Driver Safety Information Diabetes Glossary

  • Acidosis
    A condition caused by high acidity in the blood.
  • Acute Complications
    Transient complications that are temporary and reversible due to blood glucose fluctuations having a short term impact on driving capability, such as hypoglycemia, hyperglycemia, diabetic ketoacidosis, and nonketotic hyperosmolar coma.
  • Albumin
    A type of simple water soluble protein present in the urine.
  • Albuminuria
    The presence of simple protein in the urine, sometimes indicative of kidney disease.
  • Alcohol Induced Diabetes
    See Latent Diabetes
  • Angina
    Chest pain or severe spasmatic and painful suffocation in the chest casued by reduced blood flow to the heart muscle.
  • Atherosclerosis
    A chronic disease in which excessive amounts of fat and cholesterol remaining in the bloodstream collect on the inside walls of arteries, forming plaque that gradually thickens and hardens the arterial walls, slowing down and interfering with blood circulation until a blockage occurs. If blood cannot get through the affected vessel to nourish tissues, complications such as hypertension, stroke, gangrene, peripheral vascular disease, heart disease and other arteriosclerotic forms of disease can occur
  • Autonomic Neuropathy
    The autonomic nervous system (comprised of the sympathetic and parasympathetic nervous systems) are the nerves which control a whole range of bodily functions, such as the action of the stomach, intestine, esophagus, bladder, genitals, sweat glands, and even the heart and regulating changes in blood pressure levels. These are all nerves which work independently of conscious control. There may also decreased ability of the foot to perspire leading to dry, scaly skin which can crack and become infected and can gradually lead to foot ulceration problems. (Orthostatic Hypotension, Hypoglycemic Unawareness).

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  • Background Diabetic Retinopathy
    (Non-proliferative Retinopathy) Is the earliest stage of diabetic retinopathy in the mildest form, fine blood vessels and retinal capillaries within the retina become narrowed, clogged and swollen, or form balloon-like sacs. These altered vessels leak blood and fluid (macular edema) causing the retina to swell or form deposits called exudates from the center of the retina called the macula.
  • Balanced Diet
    (American Diabetes Association Diet) A proper diet is the utmost importance in the therapy for management in treating diabetes. A diet for a person with diabetes should provide sufficient calories to achieve and maintain a desirable body weight.
  • Beta Cells
    Cells that produce insulin within the body(endogenous) and found in the Islets of Langerhans in the pancreas.
  • Blood Glucose Monitoring
    Testing the blood or urine of a person with diabetes to help maintain the amount of glucose in the blood within reasonable limits. Usually, a drop of blood (obtained by pricking the finger) is placed on a small test-strip that is inserted into a blood glucose meter. The meter calculates and displays the blood glucose level in (mg/dl) milligrams per deciliter unit of measurement. Testing the blood for glucose several times a day serves as an effective guide for proper management. Many people with diabetes test before each meal. A blood test taken before eating (pre-absorptive or fasting) or after eating (postprandial) to determine the level of glucose in the blood. Normal blood glucose is usually from 100mg/dl to 160mg/dl.
  • Blood Urea Nitrogen
    (BUN) A common blood test that can determine the level of a certain waste product , urea, in the blood.
  • Brittle Diabetes
    (Labile or Unstable Diabetes) Marked fluctuations in blood glucose concentrations which are difficult to control causing frequent episodes of insulin reactions or coma despite good therapy for management and medical supervision. It is characterized by rapidly passing into either reaction or coma precipitated by fluctuation between high and low levels of glucose in the blood.
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  • Carbohydrate
    One of three major sources of calories in the diet. Carbohydrate is broken down into glucose during digestion and is the main nutrient that raises blood glucose levels. Carbohydrates come primarily from sugar (simple carbohydrate) and starch (complex carbohydrate, found in bread, pasta, beans).
  • Cardiovascular Disease
    Relating to the blood supply to the heart. Diabetes is a major risk factor for developing heart disease. Other risk factors are family history of heart disease, obesity, sedentary lifestyle, stress, cigarette smoking, and high levels of blood fats (cholesterol). Heart and blood vessel disease (coronary artery disease and hypertension) is the leading cause of death among adults in the United States.
  • Cerebrovascular Disease
    Relating to the blood supply to the brain, particularly with reference to pathologic changes such as stroke and other cognitive deficits.
  • Cerebral Vascular Accident
    (CVA, Stroke) Impaired cerebral blood supply.
  • Chemical Diabetes
    See Latent Diabetes
  • Chronic Complications
    Associated with the duration of the disease, the lack of metabolic control of blood glucose, and other factors which result in tissue damage and have a long term impact on driving capability. The main chronic complications of diabetes mellitus are: (1) Visual Impairments: blurred vision, cataracts, glaucoma, maculopathy (macular edema), diabetic retinopathy. (2) Diabetic Nephropathy: progressive kidney dysfunction causing muscular weakness and fatigue leading to dialysis. (3) Cardiovascular, Cerebrovascular, and Peripheral Diseases: narrowing of arteries causing decreased blood flow to the heart, brain, and legs. (4) Neuropathy: a disorder of the nervous system (autonomic and peripheral) which impairs sensation or movement in the feet, legs, or hands.
  • Chronic Hyperglycemia
    Excessively high blood glucose that is slow progressing and long continuance of that may result in diabetic ketoacidosis or nonketotic hyperosmolar coma.
  • Claudication
    A condition caused by a local and temporary deficiency of blood to the muscles due to narrowing (sclerosis) of the arteries (Peripheral Artery Disease) and characterized by attacks of lameness, odd sensation of tightness or pain in the affected thigh or calf muscles brought on by walking; however the condition may occur in other muscle groups.
  • Coma
    See Diabetic Coma.
  • Coronary Vascular Disease
    Relating to the blood supply to the heart, particularly with reference to pathologic changes. Coronary heart disease occurs when arteries that supply the heart muscle become narrowed by fatty deposits (atherosclerosis). Congestive heart failure, enlarged heart, syncope or collapse, angina, dyspnea (shortness of breath), or coronary insufficiency, myocardial infarction, thrombosis. A condition in which the heart cannot efficiently pump blood. Coronary artery disease is the most common form of heart disease. It occurs when the arteries that nourish the heart muscle narrow or become blocked. People with diabetes have a higher risk than the general population for developing heart disease.

