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 life-threatening 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.