Chapter VII - Endocrine System

List of Terms associated with Diabetes

Acetohexamide - A pill taken to lower the level of glucose (sugar) in the blood. Only some people with Type II diabetes take these pills.

Acetone - A byproduct of excessive fat metabolism

Acidosis - An acidic condition in the blood. If prolonged, or severe, it can cause coma and death. For a person with diabetes, this can be caused by insufficient glucose absorption (Eg, from inadequate insulin) and metabolic ketosis. It can lead to diabetic ketoacidosis, a medical emergency.

Acute - Happens for a limited period of time; abrupt onset; sharp, severe.

Adult-onset diabetes - Former term for type 2 diabetes.

Adverse effect - A harmful result

Aldose reductase inhibitor 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. The name is different in the UK.

Amyotrophy - A type of diabetic neuropathy that causes muscle weakness and wasting.

Anomalies - Birth defects; abnormalities.

Antidiabetic agent - A kind of medication that helps a person with diabetes control the level of glucose (sugar) in the blood so that the body works as it should. Arteriosclerosis is the same as atherosclerosis

Artificial pancreas - A large machine used in hospitals that constantly measures glucose (sugar) in the blood and, in response, releases the right amount of insulin. Scientists are also working to develop a small unit that could be implanted in the body, functioning like a real pancreas.

Aspartame - An artificial sweetener that can replace sugar

Asymptomatic - No symptoms; no clear sign of disease present. Most Type IIs are without clinically obvious symptoms for some time (up to decades) before they are diagnosed as diabetic. Background retinopathy also known as non-proliferative retinopathy

Basal rate - Refers to a continuous supply of something. In the case of diabetes, it refers to low levels of insulin needed for such purposes as controlling cellular amino acid uptake, potassium uptake, etc.

Biosynthetic human insulin - A man-made insulin that is chemically identical to like human insulin.

Biphasic insulin - A type of insulin that is a mixture of intermediate- and fast-acting insulin.

See 70/30.

Blood glucose

Blood glucose meter

Blood glucose monitoring

Blood pressure

Blood-sampling device

Blood sugar - Another name for blood glucose

Blood urea nitrogen (BUN) A measurement of a metabolic waste product in the blood. Urea is one end product of protein metabolism. Increased levels of BUN in the blood may indicate early kidney damage.

Blood vessels

Bolus - An extra amount of insulin given in one dose to cover an expected rise in blood glucose (sugar) such as the rise that occurs after eating.

Borderline diabetes - A term no longer used. See: Impaired glucose tolerance.

Brittle diabetes - A term used when a person's blood glucose (sugar) level often swings quickly from high to low and from low to high. Also called labile and unstable diabetes.

Bronze diabetes see Hemochromatosis.

Bunion - A bump or bulge on the first joint of the big toe caused by the swelling of a sac of fluid under the skin.

Certified diabetes educator (C.D.E.) - A health care professional who is qualified by the American Association of Diabetes Educators to teach people with diabetes how to manage their condition. The health care team for diabetes should ideally include a diabetes educator, preferably a C.D.E.

C-peptide - A substance that the pancreas releases into the bloodstream in equal amounts to insulin. A test of C-peptide levels will show how much insulin the body is making. Insulin is prepared as two insulin molecules linked by a c-peptide. When insulin is secreted, C-peptide is released as well.

Calcium channel blocker

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 keep calluses from forming.

Cerebrovascular disease - Damage to the blood vessels in the brain, resulting in a stroke. People with diabetes are at higher risk of cerebrovascular disease.

Charcot foot - A foot complication associated with diabetic neuropathy that results in destruction of joints and soft tissue. Also called "Charcot's joint" and "neuropathic arthropathy."

Chemical Diabetes - is a term that is no longer used. See: Impaired glucose tolerance.

Chlorpropamide - A pill taken to lower the level of glucose (sugar) in the blood. Only some people with non-insulin-dependent diabetes take these pills.

Chronic - Present over a long period of time. Diabetes is an example of chronic disease.

