Terms Associated with Diabetes
A1c - Hemoglobin A1c: a standard diagnostic blood test used to indicate one’s average blood glucose level over the past three(ish) months
**Antibodies - Autoantibodies:
An antibody, also known as an immunoglobulin, is a large, Y-shaped protein produced mainly by plasma cells that is used by the immune system to neutralize pathogens such as bacteria and viruses. An autoantibody is an antibody (a type of protein) produced by the immune system that is directed against one or more of the individual’s own proteins. The first antibodies described in association with the development of T1DM were islet cell autoantibodies (ICA). Subsequently, antibodies to insulin (IAA), glutamic acid decarboxylase (GAA or GAD) and protein tyrosine phosphatase (IA2 or ICA512) have all been defined. The number of antibodies, rather than the individual antibody, is thought to be most predictive of progression to overt diabetes.
Basal: background insulin used to counteract the body’s own tendency to increase blood glucose outside of eating. Basal can be a long acting insulin injection such as lantus, levemir, tresiba, or NPH. It may also be a slow trickle of rapid acting insulin continuously administered by an insulin pump.
Beta Cells: The primary function of a beta cell is to store and release insulin. Insulin is a hormone that brings about effects which reduce blood glucose concentration. Beta cells can respond quickly to spikes in blood glucose concentrations by secreting some of their stored insulin while simultaneously producing more.
Blood Sugar: A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Glucose comes from carbohydrate foods. It is the main source of energy used by the body. Insulin is a hormone that helps your body’s cells use the glucose. Insulin is produced in the pancreas and released into the blood when the amount of glucose in the blood rises. Normally, your blood glucose levels increase slightly after you eat. This increase causes your pancreas to release insulin so that your blood glucose levels do not get too high. Blood glucose levels that remain high over time can damage your eyes, kidneys, nerves, and blood vessels.
Bolus: rapid acting insulin delivered by injection or by pump, or by inhalation in a dose designed to counteract blood sugar rises from food consumed, or to correct high blood sugars outside of eating. Bolus insulins include Humalog, Novolog, Apidra, Afrezza, and Regular.
Bolus on board: how many units of insulin are still lowering the glucose from recent boluses. Otherwise known as insulin on board (IOB) or active insulin
Continuous Glucose Monitor (CGM): A device worn on the boy designed to measure glucose levels in real-time throughout the day and night. A tiny electrode called a glucose sensor is inserted under the skin to measure glucose levels in tissue fluid (interstitial fluid, rather than blood). It is connected to a transmitter that sends the information via wireless radio frequency to a monitoring and display device.
Diabetic ketoacidosis (DKA): Diabetic ketoacidosis is an acute, sometimes life-threatening, complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can’t produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.
Duration of Active Insulin (DIA): the calculation that tells you how much insulin is still active in your body from previous bolus doses.
Glycemic Index (GI): a number associated with a particular type of food that indicates the food’s effect on a person’s blood glucose (also called blood sugar) level. A value of 100 represents the standard, an equivalent amount of pure glucose. The GI represents the rise in a person’s blood sugar level two hours after consumption of the food.
Insulin: a hormone made by the pancreas that allows your body to use sugar (glucose) from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps keeps your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia).
Insulin/Carbohydrate ratio (IC or ICR): the amount of grams of carbohydrate an individual considers to be dosed for by 1 unit of bolus insulin. For example, a 1:10 IC ratio would mean the user would use 1 unit of bolus insulin to counteract 10 grams of carbohydrates eaten.
Insulin on Board (IOB): number of insulin units still actively lowering glucose
Insulin Sensitivity Factor (ISF): the amount an insulin-user considers one unit of bolus insulin to lower their blood sugar without eating. For example-- a person with an ISF of 50 would take 1 unit of bolus insulin to lower a blood sugar of 150 to 100 without eating.
Latent Autoimmune Diabetes in Adults (LADA): Autoimmune diabetes diagnosed in an adult. Progression may vary from being fully insulin dependent right away to a gradual dependence, following a “honeymoon period.”
Looping: A closed-loop artificial pancreas system is a device, or series of devices, that can work in concert with one another to automatically give the correct amount of insulin in response to food intake and rising blood glucose.
MODY: Mature Onset Diabetes of the Young - this is a specific class of inherited diabetes caused by one specific gene. At least six distinct types of MODY have been isolated. MODY can be managed with oral medications; others need insulin; others need both.
Multiple Daily Injections (MDI): indicates the vehicle for insulin delivery injections, as opposed to receiving insulin through a pump
Pancreas: The pancreas is about 6 inches long and sits across the back of the abdomen, behind the stomach. The head of the pancreas is on the right side of the abdomen and is connected to the duodenum (the first section of the small intestine) through a small tube called the pancreatic duct. The narrow end of the pancreas, called the tail, extends to the left side of the body. With Diabetes, type 1 the body’s immune system attacks and destroys the pancreas’ insulin-producing cells. Lifelong insulin is required to control blood sugar. With Type 2 Diabetes, the pancreas loses the ability to appropriately produce and release insulin. The body also becomes resistant to insulin, and blood sugar rises.
Pen: an injectable insulin pen which is used for injecting insulin, taking the place of a syringe.
Rage Bolus: The product of acute frustration with persistent elevation of blood glucose, the rage bolus is often delivered emotionally without calculating possible effects of stacking insulin. It can yield dangerous hypoglycemic episodes if not monitored closely.
Slope: referring to the direction of blood glucose and how quickly it is moving up or down
Standard Deviation: In diabetes, a low standard deviation indicates that blood sugar tends to be very close to the ideal mid-range most of the time. A high standard deviation, on the other hand, shows that a patient has a wide swing of blood sugar values, regardless of their A1c result.
Sugar surfing: Also known as Dynamic Diabetes Management. It’s the result of ‘glances’ of the BG trend (done by the Surfer and which vary in their frequency) combined by choices made to ‘act’ or ‘not act’. The power of omission is not to be underestimated. Sugar Surfing is diabetes management in the moment. It transcends static insulin dosing formulas which don’t take your BG trending pattern into consideration. This term was developed by Stephen Ponder.
Time in Range: The percentage of one’s day spent within specific, preset range of blood glucose. Devices, such as a CGM, can easily calculate one’s time in range.
Some of the resources consulted:
- ncbi.nlm.nih.gov: Autoantibodies in type 1 diabetes, Taplin & Barker Feb 2008
- Diabetic ketoacidosis at the Mayo Clinic
- Endocrine Web: the insulin entry
- WebMD: Pancreas Anatomy
- Healthline: The Mixed-Up Role of Standard Deviation in Diabetes Care
- Dynamic Management for Type 1 Diabetes, Stephen Ponder & Kevin McMahon
- Diabetes Self-Management: Diabetes and the Artificial Pancreas: Closed-Loop Systems
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