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  • Diabetes
    Either diabetes insipidus or diabetes mellitus, diseases having in common the symptom polyuria; when used without qualification, refers to diabetes mellitus characterized by high blood glucose levels.
  • Diabetes Complications
    Are either short term (acute) or long term (chronic) impairments which affect the microvascular or macrovascular blood vessels of persons with diabetes, such as: (Acute) hypoglycemia, hyperglycemia, diabetic ketoacidosis, nonketotic hyperosmolar coma; (Chronic) visual impairments, diabetic nephropathy, cardiovascular and cerebrovascular disease, and diabetic neuropathy.
  • Diabetes Control and Complications Trial
    (DCCT) A ten year study ending June 1993, was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases comparing the effects of the usual two-injection a day insulin treatment or intensive therapy using multiple daily injections or an insulin pump to prevent or slow the development of diabetic complications. The DCCT proved that "tight control" of blood glucose levels would slow or prevent complications from diabetes.
  • Diabetes Education
    Approved American Diabetes Association patient and family education for self-management and treatment of diabetes by: (1) Eating a recommended diet and paying close attention to caloric intake and timing of meals. (2) Exercising sufficiently and regularly to help maintain health. (3) Self-monitoring of blood glucose levels frequently as instructed by health care team. (4) Taking diabetes medicine as prescribed (oral diabetes tablets and/or insulin injections), that is consistent with the National Standards for Diabetes Patient Programs, preferably provided by a certified diabetes educator. By knowing proper diabetes education and treatment many people stay healthy and manage their diabetes well.
  • Diabetes Insipidus
    Chronic excretion of very large amounts of urine causing dehydration and extreme thirst; ordinarily resulting from pituitary dysfunction, damage or injury. The condition is not synonymous with diabetes mellitus.
  • Diabetes Mellitus
    There are five general types of diabetes mellitus that are recognized, but only Type I and Type II diabetes and gestational diabetes mellitus diseases are the most important involving the endocrine pancreas. Diabetes is a disease in caused by an absolute or relative deficiency of insulin which the body cannot produce insulin or cannot use the insulin it makes properly. Diabetes is a metabolic disorder of fat metabolism which changes the way our bodies break down and use starches and glucose and is a disease of the pancreas characterized by excessive thirst, hunger, urination, weakness, acidosis, and without injection of insulin, eventual coma and death.
  • Diabetic
    Relating to or suffering from diabetes. The medical condition term "diabetic" should not be used to describe a person who has a diabetes disease.
  • Diabetic Coma
    Develops when insulin and blood glucose are so out of balance that ketones accumulate in the blood. Characterized by acid poisoning (ketoacidosis), or acid intoxication caused by a lack of insulin or an elevation in counterregulatory (stress) hormones usually taking several hours or even days to occur, but can usually be controlled at the first signs of high blood glucose or ketones in the urine. It is marked by high blood glucose levels and ketones in the urine, and occurs almost exclusively in persons with Type I diabetes. Certain causes directly related to diabetes are: (1) Hypoglycemic coma resulting from excessive doses of insulin or oral hypoglycemic agents. (2) Hyperglycemic coma associated with either severe insulin deficiency (diabetic ketoacidosis Type I diabetes) or a mild to moderate insulin deficiency (nonketotic hyperosmolar coma, Type II diabetes). (3) Lactic acidosis associated with diabetes, particularly in persons with diabetes stricken with severe infection or with cardiovascular collapse.
  • Diabetic Ketoacidosis
    (DKA, also see Diabetic Coma) The basis for DKA is either absolute deficiency of insulin or acute resistance to insulin developing when absolute insulin deficiency and excess contra-insulin hormones increase liver glucose production, decrease peripheral glucose utilization, and stimulate release of fatty acids from fat cells and production of ketones by the liver. These changes cause hyperglycemia, osmotic diuresis, volume depletion, and acidosis. DKA is a severe condition caused by a lack of insulin or an elevation in stress hormones and marked by high blood glucose levels and ketones in the urine, and occurs almost exclusively in those with Type I diabetes. Its symptoms may include dry mouth, great thirst, loss of appetite, excessive urination, dry and flushed skin, heavy or labored breathing, possible vomiting, abdominal pain, fruity-smelling breath (odor of alcoholic beverage), unconsciousness, and death.
  • Diabetic Macular Edema
    See Maculopathy
  • Diabetic Neuropathy
    (Peripheral and Autonomic Neuropathies) Damage to the nervous system which affects the peripheral nervous system causing impairment of motor nerves affecting voluntary movement, and sensory nerves affecting touch and feeling sensations, especially the ability to feel pain impulses. The autonomic nervous system causes impaired bodily functions that are not under consciousness control such as heart beats, breathing, and digestion.
  • Diabetic Retinitis
    Inflammation of the retina of the eye caused or complicated by diabetes.
  • Diabetic Retinopathy
    (Background and Proliferative Retinopathy) A progressive disorder of the retina damaging the receptor cells and small blood vessels in the eye that can lead to vision changes. Early stage background retinopathy, the blood vessels bulge and leak fluids into the retina and may cause blurring. In the advanced stage, proliferative retinopathy is more serious and can cause vision loss because new blood vessels form in the retina and branch out to other areas of the eye causing blood to leak into the clear fluid (vitreous) inside the eye and cause tissue in the macula to swell or cause the retina to detach.
  • Diabetic Shock
    See Insulin Reation
  • Diabetologist
    (Diabetology) A specialist in the field of medicine concerned with diabetes.
  • Dialysis
    A method of cleaning the blood of waste and maintaining the chemical balance of the blood by either hemodialysis or peritoneal dialysis process when the kidneys have failed. Dialysis is a form of diffusion filtration to separate smaller molecular substances from larger molecular substances after end stage renal failure. Dialysis (opposed to transplantation) is the most common form of kidney replacement therapy. There are two forms of dialysis: (1) Hemodialysis, a method in which a person is connected to an artificial kidney blood filtering machine three times a week. (2) Peritoneal dialysis enables people to do dialysis without an artificial kidney filtering machine practically anywhere clean to help reduce chances of germs entering the peritoneum through the tube and catheter causing infection. A special solution of dialysate is run through a tube into the thin tissue that lines the inside of the abdomen (peritoneum) cavity, after several hours the dialysate absorbs the waste from blood circulating in the peritoneum and drained out. The two preferred processes of peritoneal dialysis are the Continuous Ambulatory Peritoneal Dialysis (CAPD) machine-free and done during normal activities in which the dialysate is in the peritoneum 24 hours a day, seven days a week. The cleansing fluid is drained and replaced 3 to 5 times a day. The Continuous Cycling Peritoneal Dialysis (CCPD) uses a machine called a "cycler" to deliver and drain the cleansing fluid usually while asleep.
  • Diet Control
    See Balanced Diet
  • Diplopia
    Objects appear double. Double vision.

