Glossary of Terms

Acidosis:
See Diabetic ketoacidosis.
Activities of daily living:
Scale developed by S. Katz and colleagues to measure personal self-maintenance ability among older adults. The activities rated are eating, toileting, dressing, bathing, transferring (e.g., getting in and out of bed), and continence.
Adherence:
The extent to which patients follow health care provider recommendations for disease management, including health-promoting activities. For people with diabetes, this includes taking medications, monitoring blood glucose, and following nutrition and physical activity guidelines. Also see Compliance.
Adiposity:
Excessive fat in the body. Also see Obesity.
Age-adjusted:
Describes rates that have been adjusted by an established procedure to minimize the effects of differences in age composition when comparing rates for different populations.
Albuminuria:
More than normal amounts of the protein albumin in the urine. Albuminuria may be a sign of kidney disease.
American Diabetes Association (ADA):
Nonprofit national health organization that provides information, advocates policy change, and conducts research to prevent and cure diabetes and to improve the life of all people affected by diabetes. For more information, see www.diabetes.org.
Angina:
A condition in which the heart muscle does not receive enough blood, resulting in pain in the chest.
Angiotensin converting enzyme (ACE) inhibitor:
A type of drug used to lower blood pressure and to help prevent progression of kidney disease in people with diabetes.
Anorexia:
Lack or loss of appetite for food.
Anorexia nervosa:
A serious eating disorder characterized by chronic decreased food intake that results in profound weight loss.
Atherosclerosis/atherosclerotic disease:
A disease in which fat builds up in the large and medium-sized arteries. This build-up of fat may slow down or stop blood flow. People with diabetes are at increased risk for atherosclerosis.
Atherosclerotic lesions/plaque:
Deposits in the arteries that result from the accumulation of cholesterol and lipids in the arteries.
Autonomic neuropathy:
Nerve damage affecting control of the internal organs, such as the bladder muscles, digestive tract, heart, and genital organs. Autonomic neuropathy can develop as a complication of diabetes.
Basal insulin:
A component of insulin therapy (along with bolus insulin) meant to maintain a stable level of insulin throughout the day and night.
Beta cell: Type of cell in the pancreas that makes and releases insulin.
Body mass index (BMI):
A measure of body size that relates weight to height. Formula: weight in kilograms divided by height in meters squared. BMI correlates highly with body fat in most people.
Bolus insulin:
The dose of insulin given before meals that is calculated to keep blood glucose levels under control (usually less than 180 mg/dl) after meals. The dose changes on the basis of meal size and composition, blood glucose level at the time, and anticipated exercise after the meal.
Bulimia: Eating disorder characterized by binge eating and induced vomiting.
Cardiovascular disease (CVD):
Disease of the circulatory system, including the heart and blood vessels. Diabetes increases the risk of CVD two-to fivefold.
Cataract:
Clouding of the lens of the eye. Diabetes increases the occurrence of cataracts.
Central adiposity or obesity:
Fat deposits that form in the center of a person’s body, especially around the intestines, often assessed by measuring waist-tohip ratio. Central adiposity increases the risk of cardiovascular complications.
Cerebrovascular disease:
Damage to the blood vessels supplying the brain that can result in a stroke (see Stroke). Diabetes increases the risk of stroke two-fold.
Cholesterol:
A fatlike substance in the blood, muscle, liver, brain, and other tissues. Too much cholesterol may cause fat to build up in the artery walls and cause disease that slows or stops the flow of blood.
Clinical trials:
Human research studies designed to produce statistically valid information on how best to treat patients.
Comorbidity:
The condition of having more than one illness at the same time (e.g., diabetes and depression, diabetes and heart disease).
Compliance:
Patients’ adherence to health care provider recommendations for disease management and health-promoting activities. See also Adherence.
Complications of diabetes:
The chronic (long-term) effects of diabetes resulting in diseases of the eyes, kidneys, nerves, and circulatory system, which carries blood to the heart, brain, and limbs. The development of these complications is related to the duration of diabetes, levels of blood glucose over time, and other factors, such as blood pressure levels and genetics.
