Glossary

A

A1C:
A test that measures a person's average blood glucose level over the past 2 to 3 months. Hemoglobin (HEE-mo-glo-bin) is the part of a red blood cell that carries oxygen to the cells and sometimes joins with the glucose in the bloodstream. Also called hemoglobin A1C or glycosylated (gly-KOH-sih-lay-ted) hemoglobin, the test shows the amount of glucose that sticks to the red blood cell, which is proportional to the amount of glucose in the blood.

Alpha cell:
A type of cell in the pancreas (in areas called the islets of Langerhans). Alpha cells make and release a hormone called glucagon, which raises the level of glucose (sugar) in the blood.

Antibodies:
Proteins made by the body to protect itself from "foreign" substances such as bacteria or viruses. People get type 1 diabetes when their bodies make antibodies that destroy the body's own insulin-making beta cells.

Aspart insulin:
(NovoLog® brand name.) A rapid-acting insulin. On average, aspart insulin starts to lower blood glucose within 10 to 20 minutes after injection. It has its strongest effect 1 to 3 hours after injection but keeps working for 3 to 5 hours after injection.

Atherosclerosis:
Clogging, narrowing, and hardening of the body's large arteries and medium-sized blood vessels. Atherosclerosis can lead to stroke, heart attack, eye problems, and kidney problems.

Autoimmune:
Disorder of the body's immune system in which the immune system mistakenly attacks and destroys body tissue that it believes to be foreign.

Autonomic neuropathy:
A type of neuropathy affecting the lungs, heart, stomach, intestines, bladder, or genitals.

B

Basal rate:
Refers to a continuous supply of low levels of insulin, as in insulin pump therapy.

Beta cell:
A type of cell in the pancreas in areas called the Islets of Langerhans. Beta cells make and release insulin, a hormone that controls the level of glucose (sugar) in the blood.

Blood glucose level:
The amount of glucose in a given amount of blood. It is noted in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L).

Blood glucose meter:
A small, portable machine used by people with diabetes to check their blood glucose levels. After pricking the skin with a lancet, one places a drop of blood on a test strip in the machine. The meter (or monitor) soon displays the blood glucose level as a number on the meter's digital display.

Blood glucose monitoring:
Checking blood glucose level on a regular basis in order to manage diabetes. A blood glucose meter (or blood glucose test strips that change color when touched by a blood sample) is needed for frequent blood glucose monitoring.

Blood glucose:
The main sugar found in the blood and the body's main source of energy. Also called blood sugar.

Blood sugar:
See blood glucose.

Bolus:
An extra amount of insulin taken to cover an expected rise in blood glucose, often related to a meal or snack.

C

Carbohydrate counting:
A method of meal planning for people with diabetes based on counting the number of grams of carbohydrate in food.

Carbohydrate:
One of the three main nutrients in food. Foods that provide carbohydrate are starches, vegetables, fruits, dairy products, and sugars.

Cardiovascular disease:
Disease of the heart and blood vessels (arteries, veins, and capillaries).

Certified diabetes educator (CDE):
A health care professional with expertise in diabetes education who has met eligibility requirements and successfully completed a certification exam. See diabetes educator.

Coma:
A sleep-like state in which a person is not conscious. May be caused by hyperglycemia (high blood glucose) or hypoglycemia (low blood glucose) in people with diabetes.

Complications:
Harmful effects of diabetes such as damage to the eyes, heart, blood vessels, nervous system, teeth and gums, feet and skin, or kidneys. Studies show that keeping blood glucose, blood pressure, and low-density lipoprotein cholesterol levels close to normal can help prevent or delay these problems.

Conventional therapy:
A system of diabetes management. Conventional therapy includes use of medication, meal planning, and exercise, along with regular visits to health care providers. The main objective in this form of treatment is to avoid very high and very low blood glucose levels.

C-peptide:
"Connecting peptide," a substance the pancreas releases into the bloodstream in equal amounts to insulin. A test of C-peptide levels shows how much insulin the body is making.

D

Dawn phenomenon:
A sudden rise in blood glucose levels in the early morning hours.

DCCT:
See Diabetes Control and Complications Trial.

Dextrose:
Simple sugar found in blood that serves as the body's main source of energy. Also called Glucose.