Complications of diabetes - Harmful effects that may happen when a person has diabetes. Some acute effects, such as hypoglycemia or hyperglycemia, can happen any time. Others develop when a person has had diabetes for a long time (years, or even decades). These include damage to the retina of the eye (retinopathy), the blood vessels (angiopathy), the nervous system (neuropathy), and the kidneys (nephropathy). Studies very clearly show that keeping blood glucose levels as close to the normal, nondiabetic range as possible does help prevent, slow, or delay the long term complications of diabetes (eye, kidney, blood vessel, and nerve damage).

Congenital defect - Problems or conditions that are present at birth.

Congestive heart failure - Heart failure caused by loss of pumping power by the heart, resulting in fluids collecting in the body.

Contraindication - A condition that makes a treatment not helpful or even harmful.

Controlled disease - Taking care of oneself so that a disease has less of an effect on the body. People with diabetes can "control" the disease by staying on their diets, by exercising, by taking medicine if it is needed, and by monitoring their blood glucose. This care will help keep the glucose (sugar) level in the blood from becoming either too high or too low.

Conventional therapy - A system of diabetes management practiced by most people with diabetes; the system consists of one or two insulin injections each day, daily self-monitoring of blood glucose, and a standard program of nutrition and exercise. The main objective in this form of treatment is to avoid very high and very low blood glucose (sugar). Contrast close control therapy. Also called: "Standard Therapy." See complications of diabetes.

Creatinine - a measure of renal function

Continuous subcutaneous insulin infusion (CSII) - See: Insulin pump

Cyclamate - A man-made chemical that people used instead of sugar.

Dawn phenomenon - A sudden rise in blood glucose levels in the early morning hours. This condition sometimes occurs in people with insulin-dependent diabetes and (rarely) in people with non-insulin-dependent diabetes. Unlike the Somogyi effect, it is not a result of an insulin reaction. People who have high levels of blood glucose in the mornings before eating may need to monitor their blood glucose during the night. If blood glucose levels are rising, adjustments in evening snacks or insulin dosages may be recommended.

Debridement - The removal of infected, hurt, or dead tissue.

Delta cell - A type of cell in the pancreas in areas called the islets of Langerhans. Delta cells make somatostatin, a hormone that is believed to control how the beta cells make and release insulin and how the alpha cells make and release glucagon.

Desensitization - A method to reduce or stop an allergic reaction to something.

Diabetes control and complications trial (DCCT) - A 10-year study (1983-1993) funded by the National Institute of Diabetes and Digestive and Kidney Diseases to assess the effects of intensive therapy on the long-term complications of diabetes. The study very clearly showed that intensive management (close control) of insulin-dependent diabetes prevents or slows the development of the long-term complications of diabetes (eye, kidney, and nerve damage caused by diabetes).

Diabetes insipidus

Diabetes mellitus - A disease that occurs when the body is not able to use dietary carbohydrates (e.g., sugar, starch,...) as it should.

Diabetic amyotrophy - A disease of the nerves leading to the muscles. This condition affects only one side of the body and occurs most often in older men with mild diabetes.

Diabetic angiopathy

Diabetic coma

Diabetic ketoacidosis (DKA)

Diabetic myelopathy - Spinal cord damage found in some people with diabetes.

Diabetic nephropathy - See: Nephropathy

Diabetic neuropathy - See: Neuropathy

Diabetic osteopathy - Loss of foot bone as viewed by x-ray; usually temporary. Also called "disappearing bone disease."

Diabetic retinopathy

Diabetogenic - Causing diabetes; some drugs cause blood glucose (sugar) to rise temporarily. Other causes it to rise permanently; if so they have caused diabetes.

Diabetologist - A doctor who sees and treats people with diabetes mellitus.

Diagnosis - The term used when a doctor finds that a person has a certain medical problem or disease.

Diastolic blood pressure - See: Blood pressure.

Diet plan - See: Meal plan.

Dietitian - An expert in nutrition who helps people with special health needs plan the kinds and amounts of foods to eat. A registered dietitian (R.D.) has special training and experience. The health care team for diabetes should ideally include a dietitian, preferably an R.D.

