Download A to Z of Diabetes

A to Z of Diabetes
A1c:
See HbA1c
Acanthosis Nigricans:
This is often seen in diabetes and is associated with insulin resistance. It is characterized by brown,
velvety patches in the axilla and body folds.
Acarbose:
Drug used for the treatment for Type 2 diabetes. It prevents breakdown of complex carbohydrate in
intestine and lowers blood glucose. It often gives flatulence and diarrhoea as side effects.
ACE:
See ACE Inhibitors
ACE inhibitors:
Drug used to treat high blood pressure. It also helps prevent or slow nephropathy (the damage to
kidney) in people with diabetes. It works by blocking Angiotensin Converting Enzyme. Cough is the
common side effect.
Acidosis :
See Ketoacidosis
ACR:
See Albumin Creatinine ratio
Acupuncture:
Acupuncture is the practise of traditional Chinese medicine that involves insertion of special needles
into specific areas of the body to stimulate the functions of the organs. Its practitioners claim this to
be beneficial in the treatment of diabetes. It has been used frequently in the treatment of painful
neuropathy.
ADA:
See American Diabetes Association
Adult-Onset Diabetes :
Now known as type 2 diabetes.
Advanced Glycated End Products:
Excess glucose in the blood settles into the cells and forms a substance known as advanced glycation
endproducts (AGEs). These accumulate over time and cause various complications of diabetes. AGEs
are found in vessels of the eyes, kidneys and extremities. They
AGE:
See Advanced Glycated End Products.
Albumin Creatinine ratio:
A measure of kidney function by testing urine in laboratory. It measures ratio of albumin to
creatinine in urine and this will diagnose micoalbuminuria and albuminuria , which are various
stages of diabetic nephropathy (Kidney damage).
Albuminuria:
Leakage of more than 300mg of albumin in urine in 24 hours. This can also be measured by albumin
creatinine ratio (ACR) or protein creatinine ratio (PCR) in a sample of urine.
Alcohol in Diabetes:
People with diabetes can also enjoy a drink. However alcohol does have an effect on blood sugar
levels and it may cause severe hypoglycaemia. Therefore binge drinking has to be avoided.
Alternative Medical Therapies for Diabetes:
Many people use alternative medical therapies for diabetes. These include dietary supplememnts
(eg methi, cinnamon,Gourd), yoga, acupuncture or Ayurvedic medicines. Although some of these
therapies may be effective, others can be ineffective or even harmful. Patients who use these
therapies should inform their health care providers.
Amayotrophy:
A type of diabetic neuropathy that causes pain, weakness and wasting of thigh muscles.
American Diabetes Association:
This is an American organisation helping develop understanding of diabetes.
http://www.diabetes.org/
Amputation:
Surgical removal of part of limb. Amputation of leg is a common complication of diabetes.
Angina:
See Ischaemic Heart Disease.
Angiogram:
Special X-Ray performed to look at blood vessel. It is commonly done to look at blood vessels
supplying heart (Coronary), legs (peripheral) or brain (cerebral).
Angioplasty:
Special procedure to open blood vessels by stretching narrowed blood vessel using a balloon. It is
commonly done in blood vessels supplying the heart (Coronary angioplasty) or the legs(Peripheral
angioplasty).
Angiotensin Receptor Blockers:
Drug used to treat high blood pressure. It works by blocking a receptor for angiotensin. It also help
prevent or slow nephropathy (the damage to kidney) in people with diabetes.
Annual Review in Diabetes:
People with diabetes need checking for complications and review of treatment once a year. In some
centres it is done all at once and is called annual review. In most centres including Diabetacare it is
spread over 3 or 4 visits.
Annular Granuloma :
See Granuloma Annulare
ARB:
See Angiotensin Receptor Blockers
Arrhythmias:
Irregular beating of the heart. During an arrhythmia, the heart can beat too fast, too slow, or with an
irregular rhythm. Most arrhythmias are harmless, but some can be serious or even life threatening.
Arthropathy (Neuropathic):
See Charcot foot
Artificial Pancreas:
A closed loop system where blood glucose is continuously monitored, necessary dose of insulin is
calculated by computer programme and appropriate amount of insulin is given by insulin pump. This
is still in experimental state.
Aspirin:
A common tablet prescribed to prevent heart attack and stroke which is common in diabetes. It
thins the blood and prevents blockage of blood vessels.
Atherosclerosis:
A condition when fat builds up in the blood vessel causing it to be narrowed with risk for blockage.
People with diabetes are three time more prone to develop this.
Autoimmune Disease:
In this condition the body’s immune system attack and destroy various organs believing it not to
belong as its own. Type 1 diabetes occurs due to autoimmune destruction of pancreatic beta cells.
Autonomic Neuropathy:
A type of neuropathy that affect internal organs of body. It can affect stomach giving gastroparesis,
heart causing Cardiac Autonomic Neuropathy and postural hypotension, bladder causing urinary
retention and sexual organ causing impotence.
Ayurvedic medicines:
Many plants extracts can lower blood sugar and are available in different format as
Ayurvedic/Homeopathic medicines all over the world. However the content of active compounds in
these medicines is not tested rigorously and scientifically. The amount of active ingredients are also
not standardised which can affect t treatment. It is very important to discuss with your doctor if you
are taking them.
