A type of drug used to lower blood pressure. Studies indicate that it may also help prevent or slow the progression of kidney disease in people with diabetes.
A pill taken to lower the level of glucose (sugar) in the blood. Only some people with noninsulin-dependent diabetes take these pills. See also: Oral hypoglycemic agents.
A chemical formed in the blood when the body uses fat instead of glucose (sugar) for energy. If acetone forms, it usually means that the cells do not have enough insulin, or cannot use the insulin that is in the blood, to use glucose for energy. Acetone passes through the body into the urine. Someone with a lot of acetone in the body can have breath that smells fruity and is called "acetone breath." See also: Ketone bodies.
Too much acid in the body. For a person with diabetes, this can lead to diabetic ketoacidosis. See also: Diabetic ketoacidosis.
Happens for a limited period of time; abrupt onset; sharp, severe.
Two organs that sit on top of the kidneys and make and release hormones such as adrenalin (epinephrine). This and other hormones, including insulin, control the body's use of glucose (sugar).
Former term for noninsulin-dependent or type II diabetes. See also: Noninsulin-dependent diabetes mellitus.
A harmful result.
More than normal amounts of a protein called albumin in the urine. Albuminuria may be a sign of kidney disease, a problem that can occur in people who have had diabetes for a long time.
Aldose Reductase Inhibitor
A class of drugs being studied as a way to prevent eye and nerve damage in people with diabetes. Aldose reductase is an enzyme that is normally present in the eye and in many other parts of the body. It helps change glucose (sugar) into a sugar alcohol called sorbitol. Too much sorbitol trapped in eye and nerve cells can damage these cells, leading to retinopathy and neuropathy. Drugs that prevent or slow (inhibit) the action of aldose reductase are being studied as a way to prevent or delay these complications of diabetes.
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 building blocks of proteins; the main material of the body's cells. Insulin is made of 51 amino acids joined together.
A type of diabetic neuropathy that causes muscle weakness and wasting.
Disease of the blood vessels (arteries, veins, and capillaries) that occurs when someone has diabetes for a long time. There are two types of angiopathy: macroangiopathy and microangiopathy. 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. Then the cells, for example, the ones in the center of the eye, do not get enough blood and may be damaged.
Birth defects; abnormalities.
One agent that opposes or fights the action of another. For example, insulin lowers the level of glucose (sugar) in the blood, whereas glucagon raises it; therefore, insulin and glucagon are antagonists.
Proteins that the body makes to protect itself from foreign substances. In diabetes, the body sometimes makes antibodies to work against pork or beef insulins because they are not exactly the same as human insulin or because they have impurities. The antibodies can keep the insulin from working well and may even cause the person with diabetes to have an allergic or bad reaction to the beef or pork insulins.
A substance that helps a person with diabetes control the level of glucose (sugar) in the blood so that the body works as it should. See also: Insulin; oral hypoglycemic agents.
Substances that cause an immune response in the body. The body "sees" the antigens as harmful or foreign. To fight them, the body produces antibodies, which attack and try to eliminate the antigens.
An agent that kills bacteria. Alcohol is a common antiseptic. Before injecting insulin, many people use alcohol to clean their skin to avoid infection.
A group of diseases in which the walls of the arteries get thick and hard. In one type of arteriosclerosis, fat builds up inside the walls and slows the blood flow. These diseases often occur in people who have had diabetes for a long time. See also: Atherosclerosis.
A large blood vessel that carries blood from the heart to other parts of the body. Arteries are thicker and have walls that are stronger and more elastic than the walls of veins. See also: Blood vessels.
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.
A man-made sweetener that people use in place of sugar because it has very few calories.
No symptoms; no clear sign of disease present.
One of many diseases in which fat builds up in the large- and medium-sized arteries. This buildup of fat may slow down or stop blood flow. This disease can happen to people who have had diabetes for a long time.
Disorder of the body's immune system in which the immune system mistakenly attacks and destroys body tissue that it believes to be foreign. Insulin-dependent diabetes is an autoimmune disease because the immune system attacks and destroys the insulin-producing beta cells.