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  • Emergency Measures
    (Emergency Diabetes Assistance) The regimen of treatment for the rapid onset of hypoglycemia. (1) A mild range of severity generally requires self-treatment. (2) A moderate range of severity may require assistance in treatment. (3) A severe range of severity usually requiring immediate attention and assistance by someone else.
  • Endocrinologist
    Specialist of endocrinology concerned with endocrine glands: Pineal body; Pituitary; Parathyroid; Thyroid; Thymus; Stomach; Pancreas (Islets of the Langerhans); Suprarenal (adrenal); Duodenum; Ovaries (female); Testes (male).

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  • Foot Ulceration
    A wound with superficial loss of tissue from trauma and may become ulcerated if infection occurs. A foot ulceration may go unnoticed in persons with diabetes who have diabetic neuropathy because of a loss of sensation, inability to feel pain or numbness.
  • Functional Impairments
    The Department of Motor Vehicles use in its medical guidelines specifically referring to a wide range of physical, mental or emotional impairments affecting a person's ability to operate a motor vehicle safely. Functional impairments help to define the mild, moderate, or severe range of severity for disease complications and its progression.

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  • Gangrene
    A form of a wet or dry infection, frequently seen in diabetes causing decay and dying of tissue in a localized part of the body or involve an organ or a limb because of an obstruction or loss of blood supply, injury, or disease resulting from arteriosclerosis.
  • Gestational Diabetes
    (GDM) Diabetes mellitus that develops during pregnancy and usually goes away after pregnancy, but about 60% of those women will eventually develop Type II diabetes. GDM is the appearance of elevation of blood glucose (hyperglycemia) during pregnancy in approximately five percent (5%) of pregnant women during the second trimester. Gestational diabetes develops in pregnant women previously not known to have diabetes. The regimen for therapy for managing GDM is either a prescribed diet or insulin injections determined by her health care team.
  • Glaucoma
    (Open-angle and acute angle-closure glaucoma, Neovascular glaucoma) A disease of the eye characterized by high intraocular pressure within the eyeball, damaged optic disk, atrophy of the optic nerve, hardening of the eyeball, and partial defect in the field of vision or complete loss of vision. Glaucoma is associated with high blood pressure, diabetes, and hardening of the arteries (atherosclerosis), or optic nerve damage.
  • Glucagon
    A hormone produced by the pancreas that raises blood glucose levels. An injectable preparation is available by prescription for use in treating a severe insulin reaction.
  • Glucopenia
    See Hypoglycemia
  • Glucose
    (Sugar) A simple form of sugar that acts as the body's fuel. It is produced when foods are metabolized in the digestive system and carried by the blood to cells for energy. The amount of glucose in the blood is known as blood glucose level.
  • Glycohemoglobin
    (GHb) A glycosylated hemoglobin test administered by the physician to review average blood glucose control for the past three to four months before the test, and can be used as a retrospective index of glucose control over a period of time. (one such test is the hemoglobin test A1C.
  • Glycosuria
    (Glucosuria) The urinary excretion of glucose usually in enhanced quantities.
  • GrowthOnset Diabetes
    See Non-Insulin Dependent Diabetes Mellitus.
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  • Health Care Team
    A support group of health-care professionals who helps persons manage diabetes. This team may include an endocrinologist, physician, registered dietitian, and certified diabetes educator (a certified diabetes educator can be a physician, registered nurse, or registered dietitian). Ophthalmologist, podiatrists, nephrologist, neurologist, cardiologist or other specialist can also be part of the team.
  • Heart Disease
    See Coronary Vascular Disease.
  • Hemodialysis
    The most common form of treatment for end stage renal failure. Surgery is required to join one artery to a vein to form a larger vein called a fistula or loop (vein carries blood to the heart; an artery carries blood from the heart), or a straight piece of graft material tubing is implanted. An artificial kidney is used to remove waste from the blood at a person's home, outpatient clinic, or hospital. Dialysis is usually done three times a week, for three to five hours each session. All sessions are normally the same at either location.
