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A skin disease characterized by grey-black warty patches usually situated in the armpit or groin or on elbows or knees and sometimes associated with cancer in the abdomen.
Albumin is the protein of the highest concentration in plasma, and transports many small molecules in the blood. Because albumin is synthesized by the liver, decreased serum albumin may result from liver disease. It can
also result from kidney disease, which allows albumin to escape into the urine.
The presence of albumin in the urine that is usually a symptom of kidney disease but sometimes a response to other diseases or physiological disturbances of benign nature. See microalbuminuria.
Hardening and thickening of the walls of the arteries as a result of deposits of atheroma (fatty material) on their inner lining. This buildup of atheroma may slow down or stop blood flow.
Beta cells are found in the islets of Langerhans in the pancreas. They produce and release insulin.
body mass index (BMI)
A key index for assessing body weight in relation to height. Body mass index (BMI) is calculated by dividing weight in kilograms (kg) by the square of height in metres (m). A person is considered obese when BMI is 30 and above.
C-peptide is a sub-unit of the hormone insulin. The C-peptide level may be measured in a person with type 2 diabetes to see if any insulin is still being produced by the body. It may also be measured in the evaluation of hypoglycemia (low blood sugar) to see if too much insulin is being produced by the person.
cardiovascular disease (CVD)
Cardiovascular diseases are defined as diseases and injuries of the circulatory system: the heart, the blood vessels of the heart and the system of blood vessels throughout the body and to (and in) the brain. Stroke is the result of a blood flow problem within, or leading to, the brain and is considered a form of CVD.
coronary heart disease (CHD)
Any disease of the heart caused by coronary artery disease, although it usually refers to heart attack and angina.
diabetes mellitus (DM)
Diabetes mellitus is a chronic condition that arises when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin produced. This causes hyperglycaemia (an abnormally high concentration of glucose in the blood), which seriously damages many of the body’s systems, especially the blood vessels and nerves. There are two basic forms of diabetes: type 1 (requiring insulin for survival) and type 2 (requiring insulin for metabolic control). People with type 1 diabetes do not produce enough insulin. People with type 2 diabetes produce insulin but cannot use it effectively.
Diabetic complications are chronic conditions caused by diabetes. They include retinopathy (eye disease), nephropathy (kidney disease), neuropathy (nerve disease), cardiovascular disease (disease of the circulatory system), foot ulceration and amputation. These complications can be prevented by timely treatment. Public and professional awareness of the risk factors for, and symptoms of, diabetes are an important step towards the control and prevention of complications.
diabetic ketoacidosis (DKA)
Also called diabetic coma. It indicates very high blood sugar level which requires emergency treatment. Ketoacidocis occurs because of lack of insulin. Without insulin, the body uses stored fat instead of glucose for energy, and acidic waste products called ketones are produced, which build up in the blood, causing ketoacidosis. Its symptoms include nausea and vomiting, which can lead to loss of water, stomach pain, and deep and rapid breathing. Other signs are a flushed face, dry skin and mouth, fruity breath odour, rapid and weak pulse, and low blood pressure. If the person is not given fluids and insulin right away, ketoacidosis can lead to coma and even death.
Disability Adjusted Life Year (DALY)
The Disability Adjusted Life Year or DALY is a health gap measure that extends the concept of potential years of life lost due to premature death to include equivalent years of ‘healthy’ life lost by virtue of being in states of poor health or disability. The DALY combines in one measure the time lived with disability and the time lost due to premature mortality. One DALY can be thought of as one lost year of ‘healthy’ life and the burden of disease as a measurement of the gap between current health status and an ideal situation where everyone lives into old age free of disease and disability.
It indicates abnormalities of the lipid metabolism and is often associated with insulin resistance in type 2 diabetes.
The branch of medicine which deals with the incidence, distribution and possible control of disease and other health-related factors.
A foot ulcer is a break in the skin or a deep sore that can occur in people with diabetes because of nerve and/or vessel damage to the foot. Foot ulceration and amputation are among the most costly diabetic complications. Diabetes is the most common cause of amputation that is not the result of accident.
gestational diabetes mellitus (GDM)
A carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy. Gestational diabetes develops during some cases of pregnancy, but usually disappears when pregnancy is over. However, women who have had gestational diabetes are at greater risk of developing type 2 diabetes at a later stage in their lives.