Coronary heart disease (CHD):
Destruction and weakening of heart muscle, secondary to decreased blood supply (atherosclerosis). The most serious danger of coronary heart disease is a heart attack, which occurs when the supply of blood to the heart is greatly reduced or stopped due to a blockage in a coronary artery. People with diabetes are two to five times more likely to have CHD than those without diabetes.
Cortisol:
One of several hormones made in the adrenal glands. Cortisol is one of the main hormones secreted as part of the stress response; it can raise blood glucose levels.
Dementia:
Loss of cognitive function; a condition of deteriorated mentality.
Dentition:
Quality and quantity of teeth, including their number, kind, and arrangement.
Diabetes Control and Complications Trial (DCCT):
Clinical study funded by the National Institutes of Health to assess the effects of intensive therapy on the long-term complications of type 1 diabetes. The study showed that intensive blood glucose control slows the onset and progression of eye, kidney, and nerve disease caused by diabetes. For more information, see www.niddk.nih.gov/health/diabetes/pubs/dcct1/dcct.htm.
Diabetes Prevention Program (DPP):
Clinical trial sponsored by the National Institutes of Health that compared the effectiveness of diet and exercise with that of metformin or a placebo in reducing the risk for type 2 diabetes in high-risk people. For more information, see www.bsc.gwu.edu/dpp/index.htmlvdoc.
Diabetes risk profile:
A descriptive term for a person’s level of known risk factors for diabetes (e.g., body mass index, physical activity level, family history).
Diabetic ketoacidosis:
Acute complication of diabetes characterized by high blood glucose in the presence of ketones in the urine and bloodstream. Diabetic ketoacidosis is often caused by illness or taking too little insulin. It requires emergency treatment. Symptoms include nausea and vomiting, stomach pain, and deep, rapid breathing.
Dyslipidemia:
Abnormal excess or abnormal forms of fat or lipids in the blood.
Dyslipoproteinemia:
Abnormal concentrations of one or more lipoproteins, a combination of a lipid and a protein, used to transport cholesterol and other lipids through the bloodstream.
Early Treatment of Diabetic Retinopathy Study (ETDRS):
Study that examined the effects of laser photocoagulation or aspirin on the progression of diabetic retinopathy in patients with diabetes. For more information, see www.nei.nih.gov/neitrials/viewStudyWeb.aspx?id=53.
Eclampsia:
Severe hypertension accompanied by seizures. Considered an obstetric emergency requiring immediate caesarean section.
Edentulous: Describes the loss of teeth, especially in elderly people; toothless.
End-stage kidney disease (ESKD):
The final phase of kidney disease, requiring treatment with dialysis or kidney transplantation. ESKD can be a complication of diabetes.
Epinephrine:
Principal blood pressure–raising hormone secreted by the adrenal medulla. Also released under times of stress.
Estrogen replacement therapy (ERT):
Refers to the use of estrogen as a prescription drug to replace the hormone estrogen, which is no longer produced by the ovaries as a result of menopause.
Excess mortality:
Increased rates or numbers of deaths in a specific population by age, sex, cause, and sometimes other variables.
Fasting glucose:
Glucose concentration in a person who has not eaten recently (usually for at least eight hours); used to diagnose diabetes.
Fatalism:
A belief that events are predetermined and cannot be altered by human effect.
Fetal malformations:
Abnormalities in the heart, urinary tract, digestive tract, spinal cord, or limbs present at birth. High levels of glucose can pass from mother to baby and affect the baby’s early organ development in the first six to eight weeks of pregnancy, resulting in malformations. This is why tight control of blood glucose is critical before conception.
Free fatty acids:
Circulating fats in the blood. Though free fatty acids are a necessary source of fuel for the body, too much of them contributes to insulin resistance and may also lead to atherosclerosis, a process that narrows blood vessels to the heart and brain. Most obese people have high levels of free fatty acids in their blood.
Functional impairment:
Damage that affects a person’s ability to perform daily activities.
Gangrene:
Death of body tissue as a result of poor circulation. Gangrene is a serious complication of diabetes and may lead to amputation.
Gestational diabetes mellitus (GDM):
Type of diabetes that can occur during pregnancy; in most cases, blood sugar levels return to normal after pregnancy. Affects 3 to 5 percent of all pregnancies.
Glaucoma: Eye disease associated with increased pressure within the eye that can damage the optic nerve and cause impaired vision and blindness. People with diabetes are at increased risk of glaucoma.