Dilated pupil examination - A necessary part of an examination for diabetic eye disease. Special drops are used to enlarge the pupils, enabling the doctor to view the back of the eye for damage.

Distal sensory neuropathy - See: Peripheral neuropathy.

Edema - collection of fluid in a part of the body. Diabetics often have endemic feet due to decreased circulation to them.

Electromyography EMG - Test used to diagnose neuropathy and check for nerve damage. 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

Endogenous - Grown or made inside the body. Insulin made by a person's own pancreas is endogenous insulin. Insulin that is supplied from outside the body (ie, injected or otherwise supplied) is exogenous.

End-stage renal disease (ESRD) - The final phase of many kidney diseases; treated by dialysis or kidney transplantation.

Euglycemia - A normal level of glucose (sugar) in the blood.

Exchange lists - A grouping of foods by type to help people on special diets stay on the diet. Each group lists food in serving sizes. 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 in six groups: (1) starch/bread, (2) meat, (3) vegetables, (4) fruit, (5) milk, and (6) fats. Within a food group, each serving has about the same amount of carbohydrate, protein, fat, and calories.

Exogenous - Grown or made outside the body; for instance, insulin made from pork or beef pancreas is exogenous insulin for people. Contrast endogenous.

Fasting blood glucose test - A method for finding out how much glucose (sugar) is in the blood, unaffected by recent food. The test can show if a person has diabetes (a single reading of 126 mg/dl is diagnostic except in newborns or pregnant women or in some unusual other conditions). A blood sample is often taken in a lab or doctor's office. The test is usually done in the morning before the person has eaten. The normal, nondiabetic range for blood glucose is approx between 70 to 110 mg/dl, depending on the person and whether the blood is from a vein or a capillary, and depending on how the measurement is made (on whole blood or just the plasma).

Fluorescein angiography - A method of taking a picture of the flow of blood in the vessels of the eye by tracing the progress of an injected dye. Foot care - Taking special steps to avoid foot problems such as sores, cuts, bunions, and calluses.

Fractional urine - Urine that a person collects for a certain period of time during 24 hours; usually from breakfast to lunch, from lunch to supper, from supper to bedtime, and from bedtime to rising. Also called "block urine."

Fundus of the eye - The central portion of the retina on back or deepest part of the eye.

Funduscopy - A test to look at the back area of the eye to see if there is any damage to the vessels that bring blood to the retina. The doctor uses a device called an ophthalmoscope to check the eye.

Galactose

Gangrene - Infection of dead body tissue. It is most often caused by a loss of blood flow, especially in the legs and feet.

Gastroparesis - A form of nerve damage that affects the stomach and intestines. Food is not digested properly and does not move through in a normal way, resulting in vomiting, nausea, or bloating. It often interferes with diabetes management.

Gestational diabetes mellitus (GDM) - A type of diabetes mellitus that can occur when a woman is pregnant. During the pregnancy (usually later in it), the woman may have glucose (sugar) in her blood at a higher than normal level. However, when the pregnancy ends, the blood glucose levels return to normal in about 95 percent of all cases. It must be treated carefully by a physician for it is dangerous to both mother and child. If treated properly, there are usually no lasting effects on either.

Gliclazide - A pill taken to lower the level of glucose (sugar) in the blood. Only some people with non-insulin-dependent diabetes take these pills.

Glimepiride - A pill taken to lower the level of glucose (sugar) in the blood. Only some people with non-insulin-dependent diabetes take these pills.

Glipizide - A pill taken to lower the level of glucose (sugar) in the blood. Only some people with non-insulin-dependent diabetes take these pills.

Glomerular filtration rate - A measure of the kidneys' ability to filter and remove waste products.

Glomeruli - Network of tiny blood vessels in the kidneys where the blood is filtered and waste products are removed.

Glucagon - A hormone that raises the level of glucose (sugar) in the blood by forcing the liver to release its intracellular stores of glucose.