A disease of the nerves affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs. These nerves are not under a person's conscious control and function automatically. Also called visceral neuropathy. See also: Neuropathy.
Early stage of diabetic retinopathy; usually does not impair vision. Also called "nonproliferative retinopathy."
Refers to a continuous supply of low levels of insulin, as in insulin pump therapy.
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.
Beta Cell Transplantation
See: Islet cell transplantation.
Biosynthetic Human Insulin
A man-made insulin that is very much like human insulin. See also: Human insulin.
A type of insulin that is a mixture of intermediate- and fast-acting insulin.
The main sugar that the body makes from the three elements of food-proteins, fats, and carbohydrates-but mostly from carbohydrates. Glucose is the major source of energy for living cells and is carried to each cell through the bloodstream. However, the cells cannot use glucose without the help of insulin.
Blood Glucose Meter
A machine that helps test how much glucose (sugar) is in the blood. A specially coated strip containing a fresh sample of blood is inserted in a machine, when then calculates the correct level of glucose in the blood sample and shows the result in a digital display. Some meters have a memory that can store results from multiple tests.
Blood Glucose Monitoring
A way of testing how much glucose (sugar) is in the blood. A drop of blood, usually taken from the fingertip, is placed on the end of a specially coated strip, called a testing strip. The strip has a chemical on it that makes it change color according to how much glucose is in the blood. A person can tell if the level of glucose is low, high, or normal in one of two ways. The first is by comparing the color on the end of the strip to a color chart that is printed on the side of the test strip container. The second is by inserting the strip into a small machine, called a meter, which "reads" the strip and shows the level of blood glucose in a digital window display. Blood testing is more accurate than urine testing in monitoring blood glucose levels because it shows what the current level of glucose is, rather than what the level was an hour or so previously.
The force of the blood on the walls of arteries. Two levels of blood pressure are measured-the higher, or systolic, pressure, which occurs each time the heart pushes blood into the vessels, and the lower, or diastolic, pressure, which occurs when the heart rests. In a blood pressure reading of 120/80, for example, 120 is the systolic pressure and 80 is the diastolic pressure. A reading of 120/80 is said to be the normal range. Blood pressure that is too high can cause health problems such as heart attacks and strokes.
A small instrument for pricking the skin with a fine needle to obtain a sample of blood to test for glucose (sugar). See also: Blood glucose monitoring.
See: Blood glucose
Blood Urea Nitrogen (BUN)
A waste product of the kidneys. Increased levels of BUN in the blood may indicate early kidney damage.
Tubes that act like a system of roads or canals to carry blood to and from all parts of the body. The three main types of blood vessels are arteries, veins, and capillaries. The heart pumps blood through these vessels so that the blood can carry with it oxygen and nutrients that the cells need or take away waste that the cells do not need.
An extra boost of insulin given to cover expected rise in blood glucose (sugar) such as the rise that occurs after eating.
A term no longer used. See: Impaired glucose tolerance.
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.
A genetic disease of the liver in which the body takes in too much iron from food. Also called "hemocromatosis."
A bump or bulge on the first joint of the big toe caused by the swelling of a sac of fluid under the skin. Shoes that fit well can keep bunions from forming. Bunions can lead to other problems such as serious infections. See also: Foot care.
C.D.E. (Certified Diabetes Educator)
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 include a diabetes educator, preferably a C.D.E.
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.
Calcium Channel Blocker
A drug used to lower blood pressure.
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. See also: Foot care.
Energy that comes from food. Some foods have more calories than others. Fats have many calories. Most vegetables have few. People with diabetes are advised to follow meal plans with suggested amounts of calories for each meal and/or snack. See also: Meal plan; exchange lists.
The smallest of the body's blood vessels. Capillaries have walls so thin that oxygen and glucose can pass through them and enter the cells, and waste products such as carbon dioxide can pass back into the blood to be carried away and taken out of the body. Sometimes people who have had diabetes for a long time find that their capillaries become weak, especially those in the kidney and the retina of the eye. See also: Blood vessels.
