Common terms used in diabetes. The terms below are not the only terms that are used, but are the most commonly used ones. If you have any term / condition that you would like more information on please click here to e-mail us and we will respond within 2 working days: firstname.lastname@example.org
A1c: (Commonly known as HbA1c). This is a measure of the level of glucose circulating in your blood over the past 2-3 months. Haemoglobin is the part of red blood cells that carries oxygen to the cells and this sometimes “joins” to the glucose molecules. This test represents the amount of glucose that “sticks” to the red blood cells, and because red blood cells last up to 120 days, the test gives you an average of the level of glucose in your blood over this time (2-3months).
The HIGHER the blood glucose levels, the more the glucose will stick to the cells and the result will thus be higher. The result is given as a % and is different to a finger prick value which is given in mmol/l.
The IDEAL range for your HbA1c should be <7% unless your doctor has advised otherwise, and you should have the test done at least 2-4 times per year.
Acanthosis nigricans: a thickening or darkening of the skin in patches in the skin folds of the armpits, neck or groin. The colour ranges from tan to a dark brown, and is usually a sign of insulin resistance.
These are sweeteners that are not found naturally – they are produced commercially and they are kilojoule / calorie free. The following artificial sweeteners are generally regarded as being safe to use:
Saccharin (e.g. Sweetex, Hermesetas) can be used in hot and cold foods / drinks. Avoid if you are pregnant or breastfeeding.
Aspartame (e.g. Pick n’ Pay, Canderel, Equal, EquiSweet) can be used in cold and warm foods but may lose some sweetness at high temperatures.
Acesulfame K (e.g. Canderel) can be used in both cold and hot foods including in baking and cooking.
Sucralose (e.g. Splenda) can be used in hot and cold foods, including baking and cooking. Often used in processed foods.
The FDA (Food and Drug Administration – USA), has published an Acceptable Daily Intake (ADI) of sweeteners: The amount is calculated per kg bodyweight e.g. 5mg/kg/day if you weight 80 kg = 40mg /day. To ensure that you are not exceeding your daily limit become a LABEL READER.
Saccharin: 5mg / kg / day Aspartame: 50mg / kg / day Acesulfame-K: 15mg / kg/ day Sucralose: 5mg / kg / day.
Auto-immune: this is a disorder of the body’s immune system that mistakes certain cells in the body as being “foreign” to the body, and thus the immune system destroys these cells. Type 1 diabetes is an auto-immune condition where the body has destroyed the insulin producing cells in the pancreas, thereby making the person with Type 1 diabetes dependant on insulin injections.
Basal Insulin: this is insulin that is injected once or twice a day and provides your body with BACKGROUND insulin over 24 hours. Basal insulin controls your blood sugar levels between meals as well as overnight. Basal insulin helps to control your FASTING BLOOD GLUCOSE levels (your blood sugar first thing in the morning before you have eaten). Examples of basal insulin are: Biosulin® N, Humulin® N, Protaphane®, Lantus®, Levemir®.
Bolus Insulin: this is the insulin that is release by the pancreas in response to a meal / food intake. If you are injecting insulin, bolus insulin is injected immediately before the meal (Apidra®; Humalog® and NovoRapid®) or 30 minutes before the meal (Biosulin® R).
Beta-Cells: These are the cells that produce (manufacture) insulin in your body. These cells are found in the pancreas, which is an organ that lies just behind the stomach. The amount of insulin release from the beta-cells is dependent on your blood sugar levels. In diabetes, these cells have either been destroyed (Type 1 Diabetes) or overtime slowly lose their ability to manufacture insulin (Type 2 Diabetes).
Blood Glucose: When we eat food that contains carbohydrates (fruit, vegetables, milk and milk products, pasta, bread, sweets, cakes, biscuits) the carbohydrates in the food are converted into glucose (a very simple form of sugar). The glucose from the food that we have eaten is passed out of the intestines into the blood so that it can be delivered to the body to be used as energy. The amount of glucose circulating in your blood at any one time is known as a BLOOD GLUCOSE level, and is tested by doing a simple finger prick, placing the blood onto a blood glucose strip which is then inserted into a blood glucose meter. Click here to see what your blood sugar levels should be if you are living with diabetes.
Blood glucose monitor: a tiny hand-held machine that helps you to measure your blood sugar levels. After pricking your finger with a special finger pricker, you place a small drop of blood onto a glucose strip and place it in the meter. Within 5 seconds the meter will read the amount of sugar (glucose) in your blood and will display this on the screen of the meter. E.g. 7.6 mmol/l
Body Mass Index (BMI): This is the unit of measurement that determines if you are of normal weight, overweight or obese. The measurement takes into account both your HEIGHT and your WEIGHT and is calculated as your weight divided by your height squared (kg/m2).