Glucose tolerance test - A test to see if a person has diabetes. The test is usually 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 a measured amount of glucose in it. After one hour, a second blood sample is drawn, and, after another hour, a third sample is taken. The object is to see how well the body deals with the glucose in the blood over time without interference from other foods. Depending on the local lab, the number and spacing of samples may vary.

Glyburide - A pill taken to lower the level of glucose (sugar) in the blood. Only some people with noninsulin-dependent diabetes take these pills.

Glycemic index - The effect of different foods on blood glucose (sugar) levels over a period of time.

Glycogen - A substance made from multiple glucose molecules. Sometimes called 'animal starch'. It is stored in liver and muscle cells and can be converted to glucose if needed. Glycogenesis (or glucogenesis) - the process by which glycogen is formed from glucose. Controlled by insulin.

Glycosylated hemoglobin test - A blood test that measures the level of a particular variety of hemoglobin (Hb1Ac) which is itself a measure of a person's average blood glucose level for the 3-month period before the test. See: Hemoglobin A1C.

HCF diet - A high-carbohydrate, high-fiber diet.

Hemodialysis - A mechanical method of cleaning the blood for people who have kidney disease.

Hemoglobin A1C (HbA1c) - Hemoglobin is the substance in red blood cells that carries oxygen to the cells. Some subtypes react with blood glucose; the HbA1c type reacts permanently with glucose. Since blood cells live about 90 days or so, the amount of HbA1c present at any time is a record of how much glucose there has been in that period.

HLA antigens - Proteins on the outer part of body cells that are (effectively) unique to that person. HLA types are inherited, and some of them are connected with Type I diabetes.

Home blood glucose monitoring - A way a person can test how much glucose (sugar) is in the blood. Also called self-monitoring of blood glucose.

Human insulin - Man-made insulins that are similar to insulin produced by your own body. Human insulin has been available since October 1982.

Hyperglycemia

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. Researchers believe that this condition may play a role in the development of non-insulin-dependent diabetes and in hypertension.

Hyperlipidemia - Too high a level of fats (lipids) in the blood.

Hyperosmolar coma - A coma (loss of consciousness) related to high levels of glucose (sugar) in the blood and requiring emergency treatment. A person with this condition is usually older and weak from loss of body fluids and weight. The person may or may not have a previous history of diabetes. Ketones (acids) are not present in the urine.

Hypoglycemia-Low glucose level.

Hypotension - Low blood pressure or a sudden drop in blood pressure. A person rising quickly from a sitting or reclining position may have a sudden fall in blood pressure, causing dizziness or fainting.

IDDM - Insulin-dependent diabetes mellitus.

IGT - Impaired glucose tolerance.

Immunosuppressive drugs - Drugs that block the body's ability to fight infection or foreign substances that enter the body. A person receiving a kidney or pancreas transplant is given these drugs to stop the body from rejecting the new organ or tissue. Cyclosporin is a commonly used immunosuppressive drug.

Impaired glucose tolerance (IGT) - Blood glucose (sugar) levels higher than normal but not high enough to be called diabetes. People with IGT may or may not develop diabetes. Other names (no longer used) for IGT are "borderline," "subclinical," "chemical," or "latent" diabetes.

Implantable insulin pump - A small pump placed inside of the body that delivers insulin in response to commands from a hand-held device called a programmer.

Ingestion - Taking food, water, or medicine into the body by mouth.

Injection - Putting liquid into the body with a needle and syringe.

Insulin allergy - When a person's body has an allergic or bad reaction to taking insulin made from pork or beef or from bacteria, or because the insulin is not exactly the same as human insulin or because it has impurities. The allergy can be of two forms. Sometimes an area of skin becomes red and itchy around the place where the insulin is injected. This is called a local allergy. In another form, a person's whole body can have a bad reaction This is called a systemic allergy. The person can have hives or red patches all over the body or may feel changes in the heart rate and in the rate of breathing. A doctor may treat this allergy by prescribing purified insulins or by desensitization.

Insulin antagonist - Something that opposes or fights the action of insulin. Insulin lowers the level of glucose (sugar) in the blood, whereas glucagon raises it; therefore, glucagon is an antagonist of insulin.