Glomerular filtration rate:
Measure of the kidney’s ability to filter and remove waste products; used to diagnose kidney disease.
Glucose tolerance test:
A kind of stress test used to diagnose diabetes. Blood glucose is measured before a patient has eaten that day. Blood is subsequently tested after the patient drinks a liquid containing glucose to see how the patient’s body metabolizes glucose over time. A more sensitive method of diagnosing diabetes and prediabetes than fasting tests.
Glycated hemoglobin:
See Hemoglobin A1c.
Glycemic control:
The level of glucose in the blood or, for the measurement of chronic control, the level of hemoglobin A1c.
Glycosuria:
The presence of glucose in the urine, a sign of poor blood glucose control.
Glycosylated hemoglobin test:
See Hemoglobin A1c.
HDL cholesterol:
High-density lipoprotein cholesterol, a transport form of cholesterol in the blood. Low concentrations of HDL cholesterol are a risk factor for cardiovascular disease (CVD), especially in people with diabetes; high levels are protective.
Hemoglobin A1c(HgbA1c):
A blood test that measures a person’s average blood glucose level for the two-to three-month period before the test.
Hormone replacement therapy (HRT):
Refers to the use of hormones as prescription drugs to replace the hormones estrogen and progesterone, which women’s ovaries stop producing during menopause. (See Estrogen Replacement Therapy.)
Hypercholesterolemia:
Abnormally high levels of cholesterol in the blood.
Hyperglycemia:
High levels of glucose (sugar) in the blood, a hallmark of diabetes. Hyperglycemia occurs when the body does not have enough insulin or cannot use the insulin it does have to transport glucose into cells. Signs of hyperglycemia include increased thirst, dry mouth, and a need to urinate often.
Hyperinsulinemia:
A high level of insulin in the blood. Increased levels of insulin often indicate underlying insulin resistance. (See Insulin resistance.)
Hyperlipidemia:
Too high a level of fats (lipids) in the blood.
Hyperosmolar coma:
Loss of consciousness or altered mental status (confusion or drowsiness) related to very high levels of glucose in the blood. Requires emergency treatment.
Hypertension:
High blood pressure, a condition that occurs when vessel resistance is high and blood circulates through the arteries with too much force, increasing the risk of heart attack, stroke, diabetic eye complications, and kidney problems.
Hypertriglyceridemia:
A high level of triglycerides, a type of blood fat. Triglycerides can increase when diabetes and weight are not under control.
Hypoglycemia:
A condition that occurs in people with diabetes when their blood glucose levels are too low, usually less than 65 mg/dl. Symptoms include anxiety or confusion, a rapid heart rate, trembling, and sweating. If not treated promptly, more severe effects can occur, including confusion, coma, or seizures.
Hypoglycemic agent:
Drug used to treat hyperglycemia in people with diabetes.
Impaired fasting glucose (IFG):
A fasting plasma glucose equal to or greater than 100 mg/dl and less than 126 mg/dl. IFG is one form of prediabetes, a risk factor for future diabetes.
Impaired glucose tolerance (IGT):
A plasma glucose level between 140 and 200 mg/dl two hours after a seventy-five-gram oral glucose tolerance test. IGT is a form of prediabetes, a risk factor for the development of future diabetes and cardiovascular disease.
Incidence:
The number of new cases of a disease among a certain group of people during a certain period of time.
Insulin:
A hormone normally secreted by the beta cells of the pancreas. Insulin controls the level of glucose (sugar) in the blood.
Insulin pump: A device that delivers a continuous supply of insulin into the body (also called continuous subcutaneous insulin infusion). The insulin is
pumped through a plastic tube that is connected to a needle, which is inserted into the skin. Insulin is delivered at one or more steady rates (called basal rates) for continuous daylong coverage, with extra boosts of insulin (called boluses) to cover meals or other times when extra insulin is needed.
Insulin resistance:
Abnormal metabolic state in which cells lose sensitivity to insulin. Insulin resistance is an underlying factor in the development of type 2 diabetes; it also increases risk of cardiovascular disease.
Intensive glucose control:
Diabetes management aimed at maintaining glucose levels as close to the nondiabetic range as safely possible, compensating for meals, activity level, menstruation, stress, and illness. Intensive or “tight” control has been shown to prevent or at least delay many of the medical complications of diabetes.