Also called dextrose. The main sugar the body produces from proteins, fats and carbohydrates. Glucose is the major source of energy for living cells and is carried to each cell through the bloodstream. However, the cells cannot use glucose without the help of insulin.
glycosylated haemoglobin (HbA1c)
Haemoglobin to which glucose is bound. Glycosylated haemoglobin is tested to monitor the long-term control of diabetes mellitus. The level of glycosylated haemoglobin is increased in the red blood cells of persons with poorly controlled diabetes mellitus. Since the glucose stays attached to haemoglobin for the life of the red blood cell (normally about 120 days), the level of glycosylated haemoglobin reflects the average blood glucose level over the past three months. Glycosylated haemoglobin is also known as glycohaemoglobin or as haemoglobin A1C (the main fraction of glycosylated haemoglobin).
See glycosylated haemoglobin
A raised level of glucose in the blood; a sign that diabetes is out of control. Many things can cause hyperglycaemia. It occurs when the body does not have enough insulin or cannot use the insulin it does have to turn glucose into energy. Signs of hyperglycaemia are great thirst, dry mouth and need to urinate often. For people with type 1 diabetes, hyperglycaemia may lead to diabetic ketoacidosis.
Very high blood pressure; this can cause health problems such as heart attacks and strokes.
Too low a level of glucose in the blood. This occurs when a person with diabetes has injected too much insulin, eaten too little food, or has exercised without extra food. A person with hypoglycaemia may feel nervous, shaky, weak, or sweaty, and have a headache, blurred vision and hunger. Taking small amounts of sugar, sweet juice, or food with sugar will usually help the person feel better within 10-15 minutes.
impaired fasting glucose (IFG)
Raised fasting levels of glucose.
impaired glucose tolerance (IGT)
Blood glucose levels that are higher than normal, but below the level of a person with diabetes. Individuals with IGT are at high risk of progressing to type 2 diabetes, although such progression is not inevitable, and approximately 30% of individuals with IGT will return to normal glucose tolerance. In addition to carrying a risk of future diabetes, IGT is also a risk factor for future cardiovascular disease.
It indicates how often a disease occurs. More precisely, it corresponds to the number of new cases of a disease among a certain group of people for a certain period of time.
A hormone whose main action is to enable body cells to absorb glucose from the blood and use it for energy. Insulin is produced by the beta cells of the islets of Langerhans in the pancreas.
insulin resistance (IR)
A state in which a given level of insulin produces a less than expected biological effect.
ischaemic heart disease
The term ‘ischaemic’ means that an organ, in this case the heart muscle, has not received enough blood and oxygen. People with this condition have weakened heart pumps, either due to previous heart attacks or due to current blockages of the coronary arteries.
islets of Langerhans
Named after Paul Langerhans, the German scientist who discovered them in 1869, these clusters of cells are located in the pancreas. They produce and secrete hormones that help the body break down and use food. There are five types of cells in an islet: alpha cells, which produce glucagon; beta cells, which produce insulin; delta cells, which produce somatostaton; and PP cells and D1 cells, about which little is known.
Chemicals that the body produces when there is not enough insulin in the blood and it must break down fat for its energy. Without insulin, ketones build up in the blood and then pass into urine so that the body can dispose of them. See diabetic ketoacidosis.
The presence of excess ketone bodies in the urine in conditions, such as diabetes mellitus, involving reduced or disturbed carbohydrate metabolism.
A condition of having ketones build up in body tissues and fluids. The signs of ketosis are nausea, vomiting and stomach pain. Ketosis can lead to ketoacidosis.
The part of the retina in the eye used for reading and seeing fine detail.
Swelling of the macula
Disease of the large blood vessels that may occur in people who have had diabetes for a long time. Fat and blood clots build up in the large blood vessels and stick to the vessel walls. The three kinds of macrovascular disease are: coronary heart disease, cerebrovascular disease and peripheral vascular disease.
Metformin is used alone or with other medications, including insulin, to treat type 2 diabetes. Metformin helps to control the amount of glucose in the blood. It decreases the amount of glucose absorbed from food and the amount of glucose made by the liver. Metformin also increases the body’s response to insulin. Metformin is not used to treat type 1 diabetes.