Diabetes Control and Complications Trial (DCCT):
A study by the National Institute of Diabetes and Digestive and Kidney Diseases, conducted from 1983 to 1993 in people with type 1 diabetes. The study showed that intensive therapy compared to conventional therapy significantly helped prevent or delay diabetes complications. Intensive therapy included multiple daily insulin injections or the use of an insulin pump with multiple blood glucose readings each day. Complications followed in the study included diabetic retinopathy, neuropathy, and nephropathy.

Diabetes educator:
A health care professional who teaches people who have diabetes how to manage their diabetes. Some diabetes educators are certified diabetes educators (CDE's). Diabetes educators are found in hospitals, physician offices, managed care organizations, home health care, and other settings.

Diabetes mellitus:
A metabolic disease caused by an absolute or a relative deficiency of insulin, a hormone that controls how the body processes glucose, protein, and fats. When the body's insulin supply is decreased, it cannot process carbohydrates and it compensates by over processing fats and protein. The condition is characterized by chronic high blood sugar and sugar in the urine. Diabetes mellitus can result in coma. Over time, complications can include nerve injury, blindness, kidney failure, and premature atherosclerosis with all of its complications.

Diabetic ketoacidosis (DKA):
An emergency condition in which extremely high blood glucose levels, along with a severe lack of insulin, result in the breakdown of body fat for energy and an accumulation of ketones in the blood and urine. Signs of DKA are nausea and vomiting, stomach pain, fruity breath odor, and rapid breathing. Untreated DKA can lead to coma and death.

Diabetic nephropathy:
Kidney disease usually resulting from diabetes that has been poorly controlled for several years.

Diabetic neuropathy:
Damage to the nervous system, most often resulting from poor control.

Diabetic retinopathy:
Damaged small blood vessels in the eye that can cause vision problems, including blindness.

Diabetologist:
A doctor who specializes in treating people who have diabetes.

DKA:
See diabetic ketoacidosis.

E

Endocrinologist:
A doctor who treats people who have endocrine gland problems such as diabetes.

Euglycemia:
A normal level of glucose in the blood.

F

Fasting blood glucose test:
A check of a person's blood glucose level after the person has not eaten for 8 to 12 hours (usually overnight). This test is used to diagnose pre-diabetes and diabetes. It is also used to monitor people with diabetes.

G

Gastroparesis:
A form of neuropathy that affects the stomach. Digestion of food may be incomplete or delayed, resulting in nausea, vomiting, or bloating, making blood glucose control difficult.

Gestational diabetes mellitus (GDM):
A type of diabetes mellitus that develops only during pregnancy and usually disappears upon delivery, but increases the risk that the mother will develop diabetes later. GDM is managed with meal planning, activity, and, in some cases, insulin.

Glargine insulin:
(Lantus® brand name.) Very-long-acting insulin. On average, glargine insulin starts to lower blood glucose levels within 1 hour after injection and keeps working evenly for 24 hours after injection. Often times used with additional daily injections of short-acting insulin administered to cover carbohydrate intake.

Glucagon:
A hormone produced by the alpha cells in the pancreas. It raises blood glucose. An injectable form of glucagon, available by prescription, may be used to treat severe hypoglycemia.

Glucose:
One of the simplest forms of sugar.

Glucose tablets:
Chewable tablets made of pure glucose used for treating hypoglycemia.

Glycemic index:
A system that ranks carbohydrate foods based on how quickly they are digested, and how quickly and how high they raise blood glucose levels.

H

Hemoglobin A1C test:
See A1C.

Honeymoon phase:
Temporary remission of hyperglycemia that occurs in some people newly diagnosed with type 1 diabetes, when some insulin secretion resumes for a short time, usually a few months, before stopping again.

Hormone:
A chemical substance produced in the body by an organ, which has a specific regulatory effect on the activity of other organs or cells. For example, insulin is a hormone made in the pancreas that tells other cells when to use glucose for energy.

Humalog®:
See Lispro Insulin.

Hyperglycemia:
A condition in which the blood contains an abnormally high level of glucose, characteristic of diabetes mellitus.

Hypoglycemia:
Too low a level of glucose (sugar) in the blood. This occurs when a person with diabetes has injected too much insulin, eaten too little food, or has exercised without extra food. A person with hypoglycemia may feel nervous, shaky, weak, or sweaty, and have a headache, blurred vision, and hunger. Hypoglycemia is treated by consuming a carbohydrate-rich food such as a glucose tablet or juice. It may also be treated with an injection of glucagon if the person is unconscious or unable to swallow. Also called an insulin reaction.

Hypoglycemia unawareness:
A state in which a person does not feel or recognize the symptoms of hypoglycemia. People who have frequent episodes of hypoglycemia may no longer experience the warning signs of it.