Insulin binding - When insulin attaches itself to something else. This can occur in two ways. First, when a cell needs energy, insulin can bind with the outer part of the cell. The cell then can bring glucose (sugar) inside and use it for energy. With the help of insulin, the cell can do its work very well and very quickly. But sometimes the body acts against itself. In this second case, the insulin binds with the proteins that are supposed to protect the body from outside substances (antibodies). If the insulin is an injected form of insulin and not made by the body, the body sees the insulin as an outside or "foreign" substance. When the injected insulin binds with the antibodies, it does not work as well as when it binds directly to the cell.

Insulin-dependent diabetes mellitus (IDDM) - A chronic condition in which the pancreas makes little or no insulin because the beta cells have been destroyed. The body is then not able to use the glucose (blood sugar) for energy. IDDM usually comes on abruptly, although the damage to the beta cells may begin much earlier. The signs of IDDM are a great thirst, hunger, a need to urinate often, and loss of weight. To treat the disease, the person must inject insulin, follow a diet plan, exercise daily, and test blood glucose several times a day. IDDM usually occurs in children and adults who are under age 30. This type of diabetes used to be known as "juvenile diabetes," "juvenile-onset diabetes," and "ketosis-prone diabetes." It is also called type I diabetes mellitus.

Insulin-induced atrophy - Small dents that form on the skin when a person keeps injecting a needle in the same spot. They are harmless.

Insulin-induced hypertrophy - Small lumps that form under the skin when a person keeps injecting a needle in the same spot.

Insulin pen - An insulin injection device the size of a pen that includes a needle and holds a vial of insulin. It can be used instead of syringes for giving insulin injections.

Insulin pump

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

Insulin shock - A severe condition that occurs when the level of blood glucose (sugar) drops quickly. The signs are shaking, sweating, dizziness, double vision, convulsions, and collapse. Insulin shock may occur when an insulin reaction is not treated quickly enough.

Insulinoma - A tumor of the beta cells in areas of the pancreas called the islets of Langerhans. Although not usually cancerous, such tumors may cause the body to make extra insulin and may lead to a blood glucose (sugar) level that is too low.

Intermittent claudication - Pain in the muscles of the leg that occurs off and on, usually while walking or exercising, and results in lameness (claudication). The pain results from a narrowing of the blood vessels feeding the muscle. Drugs are available to treat this condition.

Intramuscular injection - Putting a fluid into a muscle with a needle and syringe.

Intravenous injection - Putting a fluid into a vein with a needle and syringe.

Islet cell Transplantation - Moving the beta (islet) cells from a donor pancreas and putting them into a person whose pancreas has stopped producing insulin. The beta cells make the insulin that the body needs to use glucose (sugar) for energy. Although transplanting islet cells may one day help people with diabetes, the procedure is still in the research stage.

Islets of Langerhans - Special groups of cells in the pancreas.

Jet injector - A device that uses high pressure to propel insulin through the skin and into the body.

Juvenile onset diabetes - Former term for insulin-dependent or type I diabetes.

Ketoacidosis

Ketone bodies

Ketonuria - Having ketone bodies in the urine; a warning sign of diabetic ketoacidosis (DKA).

Ketosis

Kidney threshold - The point at which the blood is holding too much of a substance such as glucose (sugar) and the kidneys "spill" the excess sugar into the urine.

Kussmaul breathing - The rapid, deep, and labored breathing of people who have ketoacidosis or who are in a diabetic coma. Kussmaul breathing is named for Adolph Kussmaul, the 19th century German doctor who first noted it. Also called "air hunger."

Labile diabetes - A term used to indicate when a person's blood glucose (sugar) level often swings quickly from high to low and from low to high. Also called brittle diabetes.

Lactic acidosis - The buildup of lactic acid in the body.

Lactose Lancet - A fine, sharp-pointed blade or needle for pricking the skin.

Laser treatment - Using a special strong beam of light of one color (laser) to heal a damaged area. A person with diabetes might be treated with a laser beam to heal blood vessels in the eye.

Latent diabetes - Former term for impaired glucose tolerance.

Lente insulin - A type of insulin that is intermediate-acting.

