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    Glossary of Diabetes Terms

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    Autoantibody test: This blood test, called the zinc transporter 8 autoantibody (ZnT8Ab) test, is used along with other information and test results to determine if a person has type 1 diabetes and not another type of diabetes.

    Autoimmune disease: A disorder of the body's immune system in which the immune system mistakenly attacks itself; examples of these diseases include type 1 diabetes, hyperthyroidism caused by Graves' disease, and hypothyroidism caused by Hashimoto's disease.

    Autonomic neuropathy:Nerve damage to the part of the nervous system that we cannot consciously control; these nerves control our digestive system, blood vessels, urinary system, skin, and sex organs. Autonomic nerves are not under a person's control and function on their own.

    Background retinopathy: This is the mildest form of eye disease caused by diabetes; it can be associated with normal vision. With a longer duration of diabetes or with uncontrolled blood sugars, eye damage can progress to more serious forms.

    Basal rate: The amount of insulin required to manage normal daily blood glucose fluctuations; most people constantly produce insulin to manage the glucose fluctuations that occur during the day. In a person with diabetes, giving a constant low level amount of insulin via insulin pump mimics this normal phenomenon.

    Beta cell: A type of cell in an area of the pancreas called the islets of Langerhans; beta cells make and release insulin, which helps control the glucose level in the blood.

    Biosynthetic insulin: Genetically engineered human insulin; this insulin has a much lower risk of inducing an allergic reaction in people who use it, unlike cow (bovine) or pork (porcine) insulins. The manufacturers of synthetic insulin make it in a short-acting form, which works to cover mealtime increases in sugars; they also produce longer-acting insulins, which cover sugars between meals and when fasting, such as during the night.

    Blood glucose: See glucose.

    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.

    Brittle diabetes: When a person's blood sugar level often shifts very quickly from high to low and from low to high.

    Blood urea nitrogen (BUN): A product of metabolism that is excreted in the urine; it is measured in the blood as an indirect measure of how well the kidney is functioning. Increased BUN levels in the blood may indicate early kidney damage, meaning the kidneys aren't effectively excreting BUN.

    Bunion: Bump or bulge on the first joint of the big toe caused by the swelling of a sac of fluid under the skin and abnormalities in the joint; women are usually affected because of tight fitting or pointed shoes or high heels that put pressure on the toes, forcing the outward movement of the joint. People with flat feet or low arches are also prone to bunions. Shoes that fit well and are padded can prevent bunions from forming. Bunions may lead to other problems, such as serious infection from the big toe putting pressure on other toes.

    Callus: A small area of skin, usually on the foot, that has become thick and hard from rubbing or pressure; calluses may lead to other problems, such as serious infection. Shoes that fit well can prevent calluses from forming.

    Calorie: Energy that comes from food; some foods have more calories than others. Fats have more calories than proteins and carbohydrate. Most vegetables have few.

    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).

    Cardiologist: A doctor who takes care of people with heart disease; a heart specialist.

    Cardiovascular: Relating to the heart and blood vessels (arteries, veins, and capillaries).

    Certified Diabetes Educator (CDE): A health care professional who is certified by the American Association of Diabetes Educators (AADE) to teach people with diabetes how to manage their condition.

    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.

    Claudication: See intermittent claudication.

    Coma: An emergency in which a person is not conscious; may occur in people with diabetes because their blood sugar is too high or too low.

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

    Dehydration: Large loss of body water; if a person with diabetes has a very high blood sugar level, it causes increased water loss through increased urination and therefore, extreme thirst.

    Diabetes: See type 1 diabetes and type 2 diabetes.

    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.

    Dietitian: An expert in nutrition who helps people plan the type and amount of foods to eat for special health needs; a registered dietitian (RD) has special qualifications.

    Emergency medical identification: Cards, bracelets, or necklaces with a written message, used by people with diabetes or other medical problems to alert others in case of a medical emergency, such as coma.

    Endocrinologist: A doctor who treats people with hormone problems.

    Exchange lists: A way of grouping foods together to help people on special diets stay on the diet; each group lists food in a serving size. A person can exchange, trade, or substitute a food serving in one group for another food serving in the same group. The lists put foods into six groups: starch/bread, meat, vegetables, fruit, milk, and fats. Within a food group, one serving of each food item in that group has about the same amount of carbohydrate, protein, fat, and calories.

    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.

    Fructose: A type of sugar found in many fruits and vegetables and in honey; fructose is used to sweeten some diet foods, but this type of sweetener is typically not recommended for people with diabetes, because it could have a negative effect on blood sugar.

    Gangrene: The death of body tissues, usually due to a lack of blood supply, especially in the legs and feet.

    Gastroparesis: A form of nerve damage that affects the stomach and intestines; with this condition, food is not digested properly and does not move through the stomach and intestinal tract normally. It can result in nausea and vomiting, because the transit time of food is slowed by nerve damage. This type of nerve damage can also cause a significant problem with low and erratic blood sugars.

    Gestational diabetes: A high blood sugar level that starts or is first recognized during pregnancy; hormone changes during pregnancy affect the action of insulin, resulting in high blood sugar levels. Usually, blood sugar levels return to normal after childbirth. However, women who have had gestational diabetes are at increased risk of developing type 2 diabetes later in life. Gestational diabetes can increase complications during labor and delivery and increase the rates of fetal complications related to the increased size of the baby.

    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%.

    High blood pressure: A condition when the blood flows through the blood vessels at a force greater than normal; high blood pressure strains the heart, harms the arteries, and increases the risk of heart attack, stroke, and kidney problems; also called "hypertension." The goal for blood pressure in people with diabetes is less than 130/80.

    High blood sugar: See hyperglycemia.

    Home blood glucose monitoring: A way in which a person can test how much sugar is in the blood; also called "self-monitoring of blood glucose." Home glucose monitoring tests whole blood (plasma and blood cell components); thus, the results can be different from lab values, which test plasma values of glucose. Typically, the lab plasma values can be higher than the glucose checks done at home with a glucose monitor.

    Hormone: A chemical released in one organ or part of the body that travels through the blood to another area, where it helps to control certain bodily functions; for instance, insulin is a hormone made by the beta cells in the pancreas and when released, it triggers other cells to use glucose for energy.

    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.

    Hypertension: See high blood pressure.

    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."

    Injection sites: Places on the body where people can inject insulin most easily.

    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.

    Insulin resistance: When the effect of insulin on muscle, fat, and liver cells becomes less effective; this effect occurs with both insulin produced in the body and with insulin injections. Therefore, higher levels of insulin are needed to lower the blood sugar.

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