  • Human Error
    Lack of or reluctance to use proper diabetes education techniques by person with diabetes or other individual assisting in self-management and treatment involving a balanced diet and exercise, adequate blood glucose monitoring, oral diabetes medicine, or insulin injections that result in emergency measures or violating a precise and detailed therapy for management plan or the study of a biomedical problem.
  • Hyperglycemia
    A condition in which blood glucose levels are too high. Symptoms include frequent urination increased thirst, and weight loss despite increased appetite.
  • Hyperglycemic Episode or Reation
    Slow onset of severe elevation in blood glucose levels causing acute complications including stupor, lethargy, blurred vision, disorientation, slow responses, weakness, diabetic ketoacidosis (diabetic coma) and nonketotic hyperosmolar coma.
  • Hyperinsulinism
    (Hyperinsulinemia) Increased levels of insulin in the plasma due to increased secretion of insulin by the beta cells (cells that make insulin) of the pancreatic islets and decreased liver removal of insulin is a case in some persons, although hyperinsulinism usually is associated with insulin resistance and is commonly found in obesity in association with varying degrees of hyperglycemia, (Alimentary Hyperinsulinism).
  • Hyperlipidemia
    (Lipemia) The presence of an abnormally large amount of lipids (fats) in the circulating blood.
  • Hyperparathyroidism
    An endocrine condition due to an increase in the secretion of the parathyroid gland that regulates the proper functioning of the skeletal, digestive, renal, and nervous systems. Symptoms and signs may include lethargy, constipation, nausea, vomiting, polyuria. In extreme cases, bone pain (Recklinghausen's disease of the bone), renal stones, renal failure, and coma.
  • Hypertension
    Diabetes and hypertension are powerful risk factors for cardiovascular disease, stroke, peripheral vascular disease, renal failure. Five percent (5%) of high blood pressure cases are caused by glandular or hormonal abnormalities. The other 95 percent (95%) are caused by essential hypertension from diet, body size, stress, and heredity. Hypertension alone is not likely to cause sudden collapse. However, complications from sustained hypertension can cause headaches, dizziness, fatigue, and spontaneous nosebleeds, and if untreated heart attack or stroke. A systolic/diastolic blood pressure of even 140/90 is probably too high in diabetes, because renal damage starts when blood is in the high normal range.
  • Hypoglycemia
    (Insulin Reaction, Glucopenia) A condition in which blood glucose drops too low. An abnormally small concentration of glucose in the circulating blood less than the minimum of the normal range above 70mg/dl. Hypoglycemia may cause cognitive dysfunction and loss of consciousness if untreated.
  • Hypoglycemia Unawareness
    The lack of ability to recognize warning signs (symptoms) of the sympathetic nervous system (adrenergic) involving weakness, nervousness, sweating, cold sweats, increased heart rate, and irritability. Adrenergic symptoms may not occur in some persons with diabetes such as: (1) Who have nerve damage and do not release adrenaline (autonomic neuropathy). (2) Have a long duration of diabetes. (3) Have tightly controlled blood glucose levels. (4) Are taking medications for heart disease or hypertension that block the release of adrenaline and are at risk for having severe hypoglycemic reactions. If adrenergic symptoms do not appear or are ignored, the thought process and motor coordination become noticeably difficult from the lack of glucose to the brain.
  • Hypoglycemic Coma
    Resulting from excessive doses of exogenous (injected) insulin or oral hypoglycemic agents medication.
  • Hypoglycemic Episode or Reaction
    See Insulin Reactions
  • Hyponatremia
    Low blood sodium.
  • Hypoparathyroidism
    Increased secretion of parathyroid hormone. Symptoms and signs include neuromuscular excitability, cramps, spasm, and generalized tetany, paresthesias, and seizures and particularly a primary cause in catracts, chronic fungal infection of the skin, and baldness.
  • Hypoxia
    Low levels of oxygen in the brain.

