Formerly HbA_1c. An abbreviation for hemoglobin A1C. (See glycosylated hemoglobin.)

A glycoprotein IIb/IIIa receptor agonist that inhibits platelet aggregation.

A skin disease characterized by a hyperpigmentation and thickening of the skin. It may be associated with severe hyperinsulinemia and insulin resistance.

Acarbose (Precose^®) is indicated as monotherapy as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Acarbose may also be used in combination with a sulfonylurea when diet and exercise plus either acarbose or a sulfonylurea does not result in adequate glycemic control. In addition, acarbose may be used in combination with insulin or metformin. 

Abbreviation for angiotensin-converting enzyme.

See angiotensin-converting enzyme inhibitor.

Published annually in the journal Diabetes Care, these are diabetes-related clinical practice recommendations developed by the American Diabetes Association. They are one of the gold standards upon which diabetes care and treatment are based.

A collection of fat cells.

See epinephrine.

Refers to a type of nerve fiber of the autonomic nervous system.

Refers to a type of nerve fiber of the autonomic nervous system.

A class of drugs that inhibit the interaction of neurotransmitters with certain nerve fibers of the autonomic nervous system. Administered to alleviate hypertension and other conditions, these drugs decrease the heart rate and force of heart contractions.

The nonenzymatic glycosylation of protein exposed to hyperglycemic blood for long periods results in formation of AGE. AGEs accumulate over time and induce cross-linking of collagen and other matrix proteins in vascular walls and other tissues. LDLs can then become covalently trapped and accumulate. AGEs in vascular walls may also contribute to thickening, loss of elasticity, and increased permeability of the vascular wall. AGEs stimulate the release of cytokines and induce cell proliferation and inflammatory effects.

Abbreviation for advanced glycosylation endproduct.

Alanine transaminase, also called alanine aminotransferase, is an enzyme that is released into the plasma by liver cell death, a normal occurrence. When liver cell death increases, ALT levels rise above the normal range. The spillover of this enzyme into blood is measured as a marker of abnormal liver-cell damage.

The major protein component of blood and many animal tissues.

Appearance of albumin in the urine. Some albumin normally appears in the urine. Increased albumin excretion above normal may be a sign of kidney disease, often a complication of diabetes.

A steroid hormone produced by the adrenal gland. Aldosterone acts on the kidney to retain sodium ions and water and excrete potassium and hydrogen ions. Aldosterone secretion is increased by angiotensin II.

Abbreviation for alanine transaminase and alanine aminotransferase.

(Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells.

First-Generation Agents
Tolbutamide (Orinase^®), tolazamide (Tolinase^®), or chlorpropamide (Diabinese^®). Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Second-Generation Agents
Glipizide (Glucotrol^®), glyburide, or glimepiride. Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Glipizide, glyburide, or glimepiride may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Protein deposits seen at autopsy in the pancreatic b-cells of up to 90% of patients with type 2 diabetes.

Angiotensin receptor blockers are medications that modulate the renin-angiotensin-aldosterone system. These drugs block the action of angiotensin II, permitting the blood vessels to relax and dilate, which lowers blood pressure. ARBs are primarily used for the treatment of hypertension when ACE inhibitor therapy cannot be tolerated by the patient.

A protein that converts angiotensin I to angiotensin II. Angiotensin II is the active form of angiotensin and plays an important role in vasoconstriction. The action of angiotensin II results in an increase in blood pressure and a decrease in glomerular filtration rate.

A protein found in the serum that blocks the conversion of angiotensin I to angiotensin II. This results in a decrease in sodium and water retention and a decrease in blood pressure. ACE-inhibitors are used to treat hypertension, a frequent concomitant of diabetes, as well as other conditions.

A protein product of the lymphocyte cells of the blood that is produced in response to a foreign substance called an antigen.

Abbreviation for apolipoprotein B.

Abbreviation for apolipoprotein E.

The B apolipoproteins occur primarily in LDL and in lesser amounts in chylomicrons.

A class of apolipoprotein that occurs primarily in HDL and in lesser amounts in chylomicrons. Apo E is the activator of lecithin-cholesterol acyltransferase (LCAT), which forms cholesteryl esters in HDL.

Programmed cell death. It is the body's normal method of disposing of damaged, unwanted, or unneeded cells.

Abbreviation for angiotensin receptor blocker.