Background Retinopathy:
Early stage of diabetic retinopathy that does not affect vision or need treatment. It is also called
nonproliferative retinopathy. It needs regular check up.
Bariatric Surgery:
Surgery of stomach performed in very obese patient that restricts what they eat leading to weight
loss. Bariatric surgery often improves diabetes and it may go into remission.
Basal insuin:
Long acting Insulin (Levemir, Lantus, Isophane) given once or twice a day to counteract sugar
produced by liver in between meals.
Basal Bolus insulin:
A regime of giving multiple (usually 4) doses of insulin. Basal insulin is usually given once a day at
bed time and bolus insulin is given 3 times a day before meal.
Beta cells:
Cells in the pancreas in areas called the Islets of Langerhans that make and release hormone insulin
needed to control level of glucose (sugar) in the blood.
Beta Cell Transplantation:
See Transplant
Biphasic Insulin:
See Pre-mixed insulin
Blood Glucose monitoring:
It is the test done by patient usually at home to check the level of glucose in their blood by testing a
drop of blood.
Blindness:
Diabetes can damage the blood vessels of the eye, potentially leading to blindness. While those with
diabetes are at an increased risk of vision problems, most people with diabetes have no or only
minor eye disorders.
Blood Pressure:
It is the pressure within the blood vessel occurred due to contraction of the heart. Blood pressure is
usually written as 2 figures (eg 140/90) where higher figure is the systolic blood pressure and lower
pressure is diastolic blood pressure. In diabetes blood pressure should be below 130 /80. High blood
pressure is the main cause of stroke and other problems such as nephropathy, retinopathy and
heart attack.
BM Test:
See blood glucose monitoring
Bolus insulin:
Short acting insulin given before each meal.
BMI and diabetes:
BMI, or body mass index, is an indirect measurement of the amount of fat in a person's body. A high
BMI predicts the development of several diseases, including type 2 diabetes.
Body mass index:
Body mass index measures the degree of obesity.It can be calculated by dividing weight in kilogram
by height in meter squre. [BMI = Weight in kg / (height in meter)2].
Borderline Diabetes:
See Pre-diabetes
Brittle Diabetes:
Occasionally some patients with type 1 diabetes have great difficulty to control blood sugar. It
fluctuates from very high sugar to very low sugar within a short period. It is often found in patients
who do not adhere to the treatment advice.
Bronze Diabetes:
See hemochromatosis
Breastfeeding and Diabetes:
Breastfeeding will give infant a head start on a healthy life. It also helps its blood sugar levels —
which react inside the uterus mother's glucose imbalance. If the mother has diabetes, they need to
monitor diet and lifestyle extra carefully as there is risk of hypoglycaemia. Mother should take extra
meal or adjust insulin if it occurs.
Bypass:
Surgical operation to improve blood flow in an organ by bypassing the blocked blood vessel. It is
usually performed in the heart (coronary bypass) or the legs (peripheral bypass).
CAD:
See Ischaemic Heart Disease
Calcium Channel Blocker:
A drug to lower blood pressure
Callus:
Hard skin on the pressure area. In foot it can lead to ulcers.
Calorie:
Unit of measurement of energy that comes from food and is lost through exercise. Fats have high
calories but salads have least. In general average sedentary man needs 1800 calorie and women
1600 every day. Excess calorie leads to weight gain and its deficit leads to weight loss. Calorie
calculation is important if one wants to lose weight.
Cancer:
Diabetes carries an increased risk of different forms of cancer. This may be because of higher insulin
level which promotes growth of various cells or due to obesity which is commonly associated with
type 2 diabetes. The risk of liver cancer, pancreatic cancer, colon cancer, breast cancer and
endometrial cancer is higher in people with type 2 diabetes. It may also be due to various drugs used
for the treatment of diabetes. Pioglitazone can increase the risk of bladder cancer.
Capsaicin:
Cream derived from hot chilli pepper that is used to treat painful neuropathy.
Carbohydrate:
Carbohydrates are basic food component found in common food substances. It can be simple
(mainly sugars) which is found in sweets, sugar, cakes and chocolates. The glucose absorbs very fast
from the intestine when simple carbohydrates is consumed. Therefore this should preferably be
avoided by people with diabetes. It can be complex (mainly starches) which is found in rice, chapatti,
naan. The glucose absorbs slowly from complex carbohydrates. People with diabetes should
consume complex carbohydrate in moderation.
Cardiac Autonomic Neuropathy:
Autonomic neuropathy affecting the heart. This presents as high pulse rate at rest, inability to
exercise, postural hypotension and risk of sudden death.
Cardiomyopathy:
Cardiomyopathy is a disease that damages the structure and function of the heart. This disease can
lead to heart failure and arrhythmias. This can occur in people who have diabetes even without
underlying ischaemic heart disease.
Carpal tunnel syndrome:
Pain and weakness of the hand caused by compression of a nerve at the wrist. This may need
operation. It is more common in people with diabetes.
Cataract:
An eye condition where people cannot see properly because of clouding of the lens. This is often
found in old age but may be seen in young people who have diabetes.
