin. They can help the body in several ways, such as causing the cells in the pancreas to release more insulin by improving the functioning of the beta cells in the islets of Langerhans, or by changing the way glucose is absorbed in the intestines or metabolized by the liver. Drug Class Drug Names Mechanism of lowering blood glucose Sulfonylurea Glyburide Glimepiride Glipizide Chlorpropamide Tolazamide Tolbutamide Acetohexamide Stimulates release of insulin from the pancreas, an effect dependent upon functioning beta cells in the pancreatic islets Thiazolidinedione Rosiglitazone troglitazone pioglitazone Improves sensitivity to insulin in muscle and adipose tissue Glucosidase inhibitor Acarbose Miglitol Delays digestion of ingested carbohydrates, thus diminishing the increase in blood sugar after meals by inhibiting the membrane-bound intestinal alpha-glucosidase hydrolase enzymes Meglitinide Repaglinide Stimulates the release of insulin from the pancreas by a different mechanism than the sulfonylureas. Biguanide Metformin Sensitizes target tissue Phenylalanine derivative Nateglinide Stimulates pancreas to release insulin in a glucose-dependent manner; different mechanism than the sulfonylureas. Top of Page P Pancreas An organ behind the lower part of the stomach that is about the size of the hand. It makes insulin so that the body can use glucose (sugar) for energy. It also makes enzymes that help the body digest food. Distributed throughout the pancreas are little clusters of cells called the islets of Langerhans. The cells in these areas each have a special purpose. The alpha cells make glucagon, the beta cells make insulin, and the delta cells make somatostatin. Pancreas Transplant A surgical procedure that involves replacing the pancreas of a person who has diabetes with a healthy pancreas that can make insulin. The healthy pancreas comes from a donor who has just died. A portion of the pancreas can be donated by a living relative with suitable tissue compatibility. Polydipsia A great thirst that lasts for long periods of time; a sign of diabetes. Polyphagia Great hunger; a sign of diabetes caused by the " starvation " of tissue populations which need insulin to make use of glucose. People with this great hunger often lose weight because the " starving " tissue populations cannot make use of the new glucose coming into the bloodstream no matter how much the person eats. Postmeal (or post-mealtime) Blood Glucose Blood glucose (sugar) levels taken one to two hours after eating to determine the amount of glucose (sugar) in the blood following a meal. Also called postprandial glucose. Postprandial Glucose (PPG) (See Postmeal Blood Glucose). Top of Page R Regular Insulin A type of insulin that is fast acting, essentially similar in onset of action and duration of action to the insulin normally secreted by the human body's own beta cells. Retinopathy A disease of the small blood vessels in the retina of the eye that can lead to blindness. Retinopathy is often seen as a complication of disease in patients with diabetes with long-term disease or ineffective metabolic control. Risk Factor Anything that raises the chance that a person will develop a disease, or sustain an adverse consequence. Top of Page S Secondary Diabetes In addition to " pure " type 1 and type 2 diabetes mellitus, it is possible for diabetes to develop as a complication of other diseases. If the pancreas must be surgically removed, for example, or if the pancreas is damaged or destroyed by inflammation, injury, infection, or exposure to toxic chemicals, the effect is the same as if the patient had developed type 1 diabetes. The beta cells in the islets of Langerhans are no longer available to create and secrete insulin. A great many other medical conditions can cause type 2 diabetes to develop, chiefly by causing severe insulin resistance.8 It is important to distinguish between primary and secondary diabetes because the diseases causing secondary diabetes must themselves be managed. Sucrose Table sugar. Sucrose is a disaccharide, a type of complex sugar made up of two simple sugars: glucose and fructose. Taken into the digestive system, sucrose is broken down by enzymes into its two component simple sugars, and these are absorbed into the blood for use by the body. Sugar A class of carbohydrates that taste sweet. Sugar is a quick and easy fuel for the body to use. Types of sugar include lactose ( " milk sugar " ), glucose, fructose, and sucrose. Top of Page T Type 1 Diabetes Mellitus Previously known as juvenile diabetes and insulin-dependent diabetes mellitus (IDDM). Type 2 Diabetes Mellitus Previously known as adult-onset diabetes and non-insulin-dependent diabetes mellitus (NIDDM). Top of Page U Ultralente Insulin A type of insulin that has long action, compared to regular or intermediate-acting insulin compounds.. Unit of Insulin Because insulin is measured in units of activity, doses of insulin are not given by weight or by volume. Today, the most frequently used concentration of insulin is 100 units per milliliter (mL). A milliliter is equal to a cubic centimeter (cc). This concentration is called U-100, and it is the only dosing concentration of insulin in the United States. In some countries, the older concentrations of U-40 and U-80 (40 units/mL or 80 units/mL) are still in use, and specialized insulin syringes must be used to measure doses of these concentrations.9 Unstable Diabetes A type of diabetes when a person's blood glucose (sugar) level often swings quickly from high to low and from low to high. Also called " brittle diabetes " or " labile diabetes. " Top of Page References: 1. NIH Publication No. 94-3016, August 1994. 2. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Committee Report. Diabetes Care 2000 volume 23 Supplement 1. Accessed at http://journal.diabetes.org 3. See The Merck Manual Online: http://www.merck.com/pubs/mmanual/section2/chapter13/13a.htm# A 4. Merck Manual Online at http://www.merck.com/pubs/mmanual/section18/chapter251/251g.htm: " Pregnancy is a metabolic stress test for diabetes; women who fail the test and develop gestational diabetes may be obese, hyperinsulinemic, and insulin-resistant or thin and relatively insulin-deficient. " In other words, the development of GDM is an indication that the patient is inclined toward the development of type 2 diabetes.] 5. Merck Manual Online at http://www.merck.com/pubs/mmanual/section2/chapter13/13a.htm# A. If the diagnostic qualifiers of type 2 diabetes are not demonstrably manifest, the patient does not have diabetes mellitus, but could develop it.] 7. From Mosby's Rx, Harcourt Health Sciences Publishers, 2001. Accessed at http://www.mosby.com 8. See The Merck Manual Online (http://www.merck.com/pubs/mmanual/section2/chapter13/13a.htm #A). 9. American Diabetes Association Website " On the Go " (http://www.diabetes.org/ada/c60e.asp) Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.