Abbreviation for Atherosclerosis Risk in Communities.

A group of diseases (including atherosclerosis) in which the arterial walls become thickened and lose elasticity. It is often associated with hypertension and diabetes.

Aspartate transaminase, also called aspartate aminotransferase, is an enzyme normally present in the liver, heart, and other tissues. A high level of AST released into the blood may be a sign of liver or heart damage, or other diseases.

Aspirin, or acetylsalicylic acid (acetosal) is a drug in the family of salicylates, often used as an analgesic (to relieve minor aches and pains), antipyretic (to reduce fever), and as an anti-inflammatory. It also has an antiplatelet ("blood-thinning") effect and is used in long-term, low doses to prevent heart attacks and thrombus formation in hypercoaguable states (e.g.in cancer).

Abbreviation for aspartate transaminase and aspartate aminotransferase.

The formation of atheromatous lesions in the arterial intima.

A disorder of the arteries in which deposits (plaques) of cholesterol, lipids, and cellular debris line the inner layers of arterial walls. It is a major cause of serious heart disease and is associated with increasing age, obesity, tobacco use, hypertension, elevated cholesterol, dyslipidemia, and diabetes mellitus.

An immunologic disorder that results in the production of antibodies that react against an individual's own cells or cell products. Type 1 diabetes mellitus is often associated with autoantibody production, resulting in the destruction of the b-cells of the pancreas.

The part of the nervous system involved in the regulation of involuntary functions. These include the activities of the heart and glands.

An antidiabetic agent that acts mainly by suppressing hepatic glucose production and does not directly affect insulin production.

Metformin is indicated as monotherapy as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Metformin may be used in combination with a sulfonylurea or insulin to improve glycemic control.

Linagliptin and metformin hydrochloride (Jentadueto™) is a combination dipeptidyl peptidase-IV (DPP-IV) inhibitor and biguanide product indicated as an adjunct to diet and exercise to improve glycemic control among adults with type 2 diabetes in whom treatment with both linagliptin and metformin is appropriate.

JANUMET XR® (sitagliptin and metformin hydrochloride extended-release) is a combination dipeptidyl peptidase-IV (DPP-IV) inhibitor and biguanide product indicated as an adjunct to diet and exercise to improve glycemic control among adults with type 2 diabetes in whom treatment with both sitagliptin and metformin extended-release is appropriate.

Abbreviation for Bezafibrate Infarction Prevention.

The concentration of glucose ("blood sugar") in the bloodstream. Blood glucose levels are usually determined after an overnight fast, but can also be determined randomly or at set times after the ingestion of glucose. A fasting plasma glucose level of less than 100 mg/dL is considered normal. Elevated levels of glucose may be indicative of diabetes mellitus. (See fasting plasma glucose test, hyperglycemia, oral glucose tolerance test.)

Abbreviation for body mass index.

A calculated value (kg/m²) that describes weight in kilograms (kg) in relation to square of the height in meters (m).

Abbreviation for blood urea nitrogen. A measure of the kidneys' ability to excrete urea, the chief waste product of protein breakdown.

Exenatide is an injectable drug that reduces the level of glucose in the blood. It is used for treating type 2 diabetes. Exenatide is a glucagon-like peptide-1 (GLP-1) receptor agonist, and belongs in a class of drugs called incretin mimetics.

Exenatide (Bydureon™) is an extended-release formulation indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes in multiple clinical settings.

Exenatide is an injectable drug that reduces the level of glucose in the blood. It is used for treating type 2 diabetes. Exenatide is a glucagon-like peptide-1 (GLP-1) receptor agonist, and belongs in a class of drugs called incretin mimetics. 

Exenatide (Byetta^®) is indicated as adjunctive therapy to improve glycemic control in patients with type 2 diabetes mellitus who are taking metformin, a sulfonylurea, a thiazolidinedione, a combination of metformin and a sulfonylurea, or a combination of metformin and a thiazolidinedione, but have not achieved adequate glycemic control. 

Abbreviation for coronary artery bypass grafting.

Abbreviation for coronary artery disease.

Antihypertensive agent.

A measure of the cardiac output of a patient per square meter of body surface area. It is obtained by dividing the cardiac output in liters per minute by the body surface area. Normal range for a healthy adult is 2.8 to 4.2 L/min/m².