Limited joint mobility - A form of arthritis involving the hand; it causes the fingers to curve inward and the skin on the palm to tighten and thicken. This condition mainly affects people with IDDM.

Lipoatrophy - Small dents in the skin that form when a person keeps injecting the needle in the same spot.

Lipodystrophy - Lumps or small dents in the skin that form when a person keeps injecting the needle in the same spot.

Macrosomia - Abnormally large; in diabetes, refers to abnormally large babies that may be born to women with diabetes.

Macrovascular disease - A disease of the large blood vessels that sometimes occurs when a person has had diabetes for a long time.

Macular edema - A swelling (edema) in the macula, an area near the center of the retina of the eye that is responsible for fine or reading vision. Macular edema is a common complication associated with diabetic retinopathy.

Maturity-onset diabetes - Former term for non-insulin-dependent or type 2 diabetes. See: Non-insulin-dependent diabetes mellitus.

Meal plan - A guide for controlling the amount of calories, carbohydrates, proteins, and fats a person eats. People with diabetes can use such plans as the Exchange Lists or the Point System to help them plan their meals so that they can keep their diabetes under control.

Metabolic syndrome

Metabolism

Metformin - A drug treatment for type 2 diabetes; belongs to a class of drugs called biguanides.

mg/dL - Milligrams per deciliter. Term used to describe how much glucose (sugar) is in a specific amount of blood. In self-monitoring of blood glucose, test results are given as the amount of glucose in milligrams per deciliter of blood. A fasting reading of 70 to 110 mg/dL is considered in the normal (nondiabetic) range.

Microaneurysm - A small swelling that forms on the side of tiny blood vessels. These small swellings may break and bleed into nearby tissue. People with diabetes sometimes get microaneurysms in the retina of the eye.

Microvascular disease - Disease of the smallest blood vessels that sometimes occurs when a person has had diabetes for a long time.

Mixed dose - Combining two kinds of insulin in one injection. A mixed dose commonly combines regular insulin, which is fast acting, with a longer acting insulin such as NPH. A mixed dose insulin schedule may be prescribed to provide both short-term and long-term coverage.

Mononeuropathy - A form of diabetic neuropathy affecting a single nerve. The eye is a common site for this form of nerve damage.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) One of the 17 institutes that make up the National Institutes of Health, an agency of the Public Health Service.

Necrobiosis lipoidica diabeticorum - A skin condition usually on the lower part of the legs.

Neovascularization - The term used when new, tiny blood vessels grow in a new place, for example, out from the retina.

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.

Nerve conduction studies - Tests to determine nerve function; can detect early neuropathy.

Neurologist

Neuropathy

NIDDM - Non-insulin-dependent diabetes mellitus.

Non-insulin-dependent diabetes mellitus (NIDDM) - The most common form of diabetes mellitus; about 90 to 95 percent of people who have diabetes have NIDDM.

Noninvasive blood glucose monitoring - A way to measure blood glucose without having to prick the finger to obtain a blood sample. Several noninvasive devices are currently being developed.

Nonketotic coma - A type of coma caused by a lack of insulin. A nonketotic crisis means: (1) very high levels of glucose (sugar) in the blood; (2) absence of ketoacidosis; (3) great loss of body fluid; and (4) a sleepy, confused, or comatose state. Nonketotic coma often results from some other problem such as a severe infection or kidney failure.

NPH insulin - A type of insulin that is intermediate-acting.

Nutrition

Nutritionist - See: Dietitian.

Obesity

Obstetrician

OGTT - Oral glucose tolerance test.

Ophthalmologist

Oral glucose tolerance test (OGTT)

Oral hypoglycemic agents - Pills or capsules that people take to lower the level of glucose (sugar) in the blood.

Overt diabetes - Diabetes in the person who shows clear sign/s of the disease such as a great thirst and the need to urinate often.

Pancreas

Pancreas transplant - A surgical procedure that involves replacing the pancreas of a person who has diabetes with a healthy pancreas that can make insulin.

Pancreatectomy - A procedure in which a surgeon takes out the pancreas.