I

IDDM (insulin-dependent diabetes mellitus):
Former term for type 1 diabetes.

Infusion set:
A tube that carries insulin from the insulin pump to the body. The infusion set is inserted subcutaneously into the skin.

Infusion site rotation:
Changing the places on the body where insulin is infused or injected.

Injection:
Inserting liquid medication or nutrients into the body with a syringe. A person with diabetes may use short needles or pinch the skin and inject at an angle to avoid an intramuscular injection of insulin.

Insulin adjustment:
A change in the amount of insulin a person with diabetes takes based on factors such as meal planning, activity, and blood glucose levels.

Insulin:
A hormone secreted by the beta cells of the Islets of Langerhans in the pancreas. Needed by many cells to use glucose for energy.

Insulin-dependent diabetes mellitus (IDDM):
Former term for type 1 diabetes.

Insulin Pump:
A small, computerized, programmable device about the size of a beeper that can be programmed to send a steady stream of insulin into the bloodstream as basal insulin, as well as larger amounts prior to meals as boluses. It replaces insulin injections.

Insulin reaction:
When the level of glucose in the blood is too low (at or below 70 mg/dL). Also known as hypoglycemia.

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

Insulin resistance:
The body's inability to respond to and use the insulin it produces. Insulin resistance may be linked to obesity, hypertension, and high levels of fat in the blood.

Intensive therapy:
A treatment for diabetes in which blood glucose is kept as close to normal as possible through frequent injections or use of an insulin pump; meal planning; adjustment of medicines; and exercise based on blood glucose test results and frequent contact with a person's health care team.

Intramuscular injection:
Inserting liquid medication into a muscle with a syringe. Glucagon may be given by subcutaneous or intramuscular injection for hypoglycemia.

Islets or (Islets of Langerhans):
Groups of cells located in the pancreas that make hormones that help the body break down and use food. For example, alpha cells make glucagon and beta cells make insulin.

Islet transplantation:
Moving the islets from a donor pancreas into a person whose pancreas has stopped producing insulin. Beta cells in the islets make the insulin that the body needs for using blood glucose.

J

Juvenile diabetes:
Former term for insulin-dependent diabetes mellitus (IDDM), or type 1 diabetes.

K

Ketoacidosis:
A very serious condition in which the body does not have enough insulin. An excess release of free fatty acids causes high levels of ketones in the blood and urine. Also see diabetic ketoacidosis.

Ketone:
A chemical produced when there is a shortage of insulin in the blood and the body breaks down body fat for energy. High levels of ketones can lead to diabetic ketoacidosis and coma. Sometimes referred to as ketone bodies.

Ketones:
Acidic byproducts of fat metabolism.

Ketonuria:
A condition occurring when ketones are present in the urine, a warning sign of diabetic ketoacidosis.

Ketosis:
A ketone buildup in the body that may lead to diabetic ketoacidosis. Signs of ketosis are nausea, vomiting, and stomach pain.

Kidneys:
The two bean-shaped organs that filter wastes from the blood and form urine. The kidneys are located near the middle of the back. They send urine to the bladder.

L

Lancet:
A spring-loaded device used to prick the skin with a small needle to obtain a drop of blood for blood glucose monitoring.

Latent autoimmune diabetes in adults (LADA):
A condition in which type 1 diabetes develops in adults.

Lente insulin:
An intermediate-acting insulin. On average, lente insulin starts to lower blood glucose levels within 1 to 2 hours after injection. It has its strongest effect 8 to 12 hours after injection but keeps working for 18 to 24 hours after injection. Also called L insulin.

Lispro insulin:
(Humalog® brand name.) A rapid-acting insulin. On average, lispro insulin starts to lower blood glucose within 5 minutes after injection. It has its strongest effect 30 minutes to 1 hour after injection but keeps working for 3 hours after injection.

Liver:
An organ in the body that changes food into energy, removes alcohol and poisons from the blood, and makes bile, a substance that breaks down fats and helps rid the body of wastes.

Long-acting insulin:
A type of insulin that starts to lower blood glucose within 4 to 6 hours after injection and has its strongest effect 10 to 18 hours after injection. See ultralente insulin.

Low blood sugar:
See hypoglycemia.

Luer-Lock Connector:
The fitting on the end of the infusion set and on the cartridge that allows them to be connected, or locked, together securely.