Primary noninflammatory disease of the heart muscle, often of obscure or unknown etiology and not the result of ischemic, hypertensive, congenital, valvular, or pericardal disease.

Disease of the heart and blood vessels.

Abbreviation for Collaborative Atorvastatin Diabetes Study.

Abbreviation for calcium channel blocker.

Abbreviation for coronary heart disease.

A waxy lipid. Cholesterol circulates in the blood as part of a lipoprotein complex. High cholesterol levels put one at increased risk for atherosclerosis. (See high-density lipoprotein cholesterol, low-density lipoprotein cholesterol.)

Abbreviation for Cardiovascular Health Study.

A globule of lipoprotein in the serum measuring less than 0.5 mm in diameter and consisting predominantly of triglycerides. Chylomicrons transport fat from the intestine to the liver or adipose tissue.

Abbreviation for cardiac index.

The sequential process by which multiple coagulation factors of the blood interact, resulting in the formation of an insoluble fibrin clot.

A failing heart leads to congestion in the pulmonary or systemic circulation or both.

The use of a battery-powered pump system to deliver insulin into body via a needle or catheter placed in the subcutaneous tissue. It can be used by patients with type 1 diabetes as an alternative to daily injections of insulin. (See insulin pump.)

A disorder of the arteries of the heart, usually resulting from atherosclerosis. Deposits of plaque on the arterial wall cause narrowing of the lumen, thus preventing an adequate flow of oxygen and nutrients to the heart muscle.

Disease of the arteries around and supplying blood to the heart muscle.

A by-product of insulin production. Plasma C-peptide has a longer half-life than insulin and is often used to provide an indication of endogenous insulin secretion.

C-reactive protein is an indicator of acute inflammation and is produced by the liver.

A diagnostic measurement of kidney function used to estimate the glomerular filtration rate. Creatinine is a metabolic breakdown product of creatine and is found in the blood and urine. Normal blood levels range between 0.5 and 1.2 mg/dL.

Abbreviation for C-reactive protein.

Abbreviation for continuous subcutaneous insulin infusion.

Abbreviation for cardiovascular disease.

A tendency for the body to require more insulin in the early hours of the morning than during the late evening and nighttime.

Abbreviation for diastolic blood pressure.

(Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells.

First-Generation Agents
Tolbutamide (Orinase^®), tolazamide (Tolinase^®), or chlorpropamide (Diabinese^®). Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Second-Generation Agents
Glipizide (Glucotrol^®), glyburide, or glimepiride. Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Glipizide, glyburide, or glimepiride may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

A disease of carbohydrate, protein, and fat metabolism brought on by relative or absolute insulin deficiency. The disease is characterized by chronic hyperglycemia, which can result in damage to the kidneys, eyes, heart, blood vessels, and other organs. (See type 1 diabetes, type 2 diabetes, gestational diabetes.)

A life-threatening condition of decompensated diabetes mellitus. Diabetic coma can result from severe hyperglycemia and dehydration with our without diabetic ketoacidosis (See diabetic ketoacidosis). Unless treated immediately with insulin and fluid and electrolyte replacement, the person will not survive.

A disorder of acid-base balance in which severe or absolute insulin deficiency leads to unrestrained lipolysis and ketone body production that leads to accumulation of keto-acids in the bloodstream and acidosis. Diabetic ketoacidosis is usually associated with other electrolyte and fluid imbalances. The condition is fatal if not treated with fluids, electrolytes, and insulin (See diabetic coma.)

Kidney disease resulting from years of poorly controlled diabetes. The main disease occurs in the glomerulus, where there is basement membrane thickening and mesangial overgrowth leading to proteinuria and reduced glomerular filtration, respectively. Some renal tubular disease may be found as well.

Damage to the nervous system resulting from poorly controlled diabetes. Four different forms of neuropathy can be distinguished: peripheral sensorimotor neuropathy, autonomic neuropathy, mononeuritis simplex, and polyradiculopathy, The first two forms are much more common that the second two. Peripheral neuropathy affects the motor and sensory nerves that control sensation and motor tone. Autonomic neuropathy affects the nerves involved in such involuntary functions as digestion.

Damage to retinal capillaries resulting from poorly controlled diabetes that can cause vision problems, including blindness.

Sulfonylurea

(Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells.