E.g. If you weigh 80kg and your height is 1.72m BMI= 80 divided by (1.72 x 1.72). Your BMI will be 27.04 i.e. you are OVERWEIGHT. Click here to calculate your BMI
Calories (Kilojoules): This is the unit of measurement to tell you how much “energy” the food you are eating will provide your body to do your daily activities or exercise that you embark on. 1 Calorie = 4.2 Kilojoules. Some dieticians will ask you to manage the amount of Calories (Kilojoules) you eat every day, as this will assist you to manage your weight. Most foods that you can buy will have the ENERGY CONTENT printed on the label. Carbohydrates and protein contain 4 Calories (16.8 Kilojoules) per gram, Alcohol contains 7 Calories (29.4 Kilojoules) per gram, and fat contains 9 Calories (37.8 Kilojoules) per gram. We “burn” or use up calories every day, and the best way to manage your weight is to make sure that your “calories in” either equal or are less than your “calories out” (i.e. what you burn up). If your “calories in” are greater than your “calories out”, you will gain weight, and likewise if your “calories out” are greater than your “calories in” you will lose weight.
Carbohydrate(s): Carbohydrates are the main source of energy for the body. The following foods are classified as carbohydrates: sugar, honey, fruit, pasta, rice, potatoes, bread, vegetables, milk and milk products, sweets, chocolates, jams, biscuits, crisps, cakes, sweetened cold drinks and fruit juices. All carbohydrates will be converted into glucose (sugar) when digested (broken down) by the body. In people living with diabetes, too many carbohydrates can raise the blood sugar (glucose) levels higher than normal, and therefor the amount of these foods that are eaten at each meal should limited.
Carbohydrate counting: Many people living with diabetes use carbohydrate counting as a method to manage the amount of carbohydrates they are eating at each meal. Counting carbohydrates literally means that you count the amount of “sugar” you will be eating at each meal, thus limiting an overload of “sugar” (carbohydrates) at any one meal, and helping to manage your blood sugar (glucose) levels. Carbohydrate counting is normally ‘taught” to you by a dietician who has been trained in carbohydrate counting.
Cholesterol: A type of fat produced by the liver, as well as being found in some of the food that we eat like: eggs, milk, cheese, liver, meat, poultry (chicken, turkey, and duck) and some shell fish. Cholesterol is used by the body to make hormones and build cell walls, but too much cholesterol in the blood can cause damage to the blood vessels and heart which can cause heart attacks and strokes. For more information on diabetes and high cholesterol please click here
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Dawn phenomenon: An early morning rise in blood sugar (glucose) levels – normally around 4am – 8am. The dawn phenomenon is a natural reaction in the body as a result of hormones release by the body in the early morning. If you have diabetes, and your morning(fasting) blood sugar levels are higher than they should be (great then 7mmol/l), then your doctor may need to adapt your medication to prevent these blood sugar rises in the morning.
Diabetic Ketoacidosis (DKA): This is a serious condition that occurs when there is a lack of insulin in the body, leading to high blood sugar (glucose) levels, and a build-up of ketones in the blood and urine. Ketones are formed when the body breaks down fat for energy. Symptoms of DKA are: nausea, stomach ache, vomiting, chest pain, difficulty in breathing – rapid and shallow breathing, a fruity smell on the breath, difficulty to concentrate and staying awake and can lead to a coma and death if not treated immediately. For more information on DKA, please click here.
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Fasting blood glucose: This is a blood glucose test done after an overnight fast i.e. nothing to eat or drink from 10pm the night before. Normal (non-diabetic) fasting blood sugar levels are less than 5.6mmol/l
Gestational diabetes: diabetes that develops during pregnancy. This type of diabetes normally only lasts whilst being pregnant but does put the woman at greater risk of developing type 2 diabetes. For more information on gestational diabetes click here.
Glucose: the simplest form of sugar that is created when the body digests the carbohydrates that we eat. Glucose is the body’s main source of energy. Sugar, as we know it, is made up of 2 glucose molecules.