A topical ointment made from chili peppers used to relieve the pain of peripheral neuropathy.
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). The body also uses carbohydrates to make a substance called glycogen that is stored in the liver and muscles for future use. If the body does not have enough insulin or cannot use the insulin it has, then the body will not be able to use carbohydrates for energy the way it should. This condition is called diabetes. See also: Fats; protein.
A doctor who sees and takes care of people with heart disease; a heart specialist.
Relating to the heart and blood vessels (arteries, veins, and capillaries); the circulatory system.
Carpal Tunnel Syndrome
A nerve disorder affecting the hand that may occur in people with diabetes; caused by a pinched nerve.
Clouding of the lens of the eye. In people with diabetes, this condition is sometimes referred to as "sugar cataract."
Damage to the blood vessels in the brain, resulting in a stroke. The blood vessels become blocked because of fat deposits or they become thick and hard, blocking the flow of blood to the brain. Sometimes, the blood vessels may burst, resulting in a hemorrhagic stroke. People with diabetes are at higher risk of cerebrovascular disease. See also: Macrovascular disease; stroke.
A foot complication associated with diabetic neuropathy that results in destruction of joints and soft tissue. Also called "Charcot's joint" and "neuropathic arthropathy."
A term no longer used. See: Impaired glucose tolerance.
A pill taken to lower the level of glucose (sugar) in the blood. Only some people with noninsulin-dependent diabetes take these pills. See also: Oral hypoglycemic agents
A fat-like substance found in blood, muscle, liver, brain, and other tissues in people and animals. The body makes and needs some cholesterol. Too much cholesterol, however, may cause fat to build up in the artery walls and cause a disease that slows or stops the flow of blood. Butter and egg yolks are foods that have a lot of cholesterol.
Present over a long period of time. Diabetes is an example of chronic disease.
The flow of blood through the heart and blood vessels of the body.
A scientifically controlled study carried out in people, usually to test the effectiveness of a new treatment.
A sleep-like state; not conscious. May be due to a high or low level of glucose (sugar) in the blood. See also: Diabetic coma.
In a coma; not conscious.
Complications of Diabetes
Harmful effects that may happen when a person has diabetes. Some effects, such as hypoglycemia, can happen any time. Others develop when a person has had diabetes for a long time. These include damage to the retina of the eye (retinopathy), the blood vessels (angiopathy), the nervous system (neuropathy), and the kidneys (nephropathy). Studies show that keeping blood glucose levels as close to the normal, nondiabetic range as possible may help prevent, slow, or delay harmful effects to the eyes, kidneys, and nerves.
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. Congestive heart failure often develops gradually over several years, although it also can happen suddenly. It can be treated by drugs and in some cases, by surgery.
A condition that makes a treatment not helpful or even harmful.
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.
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). Also called: "Standard Therapy."
Damage to the heart. Not enough blood flows through the vessels because they are blocked with fat or have become thick and hard; this harms the muscles of the heart. People with diabetes are at a higher risk of coronary disease.
Coxsackie B4 Virus
An agent that has been shown to damage the beta cells of the pancreas in lab tests. This virus may be one cause of insulin-dependent diabetes.
A chemical found in the blood and passed in the urine. A test of the amount of creatinine in blood or in blood and urine shows if the kidney is working right or if it is diseased. This is called the creatinine clearance test.
CSII: Continuous Subcutaneous Insulin Infusion
See: Insulin pump.
A man-made chemical that people used instead of sugar. The Food and Drug Administration banned the sale of cyclamates in 1973 because lab tests showed that large amounts of cyclamates can cause bladder cancer in rats.
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 noninsulin-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. See also: Somogyi effect.
The removal of infected, hurt, or dead tissue.
Great loss of body water. A very high level of glucose (sugar) in the urine causes loss of a great deal of water, and the person becomes very thirsty.
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.
A method to reduce or stop a response such as an allergic reaction to something. For instance, if a person with diabetes has a bad reaction to taking a full dose of beef insulin, the doctor gives the person a very small amount of the insulin at first. Over a period of time, larger doses are given until the person is taking the full dose. This is one way to help the body get used to the full dose and to avoid having the allergic reaction.