Celiac Disease:
This is an autoimmune disorder of intestine triggered by cereal proteins called gluten that leads
malabsorption that can cause anaemia. This disease can be present in 5% of people with type 1
diabetes. It can be detected by doing blood test and endoscopy.
Central obesity:
Central obesity is the presence of excess fat in the abdomen making people pot bellied. In this
condition, the fat is predominantly deposited around internal organs making them susceptible to
diabetes and heart attack. If the waist circumference is more than 90 cm in males and more than 80
cm in females central obesity is present.
Cerebral Angiogram:
See Angiogram
Cerebrovascular Disease:
See Stroke
Charcot Foot:
Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who
have significant neuropathy. The bones are weakened enough to fracture, and with continued
walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the
foot takes on an abnormal shape, such as a rocker-bottom appearance. Diabetes is the most
common cause of this deformity.
CHD (Coronary Heart Disease):
See Ischaemic heart Disease
Cheiroarthropathy:
It is seen in long-standing diabetes caused by prolonged exposure of high blood glucose to the
connective tissue. This results in thickening of skin and tendons causing limited joint mobility and
contracture of hands and feet. The patient with diabetic cheiroarthropathy is unable to press the
palms together to fully flatten the hands also called "prayer sign". Limited joint mobility of feet may
be responsible for developing diabetic foot ulcer.
Cholesterol:
Cholesterol is important as it forms the outer membrane that surrounds every cell, make nerve work
properly and make hormones. Without cholesterol the body will not work. However, too much
cholesterol in the blood increases the risk of ischaemic heart disease and disease of the arteries.
There are many types of cholesterols. LDL cholesterol is harmful as its higher level increases the risk
of heart attack, but like HDL is good and its higher level protects.
Chronic Kidney Disease:
Chronic Kidney Disease (CKD) is the progressive loss in kidney function over a period of months or
years. The symptoms of worsening kidney function are unspecific. Often, chronic kidney disease is
diagnosed as a result of screening of people known to be at risk of kidney problems, such as those
with high blood pressure or diabetes.
Chronic Renal Failure:
See Chronic Kidney Disease
Cinnamon:
Recent research has suggested that cinnamon may improve blood glucose levels and blood fats in
people with Type 2 diabetes.
CKD:
See Chronic Kidney Disease
Congenital Defects:
These are abnormalities which are present at birth. Poor control of diabetes in Pregnancy can lead
to this.
Coronary Angiogram:
See Angiogram.
Coronary angioplasty:
See Angioplasty.
Coronary artery disease:
See Ischaemic heart disease
Coronary bypass:
See Bypass
Coronary Heart Disease:
See Ischaemic heart disease
Clinical Trial:
See Randomised clinical trial
C-peptide:
It is substance found in blood secreted by beta cells of pancreas along with insulin. It can be
measured to assess the amount of insulin secreted.
CRF:
See Chronic Kidney Disease
Creatinine:
It is measured in blood to see how well is kidney functioning. It rises with kidney failure.
Delayed gastric emptying:
See Gastroparesis
Depression in Diabetes:
People with diabetes have a greater risk of depression than people without diabetes. There are no
easy answers about why this happens. The stress of daily diabetes management can build this up.
Similarly complications of diabetes may reduce the quality of life and give rise to depression. On the
other had depression can block good diabetes self-care.
Diabetic Ketoacidosis:
See Ketoacidosis
Diabetes Mellitus:
Diabetes mellitus (DM) is the full scientific name of Diabetes. The content of the whole website is for
the prevention and management of diabetes mellitus.
Diabetes Insipidus:
A rare disease in which people pass lot of urine and is not related to sugar.
Diabetes type 1:
see Type 1 Diabetes
Diabetes type 2:
See Type 2 Diabetes
Diabetes UK:
Diabetes UK (DUK) is the leading UK charity that cares for, connects with and campaigns on behalf of
all people affected by and at risk of diabetes. http://www.diabetes.org.uk/
Diabetologist:
Doctor specialising in the treatment of diabetes.
Diagnosis of diabetes:
Diagnosis of diabetes can be made by one of the 3 ways. Raised fasting blood glucose, abnormal
glucose tolerance test or raised HbA1c. If you suspect that you have diabetes, Diabetacare can help
you with this.
Diet for Diabetes:
It is very important to choose appropriate diet which help manage diabetes by controlling blood
glucose levels. Diet is very important to control cholesterol, blood pressure and body mass index.
Diabetacare can help you with this.
Dialysis:
Dialysis is the treatment that replicates many of the kidney’s functions. It is often used to treat
advanced chronic kidney disease, where the kidneys have lost most or all of their function. It is also
used to support the function of kidney till its recovery if it is damaged all of a sudden (Acute Renal
Failure).
Diabetic coma:
It is the condition when the person with diabetes becomes unconscious due to its complication or
treatment. It can be due to hypoglycaemia or diabetic ketoacidosis or hyperosmolar hyperglycaemic
state.
Diabetic foot ulcers:
Wound in foot of people with diabetes which is closely linked to peripheral neuropathy, peripheral
vascular disease and foot deformity. If not treated properly it may lead to amputation.