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  • Impaired Glucose Tolerance
    (IGT) A condition, not considered a form of diabetes, diagnosed when oral glucose tolerance test results show that a person's blood glucose level falls between normal and diabetic levels. Persons with IGT have an increased risk for developing diabetes. Impaired glucose tolerance used to be called latent, chemical, or borderline diabetes but is no longer considered a form of diabetes.
  • Insulin
    A hormone that is needed to convert glucose, starches and other food into energy needed for daily life. Insulin allows cells to use glucose for fuel and is secreted by beta cells in the islets of Langerhans. The release of insulin from the pancreas is stimulated by increased blood glucose, vagal nerve stimulation, and other factors. Insulin is obtained from various animals and available in a variety of preparations. Commercial insulin preparations differ in a number of ways, including differences in the animal species from which they are obtained; their purity, concentration, and solubility; and the time of onset and duration of their biologic action. An oral hypoglycemic agent is not a form of insulin therapy.
  • Insulin Delivery
    (Insulin Injections) The method a person with diabetes learns to use for injecting exogenous insulin into the body's bloodstream. Some delivery methods are usually syringes; miniature computerized continuous insulin pumps; "no needle" jet injectors method where insulin is forced through the skin; insulin syringe like pocket-pens; infusers injection access portal into subcutaneous tissues for 2-3 days; insertion is a device to accelerate needle insertion into the skin, subcutaneous infusion where a flexible teflon catheter remains beneath the skin for several days.
  • Insulin-Dependent Diabetes
    See Insulin
  • Insulin Injections
    See Insulin Delivery
  • Insulin Reactions
    (Diabetic Shock or Hypoglycemic Reaction) Severe hypoglycemia produced by administration of insulin, manifested by sweating, tremor, anxiety, vertigo, and diplopia, followed by delirium, convulsions and collapse. If the blood glucose drops much below 70 mg/dl the person may go into insulin shock very rapidly. After unusual exercise, or after missing a meal, a person may have more insulin available than is needed to metabolize their glucose supply at that moment and the blood glucose drops and the person may suddenly get very jittery, or may lose consciousness. Often there is enough warning so that a person may eat a piece of candy to raise their blood glucose level. Hypoglycemic reactions can occur in some persons with no history of diabetes.
  • Insulin Resistance
    A condition in which the body does not respond to insulin properly. This is most common in Type II diabetes or associated with obesity, ketoacidosis, infection, and certain rare conditions. Diminished effectiveness of insulin in lowering blood glucose levels requiring 200 units or more of insulin per day to prevent hyperglycemia or ketosis.
  • Insulin Producing Cells
    See Beta Cells
  • Insulin Therapy
    See Insulin Delivery. The two types of insulin therapy (1) conventional or (2) intensive starts when the body stops making insulin or makes only a tiny amount, without insulin a person with diabetes could not survive. Insulin is injected under the skin (in the fat) for it to work. Insulin cannot be taken in a pill or tablet since stomach fluids in the digestive system would destroy the hormone before the body can put it to use. It controls blood glucose levels. There is no cure for diabetes, but can be controlled by insulin injections (exogenous insulin), self monitoring of blood glucose, pancreas and islet cell transplants, oral hypoglycemic agents, or diet and exercise. If untreated can cause heart and kidney disease, blindness, problems in pregnancy or childbirth, nerve and blood vessel damage, and can reduce the ability to fight against infection.
  • Islet's of Langerhans
    Cellular masses varying from a few to hundreds of cells lying in the interstitial tissue of the pancreas; they are composed of different cell types which comprise the endocrine portion of the pancreas and are the source of insulin and glucagon.