A simple sugar found in the blood. It is the body's main source of energy. Also called glucose. See also: Blood glucose.
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 proved that intensive management of insulin-dependent diabetes prevents or slows the development of eye, kidney, and nerve damage caused by diabetes.
A disease of the pituitary gland or kidney, not diabetes mellitus. Diabetes insipidus is often called "water diabetes" to set it apart from "sugar diabetes." The cause and treatment are not the same as for diabetes mellitus. "Water diabetes" has diabetes in its name because most people who have it show most of the same signs as someone with diabetes mellitus-they have to urinate often, get very thirsty and hungry, and feel weak. However, they do not have glucose (sugar) in their urine.
A disease that occurs when the body is not able to use sugar as it should. The body needs sugar for growth and energy for daily activities. It gets sugar when it changes food into glucose (a form of sugar). A hormone called insulin is needed for the glucose to be taken up and used by the body. Diabetes occurs when the body cannot make use of the glucose in the blood for energy because either the pancreas is not able to make enough insulin or the insulin that is available is not effective. The beta cells in areas of the pancreas called the islets of Langerhans usually make insulin.
There are two main types of diabetes mellitus: insulin-dependent (Type I) and noninsulin-dependent (Type II). In insulin-dependent diabetes (IDDM), the pancreas makes little or no insulin because the insulin-producing beta cells have been destroyed. This type usually appears suddenly and most commonly in younger people under age 30. Treatment consists of daily insulin injections or use of an insulin pump, a planned diet and regular exercise, and daily self-monitoring of blood glucose.
In noninsulin-dependent diabetes (NIDDM), the pancreas makes some insulin, sometimes too much. The insulin, however, is not effective (see Insulin Resistance). NIDDM is controlled by diet and exercise and daily monitoring of glucose levels. Sometimes oral drugs that lower blood glucose levels or insulin injections are needed. This type of diabetes usually develops gradually, most often in people over 40 years of age. NIDDM accounts for 90 to 95 percent of diabetes.
The signs of diabetes include having to urinate often, losing weight, getting very thirsty, and being hungry all the time. Other signs are blurred vision, itching, and slow healing of sores. People with untreated or undiagnosed diabetes are thirsty and have to urinate often because glucose builds to a high level in the bloodstream and the kidneys are working hard to flush out the extra amount. People with untreated diabetes often get hungry and tired because the body is not able to use food the way it should.
In insulin-dependent diabetes, if the level of insulin is too low for a long period of time, the body begins to break down its stores of fat for energy. This causes the body to release acids (ketones) into the blood. The result is called ketoacidosis, a severe condition that may put a person into a coma if not treated right away.
The causes of diabetes are not known. Scientists think that insulin- dependent diabetes may be more than one disease and may have many causes. They are looking at hereditary (whether or not the person has parents or other family members with the disease) and at factors both inside and outside the body, including viruses.
Noninsulin-dependent diabetes appears to be closely associated with obesity and with the body resisting the action of insulin.
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. See also: Neuropathy.
A severe emergency in which a person is not conscious because the blood glucose (sugar) is too low or too high. If the glucose level is too low, the person has hypoglycemia; if the level is too high, the person has hyperglycemia and may develop ketoacidosis. See also: Hyperglycemia; hypoglycemia; diabetic ketoacidosis.
Diabetic Ketoacidosis (DKA)
Severe, out-of-control diabetes (high blood sugar) that needs emergency treatment. DKA happens when blood sugar levels get too high. This may happen because of illness, taking too little insulin, or getting too little exercise. The body starts using stored fat for energy, and ketone bodies (acids) build up in the blood.
Ketoacidosis starts slowly and builds up. The signs include nausea and vomiting, which can lead to loss of water from the body, stomach pain, and deep and rapid breathing. Other signs are a flushed face, dry skin and mouth, a fruity breath odor, a rapid and weak pulse, and low blood pressure. If the person is not given fluids and insulin right away, ketoacidosis can lead to coma and even death.