Diarrhoea (Diabetic)
Dementia in Diabetes
DKA:
See Ketoacidosis
DM: See Diabetes Mellitus
Driving in Diabetes
Drugs
DUK:
See Diabetes UK
Dupuytren's contracture
EASD: The European Association for the Study of Diabetes (EASD) was founded in Montecatini, Italy
in 1965. The mission of EASD is to promote excellence in diabetes care through research and
education. Professor Andrew Boulton is the president of EASD. http://www.easd.org/easd/
Endocrinologist: Doctors specialising in the treatment of disorder of hormones including diabetes.
Erectile Dysfunction
End-stage renal disease:
End-stage renal disease (ESRD):
Kidney Failure
ESRD:
See End-stage renal disease
European Association of study of Diabetes: See EASD
Exercise
Eyes
Fasting blood glucose: Blood glucose measured first thing in the morning before eating anything.
This test can be used for diagnosis of diabetes if it is above 7 mmol/L on 2 occassions.
Fasting Hyperglycaemia: Blood sugar between 6 – 7 mmol/L in the morning at fasting state. These
people are more likely to develop diabetes in the long run.
Fat
Fatty Liver: Early stages of non-alcoholic fatty liver disese
Fibre (Dietary)
Focal neuropathy: Diabetes can affect single nerve either due to damage to the small vessel of nerve
causing damage to the nerve (mononeuritis) or due to pressure at certain points (Pressure
neuropathy). The most common are third nerve palsy, carpal tunnel syndrome, peroneal nerve
palsy.
Foot drop: See peroneal nerve palsy.
Foot Ulcer:
See Diabetic Foot Ulcer.
Footwear:
Fluorescein angiography
GAD: See Glutamoic Acid Decarboxylase
Gangrene
Gastroparesis: Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops
the movement of food from the stomach to the small intestine. The most common symptoms of
gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting
undigested food—sometimes several hours after a meal. Autonomic neuropathy due to diabetes is
one of the common cause of gastroparesis.
Gestational Diabetes: It is a condition when a woman without previous diabetes develops diabetes
during pregnancy. Babies born to mothers with gestational diabetes have increased risk of being
large and may develop other problems. Women with gestational diabetes are also at increased risk
of complications. It can be diagnosed by doing an oral glucose tolerance test. They can be treated
with diet, metformin and some may also need insulin. These women have higher incidence diabetes
at as later date.
Gliptins
Glitazone: See thiazolidinediones
GLP -1 analogues
Glucagon: Glucagon is a hormone produced in the pancreas that can raise blood sugar up.
Artificially produced glucagon is usually given by injection beneath the skin, in the muscle, or in the
vein to raise very low blood sugar during the treatment of hypoglycaemia.
Glucose Tolerance Test: Glucose tolerance tests help to diagnose type 2 diabetes or impaired
glucose tolerance. It involves comparing the levels of glucose in the blood before and after drinking
a sugary drink containing 75gm of glucose. In normal person following glucose tolerance test glucose
level is below 7.8 mmol/L after 2 hours. If it is above 11.1 mmol/L it confirms diagnosis of diabetes.
Any value between 7.8 and 11.1 mmol/L is impaired glucose tolerance.
Glutamoic Acid Decarboxylase: An enzyme found in body. Antibodies to GAD can be present in
blood of people with Type 1 Diabetes even before it is diagnosed.
Glycated Haemoglobin: See HbA1c
Glycaemic Index: The glycemic index (GI) is a ranking of carbohydrates on a scale from 0 to 100
according to the extent to which they raise blood sugar levels within 3 hours after eating. Sugars and
Indian sweets have GI as high as 100. White rice has GI of 80 but brown rice has only 50. Foods with
high GI are rapidly absorbed resulting in marked rise in blood sugar in diabetes. Low-GI foods such as
whole wheat chapatti, whole grain bread improve both glucose and lipid levels in people with
diabetes.
Glycogen: Glucose is formed in the body by the liver or absorbed from the food we eat. Any glucose
not needed right away gets stored in the muscles and the liver in the form of glycogen. Glycogen is
the source of energy most often used for exercise. It is needed for any short, intense bouts of
exercise from sprinting to weight lifting because it is immediately accessible.
Gourd: Type of climbing plants related to the pumpkin, squash, and cucumber which bear fruits with
a hard rind. Bitter gourd has been used as traditional medicine for diabetes. More recently bottle
gourd (lauki) is gaining popularity in India as Ayurvedic care to control high blood sugar.
Granuloma Annulare: This is a benign inflammatory condition of unknown aetiology with dermal
papules and annular plaques. Histology reveals foci of degenerative collagen with palisaded
granulomatous inflammation. It may be associated with diabetes but association with systemic
disease is rare.
Guardian drugs:
Gustatory Sweating: Sweating on the forehead, face, scalp, and neck occurring soon after eating.
Some gustatory sweating is normal after eating hot, spicy foods. Gustatory sweating is also a rare
complication of diabetes mellitus and sweating may occur on both sides of the head, with mild or
substantial severity.
Haemochromatosis: Hemochromatosis is a single-gene disease that causes iron accumulation in the
tissues of the body. It is fairly common, but often goes undiagnosed and untreated, which can cuase
liver problems. If untreated it may develop diabetes as a complication, which is referred to as
"bronze diabetes". It is treated effectively with frequent bloodletting.