M

mg/dL:
Milligrams per deciliter, a unit of measure that shows the concentration of a substance in a specific amount of fluid. In the United States, blood glucose test results are reported as mg/dL. Medical journals and other countries use millimoles per liter (mmol/L). To convert to mg/dL from mmol/L, multiply mmol/L by 18. Example: 10 mmol/L x 18 = 180mg/dL.

mmol/L:
Millimoles per liter, a unit of measure that shows the concentration of a substance in a specific amount of fluid. In most of the world, except for the United States, blood glucose test results are reported as mmol/L. In the United States, milligrams per deciliter (mg/dL) is used. To convert to mmol/L from mg/dL, divide mg/dL by 18. Example: 180 mg/dL ÷ 18 = 10 mmol/L.

N

Nephrologist:
A doctor who treats people who have kidney problems.

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 have kidney damage.

Noninsulin-dependent diabetes mellitus (NIDDM): :
Former term for type 2 diabetes.

NovoLog®:
See Aspart Insulin.

NPH insulin:
An intermediate-acting insulin; NPH stands for neutral protamine Hagedorn. On average, NPH insulin starts to lower blood glucose within 1 to 2 hours after injection. It has its strongest effect 6 to 10 hours after injection but keeps working about 10 hours after injection. Also called N insulin.

P

Pancreas:
A gland positioned near the stomach about the size of a hand that secretes insulin, glucagon, and many digestive enzymes.

Pancreas transplantation:
A surgical procedure to take a healthy whole or partial pancreas from a donor and place it into a person with diabetes.

Pediatric endocrinologist:
A doctor who treats children who have endocrine gland problems such as diabetes.

Peripheral neuropathy:
Nerve damage that affects the feet, legs, or hands. Peripheral neuropathy causes pain, numbness, or a tingling feeling.

Peripheral vascular disease (PVD):
A disease of the large blood vessels of the arms, legs, and feet. PVD may occur when major blood vessels in these areas are blocked and do not receive enough blood. The signs of PVD are aching pains and slow-healing foot sores.

Polyphagia:
Excessive hunger; may be a sign of diabetes.

Polyuria:
Excessive urination; may be a sign of diabetes.

Postprandial blood glucose:
The blood glucose level taken 1 to 2 hours after eating.

Pre-prandial blood glucose:
The blood glucose level taken before eating.

Pump:
See insulin pump.

R

Rapid-acting insulin:
A type of insulin that starts to lower blood glucose within 5 to 10 minutes after injection and has its strongest effect 30 minutes to 3 hours after injection, depending on the type used. See aspart insulin and lispro insulin.

Regular insulin:
Short-acting insulin. On average, regular insulin starts to lower blood glucose within 30 minutes after injection. It has its strongest effect 2 to 5 hours after injection but keeps working 5 to 8 hours after injection. Also called R insulin.

S

Self-management:
In diabetes, the ongoing process of managing diabetes. Includes meal planning, planned physical activity, blood glucose monitoring, taking diabetes medicines, handling episodes of illness and of low and high blood glucose, managing diabetes when traveling, and more.

Sharps container:
A container for disposal of used needles and syringes or other sharp objects; often made of hard plastic so that needles cannot poke through.

Short-acting insulin:
A type of insulin that starts to lower blood glucose within 30 minutes after injection and has its strongest effect 2 to 5 hours after injection. See regular insulin.

Sliding scale:
A set of instructions for adjusting insulin on the basis of blood glucose test results, meals, or activity levels.

Subcutaneous infusion:
Putting a fluid into the tissue just under the skin with an infusion set.

Sugar diabetes:
Former term for diabetes mellitus.

Syringe:
A device used to inject medications or other liquids into body tissues. The syringe for insulin has a hollow plastic tube with a plunger inside and a needle on the end.

T

Type 1 Diabetes:
In Type 1 diabetes the pancreas makes little or no insulin because the insulin-producing beta cells have been destroyed. This type of diabetes usually appears suddenly and most commonly in people younger than 30. Treatment consists of daily insulin injections or use of an insulin pump, a planned diet, regular exercise, and daily self-monitoring of blood glucose.

U

Ultralente insulin:
Long-acting insulin. On average, ultralente insulin starts to lower blood glucose within 4 to 6 hours after injection. It has its strongest effect 10 to 18 hours after injection but keeps working 24 to 28 hours after injection. Also called U insulin.

Unit of insulin:
The basic measure of insulin. U-100 insulin means 100 units of insulin per milliliter (mL) or cubic centimeter (cc) of solution.