Pancreatitis Peak action - The time period when the effect of something is as strong as it can be such as when insulin in having the most effect on lowering the glucose (sugar) in the blood.

Peripheral neuropathy - Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy."

Peripheral vascular disease (PVD) - Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood.

Peritoneal dialysis - A way to clean the blood of people who have kidney disease.

Pharmacist - practitioner of pharmacy

Photocoagulation - Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy.

Pituitary gland

Podiatrist - A doctor who treats and takes care of people's feet.

Podiatry - The care and treatment of human feet in health and disease.

Point system - A way to plan meals that uses points to rate food. The foods are placed in four classes: calories, carbohydrates, proteins, and fats. Each food is given a point value within its class. A person with a planned diet for the day can choose foods in the same class that have the same point values for meals and snacks.

Polydipsia - A great thirst that lasts for long periods of time; a sign of diabetes.

Polyphagia - Great hunger; a sign of diabetes. People with this great hunger often lose weight.

Polyunsaturated fats - A type of fat that comes from vegetables.

Polyuria - Having to urinate often; a common sign of diabetes.

Postprandial blood glucose - Blood taken 1-2 hours after eating to see the amount of glucose (sugar) in the blood.

Preeclampsia - A condition that some women with diabetes have during the late stages of pregnancy. Two signs of this condition are high blood pressure and swelling because the body cells are holding extra water.

Prevalence

Previous abnormality of glucose tolerance (PrevAGT) - A term for people who have had above-normal levels of blood glucose (sugar) when tested for diabetes in the past but who show as normal on a current test. PrevAGT used to be called either "latent diabetes" or "prediabetes."

Prognosis - Telling a person now what is likely to happen in the future because of having a disease.

Proinsulin - The substance made first in the pancreas that is then made into insulin.

Proliferative retinopathy

Pruritus - Itching skin; may be a symptom of diabetes.

Purified insulins - Insulins with much less of the impure proinsulin. It is thought that the use of purified insulins may help avoid or reduce some of the problems of people with diabetes such as allergic reactions.

Rebound - A swing to a high level of glucose (sugar) in the blood after having a low level. Receptors

Regular insulin - A type of insulin that is fast acting.

Renal - A term that means having something to do with the kidneys.

Renal threshold - When the blood is holding so much of a substance such as glucose (sugar) that the kidneys allow the excess to spill into the urine. This is also called "kidney threshold," "spilling point," and "leak point."

Retina

Retinopathy

Saccharin - A man-made sweetener that people use in place of sugar because it has no calories.

Saturated fat - A type of fat that comes from animals.

Secondary diabetes - When a person gets diabetes because of another disease or because of taking certain drugs or chemicals.

Secrete - To make and give off such as when the beta cells make insulin and then release it into the blood so that the other cells in the body can use it to turn glucose (sugar) into energy.

Segmental transplantation - A surgical procedure in which a part of a pancreas that contains insulin-producing cells is placed in a person whose pancreas has stopped making insulin.

Self-monitoring of blood glucose - A way as person can test how much glucose (sugar) is in the blood. Also called home blood glucose monitoring.

Shock - A severe condition that disturbs the body. A person with diabetes can go into shock when the level of blood glucose (sugar) drops suddenly.

Sliding scale - Adjusting insulin on the basis of blood glucose tests, meals, and activity levels.

Somatic neuropathy - See: Peripheral neuropathy.

Somatostatin - A hormone made by the delta cells of the pancreas (in areas called the islets of Langerhans). Scientists think it may control how the body secretes two other hormones, insulin and glucagon.

Somogyi effect - A swing to a high level of glucose (sugar) in the blood from an extremely low level, usually occurring after an untreated insulin reaction during the night. The swing is caused by the release of stress hormones to counter low glucose levels. People who experience high levels of blood glucose in the morning may need to test their blood glucose levels in the middle of the night. If blood glucose levels are falling or low, adjustments in evening snacks or insulin doses may be recommended. This condition is named after Dr. Michael Somogyi, the man who first wrote about it. Also called "rebound."