HbA1c:
The red blood cells have haemoglobin to carry oxygen. Glucose n the blood sticks to the
haemoglobin to make a 'glycosylated haemoglobin' molecule, called haemoglobin A1C or HbA1C.
The more glucose in the blood, the more HbA1C will be present. Red cells live for3 months so the
measurement of HbA1C can tell you how high your blood glucose has been on average over the last
3 months. The HbA1C test is currently one of the best ways to check if your diabetes is under
control. This should be below 6.5% if you are controlling by diet or by metformin alone. If you are on
insulin or complex treatment you should aim below 7.5% as you may have hypo below that level.
Discuss the treatment target with your doctor. HbA1c test can also be used for the diagnosis of
diabetes if it is above 6.5% on 2 occasions.
HDL: High-density lipoprotein (HDL), or good cholesterol - this takes cholesterol away from the cells
and back to the liver, where it's either broken down or excreted.
Heart Attack: A heart attack (Myocardial Infarction) occurs when blood flow to a part of your heart
is blocked for a long enough time that part of the heart muscle is damaged or dies. Most heart
attacks are caused by a blood clot that blocks one of the blood vessels supplying blood and oxygen
to the heart. Chest pain is the most common symptom of a heart attack and it is a medical
emergency. Prompt treatment can save life and prevent damage to heart. People with diabetes have
higher risk of suffering from heart attack.
Heart bypass: See bypass
Heart Failure: Heart failure is a condition in which heart cannot pump enough blood to meet body's
demand. The term “heart failure” doesn't mean that the heart has stopped or is about to stop
working. Heart failure is a serious condition that requires medical care. If you have heart failure, you
may tire easily and have to limit your activities. Ischaemic Heart Disease can lead to heart failure by
weakening the heart muscle over time. People with diabetes have higher risk of developing heart
failure.
HHS:
See hyperosmolar hyperglycaemic state
High-density lipoprotein: See HDL
Honeymoon Diabetes: There may be a period shortly after the diagnosis of type 1 diabetes during
which there is some restoration of insulin production by the pancreas. This is only a temporary
situation and as when external insulin is injected, the diseased pancreas may get some rest which
may then stimulate the remaining beta cells to being to produce insulin. These remaining beta cells,
however, will also eventually be destroyed and this temporary "honeymoon" period will revert back
usually within few weeks.
HONK:
See hyperosmolar hyperglycaemic state
Hormone: Chemicals released by a gland that travels through blood stream and works in various
parts of our body. Insulin is a hormone produced in beta cells of pancreas but works in various parts
of the body like liver, muscle, brain, fat cells etc.
Hyperglycaemia: High Blood Sugar
Hyperosmolar Nonketosis:
See hyperosmolar hyperglycaemic state.
Hypertension: High blood pressure.
Hyperlipidaemia
Hyperosmolar Hyperglycaemic State:
Hyperosmolar hyperglycaemic state (HHS or HONK) occurs in people with type 2 diabetes due to
very high blood glucose levels (often over 40 mmol/L). This occurs as a result of a combination of
illness, dehydration and failure to take normal diabetes medication. HHS is a potentially lifethreatening emergency.
Hypertriglyceridaemia
Hypo:
See hypoglycaemia
Hypoglycaemia:
It is a condition of low blood sugar. This occurs in people with diabetes usually if meal is missed or
after exercise. If HbA1c is below 7.5% there is more risk of hypoglycaemia when diabetes is treated
with insulin or sulfonylurea. It produces symptoms of sweating, feeling hungry and palpitation
which if not corrected leads to fits and unconsciousness. Repeated hypoglycaemia may make people
unaware of these warning symptoms and patient may become unconscious.
IDF: See International Diabetes Federation
IHD: See Ischaemic Heart Disease
Impaired Glucose Tolerance: Impaired glucose tolerance is defined as a fasting blood glucose less
than 7.0 mmol/l with a two-hour oral glucose tolerance test value of 7.8 to 11.1 mmol/l. It is
condition of pre-diabetes. There is very high risk of developing diabetes, heart attack and stroke in
this condition.
Impotency (Erectile Dysfunction)
Infection
Insulin: Insulin is a hormone that is produced by beta cells of pancreas. It causes cells in the liver,
muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and
muscle, and stopping use of fat as an energy source. When control of insulin levels fails, diabetes
mellitus will result. Artificially produced insulin is used to treat diabetes mellitus. The insulin used for
treatment may be long acting insulin, short acting insulin or mixed insulin.
Insulin Resistance:
Insulin resistance is a decreased ability of some of the cells of the body to respond to insulin.
Genetics plays a big part in the development of insulin resistance. Other causes are lack of physical
activity, obesity and old age. Insulin resistance is associated with central obesity, high blood
pressure, high triglycerides, and low HDL. These conditions are part of a constellation of problems
called metabolic syndrome (also called insulin resistance syndrome) which is a risk factor for heart
attack and Type 2 diabetes.