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  • Juvenile-Onset Diabetic
    See IDDM. Diabetes developing during childhood, usually begins before the eighteenth birthday with severe and rapidly developing symptoms of hunger, thirst, and urination and a sudden dramatic loss of weight despite a normal diet.

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  • Ketones
    Acids produced when the body breaks down fat or fuel. This occurs when there is not enough insulin to permit glucose to enter the cells and fuel them or when there are too many counterregulatory (stress) hormones appearing in the urine when the body does not have enough insulin. A moderate or large amount of ketones are a clear warning sign that diabetes is out of control (Ketonuria).
  • Ketonemia
    The presence of recognizable concentrations of ketone bodies in the plasma.
  • Ketosis
    An enhanced production of ketone bodies.

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  • Juvenile-Onset Diabetic
    See IDDM. Diabetes developing during childhood, usually begins before the eighteenth birthday with severe and rapidly developing symptoms of hunger, thirst, and urination and a sudden dramatic loss of weight despite a normal diet.

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  • Labored Breathing
    (Kussmaul) Spasmatic respiratory attack (paroxysmal) of forced deep breathing characteristic of diabetic ketoacidosis or other causes of acidosis.
  • Lactoic Acidosis
    Accumulation of excessive lactic acid in the blood resulting in muscles burning glucose instead of oxygen.
  • Latent Diabetes
    (Chemical Diabetes) A mild form of diabetes mellitus in which the person displays no overt symptoms, but displays certain abnormal responses to diagnostic procedures, such as an elevated fasting blood glucose concentration or reduced glucose tolerance. A diet high in glucose and simple carbohydrate may cause latent diabetes to become visible.
  • Lethargy
    The presence of recognizable concentrations of ketone bodies in the plasma.

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  • Maculopathy
    (Macular Edema) Retinal capillaries become clogged and swollen, leaking fluid into the retina and cause swelling. The leaking fluid from the capillaries will accumulate and pool in the center of the retina, the macula. The most sensitive part of the retina is the macula, which is responsible both for the fine vision used in reading, and for color vision.
  • Metabolic Disorder
    Common metabolic diseases of the body's endocrine glands are:
    (1) Pancreas, Islet cell of the Langerhans, diabetes mellitus.
    (2) Thyroid' hyperthyroidism, hypothyroidism.
    (3) Parathyroid, hyperparathyroidism, hypoparathyroidism.
    (4) Pituitary, diabetes insipidus, hyperpituitarism, hypopituitarism, hypophysitis.
    (5) Adrenal hyperfunction of adrenal cortex (Cushing's disease), hypofunction of adrenal gland (Addison's disease), adrenal medulla hyperfunction.
    (6) Gonads, ovaries, testes.
  • Metabolic Control
    See Diabetes Education
  • Metabolism
    The complex physical breakdown and synthesis of chemical changes occuring in the issues.
  • Microvascular Diabetic Complications
    See Diabetes Complications
  • mg/dl
    Symbol for milligram per deciliters. This is the unit of measure used when referring to blood glucose levels.
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  • Nephropathy
    Kidney damage when they fail to function. If diabetes damages kidney filters, they become leaky, allowing protein to spill from the blood to urine. They also become less able to remove waste products. Nephropathy occurs in five stages leading to end stage kidney failure leading to dialysis or kidney transplantation. A specialist concerned with the science of medical diseases of the kidneys is referred as a nephrologist. As a result of diabetes, the kidneys overwork attempting to filter out through the glomeruli capillaries excess glucose. Waste substances not needed by the body are filtered out through the glomeruli into the urine and passed on to the bladder. Eventually the kidneys becomes damaged with scarring and capillary wall build-up resulting in renal failure. (Nephrogenic Diabetes Insipidus; Vasopressin-Resistant Diabetes.) Renal failure symptoms and signs are weakness, fatigue, a metallic taste in the mouth, loss of appetite, generalized twitching, and if untreated loss consciousness, seizures, and death.
  • Nonketotic Hyperosmolar Coma
    (NKHC, Hyperglycemic Coma) This is a gradual loss of consciousness, most often in an older person whose diabetes usually does not require insulin injections. NKHC is seen generally in older persons with Type II diabetes who are institutionalized, or mentally impaired due to a prior cerebrovascular accident that may mask the signs and symptoms of NKHC including focal neurologic abnormalities, transient hemiparesis, hemisenory deficits, aphasia, involuntary muscle contractions, hallucinations, delirium and coma.
  • Non-Insulin Dependent Diabetes Mellitus
    (NIDDM.) Type II diabetes; adult or maturity onset diabetes; an often mild form of diabetes mellitus of gradual onset, usually in obese individuals over age 35. A milder form of diabetes, circulating endogenous (contained within the body) insulin is sufficient to prevent diabetic ketoacidosis but is often either subnormal or relatively inadequate because of tissue insensitivity and responds well to dietary regulation and/or oral hypoglycemic agent, but diabetic complications and degenerative changes can develop.
  • Nonproliferative Diabetic Retinopathy
    See Background Diabetic Retinopathy
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  • Obesity
    Excessively fat or overweight.
  • Oral Hypoglycemic Agents
    (First and Second generation Sulfonylureas; Biguanides) Usage by Type II diabetics to lower blood glucose, but they are not insulin pills. Insulin is a protein and can't be taken orally because it would be broken down in the digestive tact, and destroyed before becoming effective. Oral medications treating hyperglycemia in non-insulin dependent diabetics increases the release of endogenous insulin as well as improve its peripheral effectiveness. Biguanides may cause lactic acidosis build up.
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  • Pancreas