Glucose Tolerance Test (Oral Glucose Tolerance Test - OGTT): This is a blood test that is done to test whether you may / may not have diabetes. This is normally done at the blood laboratory. You are required to drink 250ml of liquid containing pure glucose, and after 2 hours your blood sugar (glucose) level is tested. If your blood sugar (glucose) level is greater than 11.1mmol/l you have diabetes. If your blood sugar (glucose) level is between 7.8 and 11.0mmol/l then you have “Impaired Glucose Tolerance” also known as pre-diabetes.
Glycaemic Index (GI): This is a system of “ranking” foods according to how quickly and by how much they raise your blood sugar (glucose) levels. HIGH GI foods raise blood sugar levels relatively quickly and relatively high, while LOW GI foods will raise the blood sugar levels slower and over a longer period of time thus keeping the blood sugar levels lower and more constant. For more information on the Glycaemic Index click here
Glycogen: the way in which the body stores glucose for later use, for example when your blood sugar levels drop or when you are exercising. Glycogen is stored in the liver and the muscles.
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Hyperglycaemia: “hyper” means high; gly = glucose; aemia = blood: therefore hyperglycaemia means HIGH BLOOD GLUCOSE levels. Normally symptoms of hyperglycaemia will only appear if the blood glucose (sugar) level is greater than 11.0mmol/l.
The causes of hyperglycaemia are:
- Not using enough insulin or oral diabetes medication
- Not injecting insulin properly or missing an insulin injection
- Not following your diabetes eating plan
- Being inactive
- Having an illness or infection
- Using certain medications, such as steroids
- Being injured or having surgery
- Experiencing emotional stress, such as family conflict or workplace challenges
The symptoms of hyperglycaemia are:
- Frequent urination (needing to go to the toilet more often than normal)
- Increased thirst
- Blurred vision
- Fatigue (unusual tiredness)
If hyperglycaemia is left untreated it can be serious and can result in Diabetic Keto-acidosis (DKA) or Hyperosmolar State. For more information on hyperglycaemia click here
Hypoglycaemia: “hypo” means low; gly = glucose; aemia = blood: therefore hypoglycaemia means LOW BLOOD GLUCOSE levels. Symptoms will normally appear when blood glucose (sugar) levels are less than 4.0mmol/l. The brain needs glucose (sugar) to function, so if your blood glucose level drops too much then this will affect your ability to function normally. If left untreated it can lead to a coma. Click here for information on how to treat hypoglycaemia.
The causes of hypoglycaemia are:
- Taking too much medication especially too much insulin
- Not eating / missing a meal
- Unplanned exercise
The early warning signs and symptoms of hypoglycaemia are:
- Feeling shaky
- Pounding heart; racing pulse
- Feeling hungry
- Pale skin
Hypertension: HIGH blood pressure: i.e. the pressure of the blood flowing through your blood vessels is HIGH. This can lead to heart attacks, strokes and kidney damage. For more information on hypertension click here
Impaired fasting glucose (IFG): This is a fasting blood glucose level (first thing in the morning after no food for at least 8 hours) that is above normal. A normal fasting blood glucose is less than 5.6mmol/l: If you have a fasting blood glucose between 5.6mmol/l and 6.9mmol/l then you have impaired glucose tolerance. This is also known as “pre-diabetes”.
Impaired glucose tolerance (IGT): This is when the blood glucose levels following a meal (glucose load) are higher than normal. Normal blood glucose levels 2 hours after a meal (glucose load) should be less than 7.8mmol/l. If your blood glucose level is between 7.8mmol/l and 11.0mmol/l, then you have impaired glucose tolerance. This is also known as “pre-diabetes”.
Insulin: insulin is a hormone that is produced by special cells in the body called beta-cells. (Beta-cells are found in the pancreas). Insulin is the hormone that controls the amount of sugar (glucose) in your blood. Insulin does this by helping to move sugar (glucose) out of the blood and into the body’s cells so that it can be used for energy. To see how insulin helps sugar (glucose) get into the body’s cells click here.
Insulin resistance: this is a condition where the body’s cells are resistant to insulin i.e. the body’s cells cannot use the insulin properly to help get the glucose into the cells. Insulin resistance is normally associated with being overweight or obese, and thus weight loss is one of the most important treatments for insulin resistance. There are tablets that are available that your doctor can prescribe for you to help the body’s cells to use the insulin properly. These tablets are called sensitizers and the most commonly used tablets are called metformin.
Lifestyle modification: for conditions like diabetes, high blood pressure and high cholesterol, lifestyle modifications are the most important aspect of treatment. Lifestyle modification involves healthy eating and exercise.