Intermittent hyperglycaemia: It is a condition of high blood sugar intermittently due to stress or
other illness. It can be diagnosed by HbA1c between 5.5% and 6.5%. It is a pre-diabetes condition.
International Diabetes Federation: The International Diabetes Federation (IDF) is an umbrella
organization of over 200 national diabetes associations in over 160 countries. It represents the
interests of the growing number of people with diabetes and those at risk. The Federation has been
leading the global diabetes community since 1950. http://www.idf.org/
Ischaemic Heart Disease: Ischaemic Heart Disease is a condition in which fatty deposits builds up in
the linings of the walls of the coronary arteries which causes reduced blood flow to the heart
muscle. This can produce pain in the chest with exertion that is commonly called angina. If the
coronary artery is completely blocked it precipitates heart attack. People with diabetes have higher
risk of developing ischaemic heart disease.
Islet: These are clumps of cells present in pancreas which have specialized cells that produce
hormones.Insulin is produced by betacells in the islet, which is necessary for glucose balace in the
blood.
Islet of Langerhans: See Islet
Islet transplant : See Transplant
Juvenile onset diabetes: See Type 1 diabetes
Ketoacidosis:
This can occur in people with type 1 diabetes who do not have enough insulin. It occurs when the
body cannot use glucose as a fuel source because there is not enough insulin. Fat is used for fuel
instead. Byproducts of fat breakdown, called ketones, build up in the body. In high levels, ketones
are poisonous. This condition is known as ketoacidosis.
Kidney:
There are 2 kidneys which are responsible for cleaning blood from impurities generated within the
body. Every day the kidneys filter the blood, removing waste products collected as part of normal
bodily functions, along with any excess fluid. The waste products and excess fluid become urine.
Diabetes can affect kidney which is called diabetic nephropathy. When it is advanced the kidney
failure occurs and patient may need dialysis or kidney transplant to maintain life.
Lancet: Small pin used to prick finger to collect drop of blood for test.
Laser Treatment
Lauki: See Groud
LDL: Low-density lipoprotein (LDL), often known as bad cholesterol - this carries cholesterol from the
liver to the cells and, if supply exceeds demand, can cause harmful build-up of cholesterol.
Limited joint mobility:
See Cheiroarthropathy
Lipids: Various types of fat are present in the blood. Cholesterol, LDL, HDL and triglycerides are
common that are measured in the blood as lipids.
Long acting insulin: These insulin takes about 1 hour to work but its action lasts for up to 24 hours.
Isophane insulin, levemir and Lantus are examples of long acting insulin.
Low Density Lipoprotein: See LDL
Maturity Onset Diabetes in Young: See MODY
Metabolic Syndrome: See Insulin Resistance
Metformin
Macrosomia (Fetus)
Menstrual Cylcle and diabetes
Menopause and Diabetes
Metabolic Syndrome: See Insulin Resistance
Microalbuminuria: Microalbuminuria is an early stage of diabetic nephropathy (kidney damage)
when it is reversible. It is characterised by leakage of small amount of albumin (30 – 300 mg in 24
hours) which may not be detected by simple urine test. It can also be measured by Albumin
Creatinine ratio (ACR) which if more than 3.5 mg /mmol in females and 2.5 mg/mmol in males is
microalbuminuria.
Microvascular Disease
Mixed Insulin: These are mixture of short acting insulin and long acting insulin.The mixtures can be
of varying proportion. Mixtard 30, Humalog mix 25, Novomix 30, Humulin M3 etc are examples of
mixed insulin.
MODY: Maturity Onset Diabetes in Young (MODY) is a rare form of diabetes which is different from
both Type 1 Diabetes and Type 2 diabetes, and runs strongly in families. MODY is caused by a
mutation (or change) in a single gene. If a parent has this gene mutation, any child they have, has a
50% chance of inheriting it from them. If a child does inherit the mutation, they will generally go on
to develop MODY before they’re 25, whatever their weight, lifestyle, ethnic group etc.
Mononeuritis: See Focal Neuropathy
Myocardial Infarction: See Heart attack
NAFLD: see Non Alcoholic Fatty Liver Disease
Necrobiosis: Necrobiosis lipoidica is a rare skin condition due to inflammation, which is irregularly
shaped with reddish-brown pigmentation and central atrophy. It is usually seen in people with
diabetes but also seen in other condition. It is commonly seen in the leg and is painless, however it
can be seen anywhere and can be painful.
Nephropathy: Kidney damage caused by diabetes presenting with microalbuminuria which
progresses to proteinuria that ultimately leads to chronic kidney disease and kidney failure needing
dialysis or transplant. The main cause for this is high blood sugar, high blood pressure and long
duration of diabetes. ACE inhibitors and Angiotensin Receptor Blockers prevent progression of
nephropathy.
Neuropathic arthropathy: See Charcot foot
Neuropathy: It is the damage of the nerve due to diabetes. The most common is peripheral
neuropathy. Other types are painful neuropathy, autonomic neuropathy, focal neuropathy and
amyotrophy.
New Drugs
Non Alcoholic Fatty Liver Disease: Non-alcoholic fatty liver disease is a range of conditions caused
by a build-up of fat within liver cells. It is very common and is linked to being overweight. Most
people with non-alcoholic fatty liver disease do not cause problems but in some it can lead to
serious liver problems. All people with non-alcoholic fatty liver disease have an increased risk of
developing heart attack and stroke. People with type 2 diabetes have a higher risk of developing
Non-alcoholic fatty liver disease.