    A comma-shaped endocrine gland that produces enzymes for digesting food and hormones that regulate the use of fuels in the body, including insulin and glucagon. In a fully functioning pancreas, insulin is released through special cells located in clusters called islets of the Langerhans. The three hormones (insulin, glucagon, somatostatin) produced by the pancreas enable the body to break down (metabolize) food that is eaten.

    When the pancreas is fully functioning normally, the glucose concentration in the blood changes in response to a wide variety of events including meals, exercise, stressful situations, and infections, but remaining within therapeutic ranges.

  • Peripheral Artery Disease
    The artery passage is blocked from the heart with a build up of fat and fibrous tissue, called plaque. Atherosclerosis complications of the vessels that supply blood to the arms and legs or hardening of the arteries that supply blood to every part of the body. Peripheral arterial disease can cause intermittent claudication (pain on walking, usually in the calf or thigh, but is relieved by resting), infections, gangrene, and even amputation of apart of the foot or leg. This reduces circulation to the lower legs and feet, so that if the foot is cut or injured in any way, healing may be slowed and the risk of infection increased. Treatment may include angioplasty, atherectomy, arterial bypass surgery.
  • Peripheral Neuropathy
    Affects the peripheral nervous system, which links the legs, arms, and outer trunk with (motor functions) the brain. This system of nerves allows you to feel sensations, telling you, for instance, to move your havd if you touch a hot skillet. It allows you to walk, grasp objects, manipulate your fingers. It is further categorized as:
    (1) Distal Symmetrical Polyneuropathy.
    (2) Mononeuropathy.
    (3) Cranial Mononeuropathy.
    (4) Truncal Mononeuropathy.
    (5) Proximal Motor Neuropathy.
    (6) Focal Neuropathy.
  • Polydipsia
    Excessive thirst that is relatively chronic.
  • Polyphagia
    Excessive appetite.
  • Polyuria
    (Hydruria.) Excessive excretion or discharge of urine.
  • Pregnancy Diabetes
    See Gestational Diabetes
  • Prosthesis
    The artificial replacement device for a limb, or other part of the body.
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  • Range of Severity
    The area or scope of a physical or mental condition or complication of a physical or mental condition occurring during another disease and aggravating it within a mild, moderate or severe degree of impairment limit.
  • Rebound Hyperglycemia
    (Somogyi Effect) In diabetes a rebound phenomenon of reactive hyperglycemia in response to a proceeding period of relative hypoglycemia that has increased secretion of hyperglycemic agents (adrenaline, norepinephrine, glucagon, cortisol, and growth hormone) described in diabetic patients given too much insulin who developed unrecognized nocturnal hypoglycemia that made them hyperglycemic (suggesting insufficient insulin) when tested the next morning. It may be mistaken for inadequate control.
  • Renal Failure
    As a result of excessive glucose in the bloodstream, the capillary walls (referred to as basement membranes) overwork in filtering the waste products and builds up scar-like material that eventually collapse the glomeruli filtering process causing kidney damage. Valuable parts of blood, such as red blood cells and protein are too large to pass through the filter and leak into the urine. The kidneys almost completely stop cleaning wastes out of the blood. Wastes build up to poisonous levels and can cause death. When creatinine and blood urea nitrogen levels in the blood are high, kidney failure will likely progress more rapidly unless treated. The two choices for renal failure are dialysis and kidney transplant.
  • Renal Threshold
    Concentration of plasma substance above which the substance appears in the urine.
  • Rest Pain
    An unpleasant sensation associated with actual or potential tissue damage, occurring usually in the extremities during body inactivity while sitting or lying down.
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  • Secondary Diabetes
    Type of diabetes caused by another disease altogether or damage to the pancreas from chemicals, certain medicines, or diseases of the pancreas (such as cancer) or other glands. Secondary diabetes can occur as a consequence of disorders such as acromegaly, Cushing's Syndrome, hyperthyroidism, or surgical removal of the pancreas.
  • Self-Management Training
    See Diabetes Education.
  • Seizure Condition