Albuminuria characterized by a relatively low rate of urinary excretion of albumin typically between 30 and 300 milligrams per 24-hour period. Albuminuria is a typical finding of disorders such as diabetic nephropathy.
Disease of the smallest blood vessels that may occur in people who have had diabetes for a long time. The walls of the vessels become abnormally thick but weak. Therefore, they bleed, leak protein and slow the flow of blood through the body.
Diabetic nephropathy (kidney damage) results in large amounts of urine protein and hypertension, and progressively leads to kidney failure. Diabetes is also the leading cause of nephropathy. Nephropathy can be detected by testing for traces of protein in the urine.
Diabetic neuropathy refers to damage to the nerve fibres caused by diabetes. It is the most common diabetic complication of a microvascular nature. Hyperglycaemia is a significant risk factor which can cause diabetic neuropathy. Diabetic neuropathy is a major cause of impotence in men with diabetes.
The National Health and Nutrition Examination Survey (NHANES) is a survey conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. This survey has been designed to collect
information about the health and diet of people in the USA.
oral hypoglycaemic agent (OHA)
Drugs that lower the level of glucose in the blood. They work for some people with type 2 diabetes if their pancreas still produces some insulin. They can help the body in several ways such as causing the cells in the pancreas to release more insulin. All oral hypoglycaemic agents belong to a class of drugs known as sulfonylureas.
The pancreas is an organ situated behind the lower part of the stomach which produces insulin.
A disease or degenerative state of the peripheral nerves in which motor, sensory, or vasomotor nerve fibers may be affected, and which is marked by muscle weakness and atrophy, pain and numbness.
polycystic ovary syndrome (PCOS)
Polycystic ovary syndrome is an accumulation of many incompletely developed follicles in the ovaries. This condition is characterized by irregular menstrual cycles, scanty or absent menses, multiple small cysts on the ovaries (polycystic ovaries), excessive amounts of facial or body hair (hirsutism) and infertility. Many women who have this condition also have diabetes with insulin resistance.
A toxic condition developing in late pregnancy that is characterized by a sudden rise in blood pressure, excessive gain in weight, generalized oedema, albuminuria, severe headache and visual disturbances.
The number of people in a given group or population who are reported to have a disease at any point in time.
quality-adjusted life years (QALY)
A quality-adjusted life year (QALY) takes into account both quantity and the quality of life generated by healthcare interventions. It is the arithmetic product of life expectancy and a measure of the quality of the remaining life years. A QALY places a weight on time in different health states. A year of perfect health is worth 1; however, a year of less than perfect health life expectancy is worth less than 1. QALYs provide a common currency to assess the extent of the benefits gained from a variety of interventions in terms of health related quality of life and survival for the patient.
Retinopathy is a disease of the retina of the eye which may cause visual impairment and blindness.
A device which measures the amount of ultraviolet light absorbed by a substance.
A sudden loss of function in part of the brain as a result of the interruption of its blood supply by a blocked or burst artery.
Any of several hypoglycaemic compounds (as glipizide and tolbutamide) related to the sulfonamides and used in the oral treatment of type 2 diabetes.
transient ischaemic attacks
‘Mini strokes’ that produce stroke-like symptoms and signs which clear completely within 24 hours. These attacks are strong predictors of stroke.
tropical and malnutrition diabetes
Diabetes mellitus associated with chronic malnutrition and, sometimes, chronic pancreatitis. Whether tropical diabetes exists as a distinct entity is under debate. Also called malnutrition-related diabetes.
type 1 diabetes
Type 1 diabetes mellitus develops most frequently in children and adolescents. About 10% of people with diabetes have type 1. The symptoms of type 1 vary in intensity. Symptoms include excessive thirst, excessive passing of urine, weight loss and lack of energy. Insulin is a life-sustaining medication for people with type 1 diabetes. They require daily insulin injections for survival.
type 2 diabetes
Type 2 diabetes mellitus is much more common than type 1, and occurs mainly in adults although it is now also increasingly found in children and adolescents. The symptoms of type 1, in a less marked form, may also affect people with type 2. Some people with type 2, however, have no early symptoms and are only diagnosed several years after the onset of the condition, when various diabetic complications are already present. People with type 2 may require oral hypoglycaemic drugs and may also need insulin injections.