Obesity: Obesity is a condition of excess body fat. Obesity can have a severe impact on people’s
health, increasing the risk of type 2 diabetes, some cancers, and heart and liver disease.
Obstructive Sleep Apnoea: Obstructive sleep apnoea is a condition that causes interrupted
breathing during sleep which results in daytime tiredness. Diabetes and obstructive sleep apnea
often coexist. One explanation for this overlap is the presence of shared risk factors such as obesity.
There may also be a more complex relationship between these conditions in which an underlying
disorder predisposes to both. Both diabetes and obstructive sleep apnea are associated with
increased heart attack and stroke, therefore the presence of both conditions may result in additive
health risks.
Oral hypoglycaemics: Tablets used to control blood sugar in type 2 diabetes. These are metformin,
sulfonylurea, acarbose, glitazone and gliptin.
Osteomyelitis: Infection of bone. In diabetes it can be complication of diabetic foot ulcers.
Pancreas: Pancreas is an oblong flattened gland located deep in the abdomen. It is an integral part
of the digestive system and produces various enzymes necessary for digestion of food. In addition it
also produce various hormones like insulin, glucagon etc which plays important part in control of
blood sugar and development of diabetes.
Painful neuropathy: It is a type of neuropathy in which burning and stabbing pain in foot and leg
occurs in people with diabetes. It is worse at night and can be treated with various tablets and
creams.
Pancreatic Diabetes
Pancreatic Cancer: Pancreatic cancer occurs when abnormal cells in the pancreas grow out of
control. It can occur in the head, body or tail of the pancreas. Weight loss, abdominal pain and
jaundice are common presenting feature of this rare cancer. Diabetes can be a presenting feature of
pancreatic cancer in older people.
Pancreatic transplant: See Transplant
PCR: See Protein creatinine ratio
Peripheral Angiogram: See Angiogram
Peripheral angioplasty: See Angioplasty
Peripheral bypass: See bypass
Peripheral neuropathy: It is a common type of neuropathy in which damage to nerve in limbs
causing loss of sensation and loss of muscle power. In diabetes it commonly affects foot and may
lead to diabetic foot ulcer.
Peripheral Vascular Disease: Blockage of blood vessels going to the leg caused by smoking, diabetes
and high cholesterol.
Peroneal nerve palsy: Foot drop due to damage to peroneal nerve causing inability to lift the ankle
up. This is common in diabetes and may be easily missed if not looked for carefully. It is very difficult
to treat this and can be helped with special footwear.
Pioglitazone: Pioglitazone is an oral drug that reduces the amount of glucose in the blood. It is in a
class of anti-diabetic drugs called thiazolidinediones that are used in the treatment of type 2
diabetes. It can make heart failure worse and increase risk of fractures. It also increases the risk of
bladder cancer and has been withdrawn in some countries.
Polycystic ovary and diabetes:
Pre-diabetes: It is a condition when there is high risk of developing diabetes in future. Fasting
hyperglycaemia, intermittent hyperglycaemia, impaired glucose tolerance and gestational
diabetes are pre-diabetes state.
Pre-mixed insulin: See Mixed Insulin.
Pre-pregnancy counselling in diabetes
Pregnancy (in Diabetes): Many women who have diabetes (Type 1 diabetes, Type 2 diabetes and
Gestational diabetes) have healthy pregnancies and healthy babies. But it requires a lot of work and
dedication from patients.
Pressure Neuropathy: See focal neuropathy.
Protein creatinine ratio: A measure of kidney function by testing urine in laboratory. It measures
ratio of protein to creatinine in urine to diagnose proteinuria and monitor kidney damage.
Proteinuria: Leakage of protein in urine which is detected by urine testing. The presence of
proterinuria in diabetes signifies presence of diabetic nephropathy.
Peripheral Vascular Disease: Peripheral vascular disease is narrowing of the arteries, usually those
that supply blood to the legs. It is caused by diabetes, smoking and high cholesterol. The main
symptom is pain in one or both legs when you walk. Treatment usually includes: stopping smoking (if
you smoke), regular exercise, medication to lower your cholesterol level, a daily aspirin and lowering
your blood pressure if it is high. Surgery may be needed in severe cases.
Postural Hypotension: Sudden drop in blood pressure when standing. This is due to Autonomic
neuropathy affecting heart and blood vessel. Diabetes is the common cause for this and patients
feel dizzy when standing up. It can be helped by tablets that increase blood volume.
Randomised clinical trial
Renal Failure: Ki
Research
Retinopathy:
Risk of Developing Diabetes
Rosiglitazone: Rosiglitazone is oral treatment for type 2 diabetes. It is thiazolidinedione group of
drug that work by reducing insulin resistance. It has been withdrawn in many countries because of
increased risk of heart attack. The other side effects are worsening of heart failure and increased
risk of fractures.
Self Glucose Monitoring
Sexual Dysfunction Male (Erectile Dysfunction)
Sexual Dysfunction (Female)
Shoes
Short acting insulin: These insulin work immediately after injection and last for 3 to 6 hours.