Ischemic heart disease:
See Coronary heart disease.
Juvenile Diabetes Research Foundation International (JDRF):
Major diabetes organization focused exclusively on diabetes research. JDRF focuses on type 1 diabetes. For more information, see www.jdf.org.
Ketoacidosis:
See Diabetic ketoacidosis.
LDL cholesterol:
Low-density lipoprotein cholesterol, a transport form of cholesterol in the blood. High concentrations of LDL cholesterol are a risk factor for cardiovascular disease.
Lipids:
Fats, including cholesterol, triglycerides, and phospholipids.
Lipoprotein:
Combination of protein and fat that transports lipids (cholesterol, triglycerides) in the bloodstream. Major lipoproteins are named for their density and buoyancy in water, such as low-density (LDL), high-density (HDL), and very low–density (VLDL) lipoproteins.
Locus of control:
A common measure of a person’s perceived ability to control events.
Macroalbuminuria:
High levels of the protein albumin in urine, a sign of progressing kidney disease. Usually greater than 300 mg per twenty-four hours.
Macrosomia: A condition in which a baby is “large-for-date,” that is, weighs more than normal as a result of high blood glucose levels. Macrosomia can complicate the delivery.
Macrovascular disease:
Disease of the large blood vessels caused by atherosclerosis. There are three types of macrovascular disease: coronary (heart) disease, cerebrovascular disease (vessels supplying the brain), and peripheral vascular disease (vessels supplying the extremities).
Metabolism:
The chemical and physical processes in the body that sustain life and are related to the assimilation of food, growth, and provision of energy. Diabetes affects many aspects of the body’s metabolism.
Metformin:
A drug used to treat type 2 diabetes.
mg/dl:
Milligrams per deciliter. Term used to describe how much of a substance is in a specific amount of liquid (e.g., the number of milligrams of glucose in one deciliter of blood).
Microalbuminuria:
Low but abnormal levels of albumin excretion in the urine. Microalbuminuria is defined as more than 30 mg of the protein albumin excreted in a twenty-four-hour period or as a spot urine sample with 30 mg per gram of creatinine. It is an early indicator and risk factor for future kidney disease.
Microvascular disease:
Disease of the small blood vessels, especially of the kidney or the eye.
Myocardial infarction (MI):
Also called a heart attack, MI occurs when heart muscle is destroyed as a result of narrowed or blocked blood vessels that interrupt the blood supply to the area. MI is a serious complication of diabetes that can cause death.
National Cholesterol Education Program (NCEP):
Program begun in 1985 by the National Institutes of Health. The goal is to reduce the percentage of Americans with high blood cholesterol through educational efforts. The NCEP raises awareness of high blood cholesterol as a risk factor for coronary heart disease and teaches the benefits of lowering cholesterol levels as a means of preventing coronary heart disease. For more information, see www.nhlbi.nih.gov/about/ncep/index.htm.
National Diabetes Education Program (NDEP):
Federally sponsored initiative that involves public and private partners to improve the treatment and outcomes for people with diabetes, to promote early diagnosis, and ultimately to prevent the onset of diabetes. For more information, see www.cdc.gov/diabetes/projects/ndeps.htm.
Nephropathy:
Kidney disease, a serious complication of diabetes.
Neuroendocrine:
Pertaining to the interaction between the nervous and endocrine systems.
Neuropathy:
Disease of the nervous system caused by damage to the nerves, a serious complication of diabetes.
Nutrients:
Ingredients in food that provide nourishment. Proteins, carbohydrates, and fats are all essential nutrients that a healthy body needs to function.
Oral glucose tolerance test (OGTT):
See Glucose tolerance test.
Osteoporosis: A disease characterized by a significant loss of bone density. Osteoporosis increases the risk of bone fractures or curvature of the spine.
Pancreas:
The organ located behind the stomach that is responsible for producing insulin. Also produces and secretes other hormones and digestive chemicals called enzymes.
Periodontal disease:
Disease of the gums; can be a complication of diabetes.
Peripheral vascular disease (PVD):
Disease of the large blood vessels of the arms, legs, and feet caused by blocking of major blood vessels.