There is no such thing as a “diabetic diet” it is just following basic principles of eating the right foods (no junk food), watching your food portions (the amount of food you eat at each meal) and limiting your intake of alcohol.
Exercise does not necessarily mean that you have to join the local gym or run 10kms per day, it merely means “getting active” i.e. doing at least 30 minutes of activity at least 5 days per week.
For some very basic exercises that you can do at home, there are 5 different videos that you can watch. Click here.
Metabolism: this is the process whereby the body uses the food that we eat to be converted into energy, and to build and restore the body’s cells.
Microalbuminuria: this is the presence of small amounts of protein in the urine. This is tested by dipping a special test strip into a urine sample, and is normally done by your doctor. If you have any protein in your urine it is an early warning sign of damage to the kidneys.
Nephropathy: this is the term used for damage to the kidneys. Nephropathy can occur in people with diabetes and or high blood pressure. By controlling your diabetes and or blood pressure you can avoid damage to the kidneys.
The kidneys are an important organ in the body as they filter the blood and help the body to get rid of waste products from the blood. The kidneys also balance the amount of fluid in the body, the waste products and excess fluid is then passed out of the body as urine.
Neuropathy:this is damage to the nerves. In diabetes uncontrolled blood sugar levels can cause damage to the nerves, this can cause a lot of pain as well as affecting your daily functioning. There are 2 types of nerve damage that can occur – damage to the nerves that help us feel (sensory nerves) and damage to the nerves that control the automatic things that our body does (autonomic nerves).
Damage to the sensory nerves is seen in the legs and hands (peripheral neuropathy). This can affect the feelings in your feet and hands and initially can cause shooting pains and burning. Peripheral neuropathy increase the risk amputations
Damage to the autonomic nerves affects the functioning of the stomach and bladder causing uncontrolled diarrhoea and / or constipation and the inability to control your bladder.
Controlling your blood glucose levels can prevent damage to the nerves, thus avoiding these complications.
Nocturnal hypoglycaemia: this is hypoglycaemia that occurs over night while you are sleeping, in other words your blood sugar level drops below 4.0mmol/l while you are sleeping. For more information on hypoglycaemia click here.
Oral glucose lowering agents (oral anti-diabetic medications): These are the tablets that are used to treat diabetes. There are different types of tablets available that are used to treat different aspects of diabetes. The 2 main types of tablets that are used are:
SENSITIZERS: (metformin) these are used to treat insulin resistance
SECRETAGOGUES: (Sulphonylureas are the most commonly used tablets) these are used to stimulate (kick start) the pancreas (beta-cells) to make more insulin
Often your doctor will prescribe these 2 types of tablets together.
Pancreas: The organ in the body that contains the beta-cells which are the cells that make insulin. The pancreas also has cells called alpha-cells which make the hormone glucagon, which is the hormone that your body will release when your blood sugar levels go too low (hypoglycaemia). The pancreas also contains other cells that help with digestion.
Premix insulin: this is an insulin that you can inject that contains a short acting (bolus) insulin and a longer acting (basal) insulin in one injection. Premix insulin can be injected once, twice or three times per day depending on what your requirements are. Premix insulin is normally injected immediately before the meal (Humalog® Mix25; Humalog® Mix50; NovoMix® 30), or 30 minutes before the meal (Actraphane®; Biosulin® 30/70; Humulin® 30/70; Insuman® Combo 30/70)
Retina: this is the thin light sensitive lining in the back of the eye which acts like the film in a camera that helps us to see images.
Retinopathy: this is damage to the retina. The damage is cause by damage to the blood vessels in the retina due to uncontrolled and high blood sugar (Glucose) levels.
Controlling your blood sugar (glucose) levels can prevent damage to the retina.
- Background / non-proliferative retinopathy: this is the initial stage of retinopathy. High blood sugar levels cause damage to the blood vessels and cause them to leak fluid which causes the retina to swell. This can result in blurred vision.
- Proliferative retinopathy: this is more serious damage to the retina which results in reduced vision and even blindness.
If you are experiencing blurred vision or have noticed that your vision is getting worse, speak to your doctor to refer you to an ophthalmologist – which is a special eye doctor that can look into your eye and see if there is any damage to the retina.
Rebound hyperglycaemia: (Somogyi phenomena): this is a high blood sugar that can occur in response to hypoglycaemia (low blood sugar (glucose) levels). When you have low blood sugar (glucose) levels, your body will respond by getting the liver to make glucose to raise your blood sugar (glucose) levels, but sometimes the liver makes too much glucose and causes your blood sugar (glucose) levels to go too high.