Humalog, novorapid, apidra, actrapid are examples of short acting insulins.
Smoking in Diabetes
Statin
Statistics
Steroid induced Diabetes
Steroid treatment in Diabetes
Stroke: Stroke is the rapid loss of brain function due to disturbance in the blood supply to the brain.
Loss of brain function causes loss of speech, paralysis or face deformity. It can be due to blockage of
blood vessel or due to bleeding. Sometimes it can last only few minutes which is called Transient
Ischaemic Attack (mini stroke).
Sulfonylurea
Surgery in Diabetes
Sweating in Diabetes (Gustatory)
Teeth and diabetes
Thiazolidinediones: Thiazolidinediones are oral medications that help lower blood sugar in type 2
diabetes. It helps to lower insulin resistance in cells, improving the way that the body responds to
insulin. They are available as pioglitazone and rosiglitazone.
Third nerve palsy: Closure of one eye due to dropping of eye lid associated with double vision. This
is due to damage to the nerve and is very common in diabetes. This generally gets better with time.
Transfat: Trans fats are made by a chemical process called partial hydrogenation in which liquid
vegetable oil is packed with hydrogen atoms and converted into a solid fat (eg make vanaspati
ghee). This improves the taste and makes it easy to store but it is harmful as it increases bad
cholesterol called LDL and reduces good cholesterol called HDL.
Treatment target: It is the target set by your doctor for various part of your treatment. The usual
treatment target for people with diabetes for home blood glucose is between 4 – 7 mmol/L, HbA1c
is less than 7.5%, blood pressure is below 130/80 mm and for blood cholesterol is below 4 mmol/L.
Thrush: Poor control of diabetes can result in yeast infection of genitalia. There may be intense
itching and whitish discharge.
Transient Ischaemic Attack: In this condition the function of brain is lost generally for few minutes
and returns back to normal in 24 hours. Loss of brain function causes loss of speech, paralysis or face
deformity. This can lead to full blown stroke if proper medical treatment is not given.
Transplant: Organ transplant is the moving of an organ from the donor body to the recipient patient
for the purpose of replacing the function. It is a major surgery and the recipient needs special drugs
to prevent the donor organ being rejected by the body. Often the donors have died recently, but live
donors are used sometimes. In diabetes the most common organ that is transplanted is kidney.
Pancreas is also increasingly being transplanted to make patient independent from the need to
inject insulin. More recently islet transplant, which is beta cell transplant, has been tried in the
place of whole pancreas. The advantage of islet transplant is the avoidance of major surgery during
transplant and can be done under local anaesthesia.
Triglycerides:
Triglycerides are a type of fat in the bloodstream and fat tissue. Too much of this type of fat can
contribute to the hardening and narrowing of your arteries. This puts you at risk of having a heart
attack or stroke. Diseases such as diabetes, obesity, kidney failure or alcoholism can cause high
triglycerides.
Type 1 Diabetes:
Diabetes caused by to reduced insulin production in beta cells of pancreas. It generally starts in
young age and these people are prone to develop ketoacidosis when insulin treatment is missed.
Type 2 Diabetes:
Diabetes caused by relative deficiency of insulin due to insulin resistance. It runs in family and is
generally starts in old age. People with type 2 diabetes are overweight and often have high blood
pressure. This can be treated with diet, exercise and oral hypoglycaemics initially but may need
insulin later on.
Type 2 Diabetes in children: The vast majority of children with diabetes have Type 1 diabetes, but
an increasing number are now developing Type 2 diabetes. Children most at risk of Type 2 diabetes
are those who are overweight and between 10-20 years old with close family member with Type 2
diabetes.
Ulcer (Diabetic foot)
Urea
Urinary Incontinence: When there is autonomic neuropathy affecting bladder some people may
lose control of their urinary bladder and pass urine automatically.
Urinary Retention: When there is autonomic neuropathy affecting bladder some people may lose
control of their urinary bladder and cannot pass urine automatically. They need to pass a tube
regularly to empty bladder.
Weight loss and diabetes
WHO :
See World Health Organisation
World Diabetes Day: 14th November (the birthday of Banting, one of the discoverers of insulin) is
celebrated as world diabetes day. World Diabetes Day was jointly introduced by the World Health
Organisation and the International Diabetes Federation to increase global awareness campaign of
diabetes.
World Health Organisation: It is the directing and coordinating authority for health within the
United Nations system. It is responsible for providing leadership on global health matters. It’s
constitution came into force on 7 April 1948 – a date now celebrated every year as World Health
Day.
X-Ray in diabetes:
There is no additional risk of undertaking x-ray examinations if you have diabetes. However, if you
need injection of dye for special x-ray (eg Angiogram or Angioplasty) you should stop taking
metformin as it can cause kidney problem.
Yoga and diabetes:
Some reports suggest that because yoga can decrease stress, it may be helpful in controlling glucose
levels in people with either type 1 or type 2 diabetes. As people who practice yoga has self discipline
it helps in adherence to diet and exercise which is essential to treat diabetes. However If you are
taking medicines for diabetes you should not replace it with yoga without consulting your doctor.