Sorbitol

Spilling point - When the blood is holding so much of a substance such as glucose (sugar) that the kidneys allow the excess to spill into the urine.

Split dose - Division of a prescribed daily dose of insulin into two or more injections given over the course of a day. Also may be referred to as multiple injections. Many people who use insulin feel that split doses offer more consistent control over blood glucose (sugar) levels.

Stiff hand syndrome - Thickening of the skin of the palm that results in loss of ability to hold hand straight. This condition occurs only in people with diabetes.

Stroke

Subclinical diabetes - A term no longer used. See: Impaired glucose tolerance.

Subcutaneous injection - Putting a fluid into the tissue under the skin with a needle and syringe.

Sucrose

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

Sulfonylureas - Pills or capsules that people take to lower the level of glucose (sugar) in the blood.

Symptom - A sign of disease. Having to urinate often is a symptom of diabetes.

Syndrome - A set of signs or a series of events occurring together that make up a disease or health problem.

Syndrome X/Metabolic syndrome - DM type II clustered with other diseases that feature insulin resistance

Syringe

Systemic - A word used to describe conditions that affect the entire body. Diabetes is a systemic disease because it involves many parts of the body such as the pancreas, eyes, kidneys, heart, and nerves.
Systolic blood pressure - See: Blood pressure.
Team management - Describes a diabetes treatment approach in which medical care is provided by a physician, diabetes nurse educator, dietitian, and behavioral scientist working together with the patient.

Thrush - An infection of the mouth. In people with diabetes, this infection may be caused by high levels of glucose (sugar) in mouth fluids, which helps the growth of fungus that causes the infection. Patches of whitish-colored skin in the mouth are signs of this disease.

Tolazamide - A pill taken to lower the level of glucose (sugar) in the blood. Only some people with non-insulin-dependent diabetes take these pills.

Tolbutamide - A pill taken to lower the level of glucose (sugar) in the blood. Only some people with non-insulin-dependent diabetes take these pills.
Toxemia of pregnancy (preeclampsia) - A condition in pregnant women involving high blood pressure, protein in the urine, and edema. It can harm both mother and child, but resolves after delivery. The first signs of toxemia are swelling near the eyes and ankles (edema), headache, high blood pressure, and weight gain that the mother might confuse with the normal weight gain of being pregnant. The mother may have both glucose (sugar) and acetone in her urine. The mother should tell the doctor about these signs at once. Women who become diabetic during their pregnancies have a 15% higher chance of developing preeclampsia; women who are diabetic before becoming pregnant have a 30% chance of developing preeclampsia.

Toxic - Harmful; having to do with poison.

Transcutaneous electronic nerve stimulation (TENS) - A treatment for painful neuropathy.

Twenty-four hour urine - The total amount of a person's urine for a 24-hour period.

Ulcer - A break in the skin; a deep sore. People with diabetes may get ulcers from minor scrapes on the feet or legs, from cuts that heal slowly, or from the rubbing of shoes that do not fit well. Ulcers can become infected.

Ultralente insulin - A type of insulin that is long acting.

Medical ultrasound

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. Most insulin made today in the United States is U-100.

Unsaturated fats - A type of fat.

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."

Urine testing - Checking urine to see if it contains glucose (sugar) and ketones. Special strips of paper or tablets (called reagents) are put into a small amount of urine or urine plus water. Changes in the color of the strip show the amount of glucose or ketones in the urine. Urine testing is the only way to check for the presence of ketones, a sign of serious illness.

Vaginitis - An infection of the vagina usually caused by a fungus. A woman with this condition may have itching or burning and may notice a discharge. Women who have diabetes may develop vaginitis more often than women who do not have diabetes.

Vascular - Relating to the body's blood vessels (arteries, veins, and capillaries).

Visceral neuropathy

Vitrectomy - Removing the gel from the center of the eyeball because it has blood and scar tissue in it that blocks sight. An eye surgeon replaces the clouded gel with a clear fluid.

Xylitol - A sweetener found in plants and used as a substitute for sugar; it is called a nutritive sweetener because it provides calories, just like sugar.