Pharmacotherapy:
The treatment of disease with medicines.
Polycystic Ovary Syndrome (PCOS):
A cluster of findings, including irregular menstrual periods and overproduction of the hormone androgen, with such signs as excess hair growth on the face, chest, and back. Other signs of PCOS are insulin resistance, obesity, acne, infertility, and cysts on the ovaries. Women with PCOS have a high risk for developing type 2 diabetes.
Prediabetes:
A stage when glucose levels are higher than normal but not high enough to be considered diabetes. See also Impaired fasting glucose and Impaired glucose tolerance. Someone with prediabetes has a very high risk of developing diabetes and an increased risk of developing cardiovascular disease.
Preeclampsia:
Condition characterized by high blood pressure that some women develop during the late stages of pregnancy. Preeclampsia is more common in women with diabetes.
Prevalence:
The percentage of people in a given group who are reported to have a disease at a certain point in time.
Proliferative diabetic retinopathy (PDR):
Growth of abnormal blood vessels and fibrous tissue from the inner retinal surface. A severe form of retinopathy.
Proteinuria:
Too much protein in the urine; may be a sign of kidney damage.
Relative risk (RR):
The ratio of the risk of death or disease in a specified group compared with a control population.
Renoprotective:
Describes a factor that preserves kidney function or prevents kidney disease.
Retinopathy:
A disease of the small blood vessels in the retina of the eye.
Self-efficacy:
One’s personal judgment of one’s own ability to succeed in reaching a specific goal; belief in one’s ability to maintain behavioral change in the face of situational challenges.
Self-management:
A set of skilled behaviors that allow patients to manage their illnesses. For diabetes, this includes self-monitoring glucose management; taking medications for diabetes, blood pressure, and hyperlipidemia; adjusting diabetes medications as needed; and following dietary and activity guidelines and sick-day plans.
Sequelae:
Results of a disease or injury or of complications. Sequelae of diabetes include its complications.
Social network:
A set of social ties that connects an individual with others.
Social support:
Emotional or task-oriented assistance provided by the community, family, friends, or significant others.
Socioeconomic status (SES):
A descriptive term for a person’s position in society, using criteria such as income, educational level attained, occupation, and value of dwelling place.
Stroke:
Damage to the brain caused by blocked blood vessels in the brain. Depending on the part of the brain affected, stroke can cause loss of muscle function, mental function, vision, sensation, or speech. Diabetes increases the risk of stroke.
Sulfonylurea:
A drug used to treat type 2 diabetes that increases insulin secretion and lowers the level of glucose (sugar) in the blood.
Thrombosis: The formation, development, or presence of a thrombus, or blood clot, in a blood vessel. Thrombosis can develop as a complication of atherosclerosis and is more common in people with diabetes.
Triglycerides:
Type of blood fat.
United Kingdom Prospective Diabetes Study (UKPDS):
Clinical study of newly diagnosed patients with type 2 diabetes. The UKPDS demonstrated that intensive glucose control prevents complications of diabetes.
Urinary incontinence:
Uncontrollable loss of urine. There are two general types: urge incontinence, which is characterized by a sudden, uncontrollable urge to urinate; and stress incontinence, characterized by loss of urine after a physical activity such as sneezing, coughing, exercise, or laughing.
Urinary tract infections:
Infections that occur when bacteria grow somewhere in the urinary tract (bladder or kidney).
Vaginitis:
Any one of several types of inflammations of the vagina, caused by various organisms or by the low level of estrogen after menopause.
Vascular:
Relating to the body’s blood vessels (arteries, veins, capillaries). See Cardiovascular disease.
Vitreous hemorrhage:
Bleeding into the clear jelly (gel) that fills the center of the eye.
Waist-to-hip ratio (WHR):
A measure of central obesity, which is related to insulin resistance and diabetes risk. Formula: waist circumference divided by hip circumference.

Disclaimer: This book and web site are meant to educate, but should not be used as a substitute for personal medical advice. Readers should consult their physicians for specific information concerning their individual medical conditions. The authors have done their best to ensure that the information presented here is accurate up to the time of publication. However, as research and development are ongoing, it is possible that new findings may supersede some of the data presented here.

Copyright © 2008 by the President and Fellows of Harvard College. All rights reserved.