    Metabolic seizures resulting from unbalanced chemical and physical processes occurring in the body, such as hypoglycemia (low blood glucose), hyponatremia (low blood sodium), or hypoxia (low level of oxygen in the tissue). Symptomatic seizures resulting from a known structural brain abnormality or other medical condition such as, severe sleep deprivation, stroke, multi-infarct dementia, or pregnancy.
  • Severe Hypoglycemia
    Insulin reaction symptoms consistent with hypoglycemia that could not be treated by the person with diabetes alone, but required the attention and assistance from another person who aided with oral carbohydrate, injected glucagon intramuscularly, or glucose intravenously, for which hospital admission may have followed. Causes include lack of care or alertness and diabetes education, human error, improper combination of insulin, alcohol use, and hypoglycemia unawareness. Severe hypoglycemia includes all episodes in which neurologic impairment was severe enough to prevent self-treatment, and possibly causing seizures, convulsions or coma.
  • Somogyi Effect
    See Rebound Hyperglycemia
  • Stupor
    Marked by a cessation of mental activity or feeling, often produced by sleepiness, illness, or the effect or alcohol, or narcotics.
  • Sugar
    See Glucose
  • Syncope
    A brief loss of consciousness from a transient deficiency in the oxygen carrying material of the blood to the brain. Fainting or loss of consciousness due to loss cardiac output. Syncope is not a seizure. The three types of syncope are:
    (1) Situational, cough, emotion, or while urinating (micturitional).
    (2) Cardiogenic, decrease of cardiac output secondary to rhythm disturbance or failed pump.
    (3) Vasovagal or vaso-depressor, precipitated by fright or pain. Fainting or loss of consciousness due to loss of cardiac output.
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  • Temporary Precipitating Factor
    A transient unforeseen or unknown event that contributes to or results in insulin reaction episodes in spite of consciousness efforts by a person with diabetes and their health care team, such as human error or other contributing factor that may affect safe driving.
  • Therapy for Management
    (Regimen of Therapy) The treatment of disease by various methods. The key to treating and managing diabetes is controlling the blood glucose concentration by monitoring it.
  • Tight Control
    Suggested by the Diabetes Control and Complications Trial ten year study and the American Diabetes Association as an important way to delay the onset and dramatically slow the progression of complications from diabetes. Intensive insulin therapy for management consisting of strict monitoring of blood glucose levels to keep as close to normal by multiple daily insulin injections, a lifestyle change, exercise and healthier eating. Tight control significantly increases the danger of serious hypoglycemic reactions, and is not recommended for everyone.
  • Tissue Damage
    Impairment of the usefulness of the four basic tissues in the body:
    (1) membranous tissue, epithelium,
    (2) the connective tissues; including blood, bone, and cartilage,
    (3) muscle tissue,
    (4) nerve tissue.
  • Topical Burning
    An indirect reference of intense heat pertaining to a local part on the body.
  • Tumefactions
    Swelling and edema caused by insulin injections.
  • Type I Diabetes
    See Insulin Dependent Diabetes.
  • Type II Diabetes
    See Non-Insulin Dependent Diabetes Mellitus.
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  • Urine Tests
    (Urinalysis.) Analysis of the fluid and dissolved substances excreted by the kidney. Urine tests for ketones are the only tests measure ketones and are important in preventing ketoacidosis.
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  • Vascular Changes
    Complications relating to or containing the thickening of blood vessel linings causing decreased blood flow of nutrients through narrowed arteries (atherosclerosis) to the heart (cardiovascular), brain (cerebrovascular), and extremities primarily in the legs (peripheral vascular) diseases.
  • Violation of Protocol
    Deviation from a precise and detailed therapy for management plan or the study of a biomedical problem.
  • Visual Changes

    Diabetes-induced vision problems are an alteration from a person's normal vision due to changes in the small arteries that provide blood for the retina. Diabetic vision complications are:
    (1) Cataracts.
    (2) Background retinopathy.
    (3) Macular edema.
    (4) Retinitis.
    (5) Proliferative retinopathy.
    (6) Glaucoma.
    (7) Retinal detachment.
    (8) Blindness.

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  • Warning Symptoms
    Signs of impending departure from the normal sensations or functions experienced by persons with diabetes.