Spinal cord damage found in some people with diabetes.
Loss of foot bone as viewed by x-ray; usually temporary. Also called "disappearing bone disease."
A disease of the small blood vessels of the retina of the eye. When retinopathy first starts, the tiny blood vessels in the retina become swollen, and they leak a little fluid into the center of the retina. The person's sight may be blurred. This condition is called background retinopathy. About 80 percent of people with background retinopathy never have serious vision problems, and the disease never goes beyond this first stage.
However, if retinopathy progresses, the harm to sight can be more serious. Many new, tiny blood vessels grow out and across the eye. This is called neovascularization. The vessels may break and bleed into the clear gel that fills the center of the eye, blocking vision. Scar tissue may also form near the retina, pulling it away from the back of the eye. This stage is called proliferative retinopathy, and it can lead to impaired vision and even blindness. See also: Photocoagulation or vitrectomy for treatments.
Causing diabetes; some drugs cause blood glucose (sugar) to rise, resulting in diabetes.
A doctor who sees and treats people with diabetes mellitus.
The term used when a doctor finds that a person has a certain medical problem or disease.
A method for removing waste such as urea from the blood when the kidneys can no longer do the job. The two types of dialysis are: hemodialysis and peritoneal dialysis. In hemodialysis, the patient's blood is passed through a tube into a machine that filters out waste products. The cleansed blood is then returned to the body.
In peritoneal dialysis, a special solution is run through a tube into the peritoneum, a thin tissue that lines the cavity of the abdomen. The body's waste products are removed through the tube. There are three types of peritoneal dialysis. Continuous ambulatory peritoneal dialysis (CAPD), the most common type, needs no machine and can be done at home. Continuous cyclic peritoneal dialysis (CCPD) uses a machine and is usually performed at night when the person is sleeping. Intermittent peritoneal dialysis (IPD) uses the same type of machine as CCPD, but is usually done in the hospital because treatment takes longer. Hemodialysis and peritoneal dialysis may be used to treat people with diabetes who have kidney failure.
Diastolic Blood Pressure
See: Blood pressure.
See: Meal plan.
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 qualifications. The health care team for diabetes should 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.
A drug that increases the flow of urine to rid the body of extra fluid.
DKA See: Diabetic ketoacidosis.
DNA (Deoxyribonucleic Acid)
A chemical substance in plant and animal cells that tells the cells what to do and when to do it. DNA is the information about what each person inherits from his or her parents.
A condition that causes the fingers to curve inward and may also affect the palm. The condition is more common in people with diabetes and may precede diabetes.
A swelling or puffiness of some part of the body such as the ankles. Water or other body fluids collect in the cells and cause the swelling.
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.
Glands that release hormones into the bloodstream. They affect how the body uses food (metabolism). They also influence other body functions. One endocrine gland is the pancreas. It releases insulin so the body can use sugar for energy. See also: Gland.
A doctor who treats people who have problems with their endocrine glands. Diabetes is an endocrine disorder. See also: Endocrine glands.
Grown or made inside the body. Insulin made by a person's own pancreas is endogenous insulin. Insulin that is made from beef or pork pancreas or derived from bacteria is exogenous because it comes from outside the body and must be injected.
End-Stage Renal Disease (ESRD)
The final phase of kidney disease; treated by dialysis or kidney transplantation. See also: Dialysis; nephropathy.
A special type of protein. Enzymes help the body's chemistry work better and more quickly. Each enzyme usually has its own chemical job to do such as helping to change starch into glucose (sugar).
The study of a disease that deals with how many people have it, where they are, how many new cases develop, and how to control the disease.
One of the secretions of the adrenal glands. It helps the liver release glucose (sugar) and limit the release of insulin. It also makes the heart beat faster and can raise blood pressure; also called adrenalin.
The study of what causes a disease; also the cause or causes of a certain disease.
A normal level of glucose (sugar) in the blood.
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.
Grown or made outside the body; for instance, insulin made from pork or beef pancreas is exogenous insulin for people.