First-Generation Agents
Tolbutamide (Orinase^®), tolazamide (Tolinase^®), or chlorpropamide (Diabinese^®). Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Second-Generation Agents
Glipizide (Glucotrol^®), glyburide, or glimepiride. Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Glipizide, glyburide, or glimepiride may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

A naturally occurring enzyme responsible for the inactivation of GLP-1, as well as numerous other proteins.

A new class of agents that inhibit the activity of DPP- IV.

Jentadueto™ (linagliptin and metformin hydrochloride) is a combination dipeptidyl peptidase-IV (DPP-IV) inhibitor and biguanide product indicated as an adjunct to diet and exercise to improve glycemic control among adults with type 2 diabetes in whom treatment with both linagliptin and metformin is appropriate.

Januvia™ (sitagliptin) is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus. Sitagliptin is also indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with metformin or a PPAR-gamma agonist (e.g., thiazolidinediones) when the single agent alone, with diet and exercise, does not provide adequate glycemic control.  

Janumet™ (sitagliptin/metformin HCl) is indicated as an adjunct to diet and exercise to improve glycemic control in adult patients with type 2 diabetes mellitus who are not adequately controlled on metformin or sitagliptin alone or in patients already being treated with the combination of sitagliptin and metformin.  

JUVISYNC™ (sitagliptin and simvastatin tablets)  is indicated in patients for whom treatment with both sitagliptin and simvastatin is appropriate. Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Simvastatin is an HMG-CoA reductase inhibitor (statin) indicated as an adjunctive therapy to diet to reduce the risk of total mortality.

Onglyza™ (saxagliptin) is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus in multiple clinical settings. Onglyza should not be used for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis.

Tradjenta™ (linagliptin) is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. This agent should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis and has not been studied in combination with insulin.

JANUMET XR® (sitagliptin and metformin hydrochloride extended-release) is a combination dipeptidyl peptidase-IV (DPP-IV) inhibitor and biguanide product indicated as an adjunct to diet and exercise to improve glycemic control among adults with type 2 diabetes in whom treatment with both sitagliptin and metformin extended-release is appropriate.

Abbreviation for diabetic ketoacidosis.

Abbreviation for Diabetes Prevention Program.

Abbreviation for dipeptidyl peptidase-IV.

An abnormal profile of blood lipids. The characteristic dyslipidemia associated with insulin resistance and poorly controlled diabetes includes high levels of triglycerides, low levels of HDL-C, and partitioning of LDL-C into relatively small and dense particles.

Insulin secreted by the pancreatic b-cells. In patients with type 1 diabetes, endogenous insulin is virtually undetectable because of immune damage to the b-cell. Patients with type 2 diabetes have detectable insulin levels, but they are insufficient to overcome the increased insulin needs caused by insulin resistance.

Abnormal function of endothelial cells that may be detected by reduced ability to stimulate vascular dilation in response to ischemia and/or sheer stress. Endothelial function is known to be abnormal in diabetes and may be an early step in the development of atherosclerotic lesions.

A vasoconstricting polypeptide, produced by endothelial cells that also may function as a neurotransmitter.

The layer of endothelial cells lining the cavities of the heart and of the blood and lymph systems.

The most severe, fully developed phase of renal disease, in which the kidneys have lost so much function that dialysis or kidney transplantation is needed for patient survival.

A hormone secreted by the adrenal gland during stress and when blood glucose levels are low. It has many actions, one of which is to counteracts the action of insulin by promoting glycogen breakdown in the liver and the release of fatty acids from adipose tissue.

Abbreviation for end-stage renal disease.

A state of normal blood glucose concentration (also referred to as normoglycemia).

Physiologic studies used to measure insulin resistance in a research setting, Insulin is infused to create matched insulin levels in all subjects. Glucose is infused to maintain matched glucose levels as well. Glucose requirements are used as a measure of insulin sensitivity. Clamps can be performed with isotope-labeled glucose to separately assess the effects of insulin on glucose production and glucose utilization.

Lists of foods-such as starch/bread, meat, vegetable, fruit, milk, and fat-and their quantity, which may be exchanged with other foods on the same list without changing the nutritional content of the diet.

Exenatide is an injectable drug that reduces the level of glucose in the blood. It is used for treating type 2 diabetes. Exenatide is a glucagon-like peptide-1 (GLP-1) receptor agonist, and belongs in a class of drugs called incretin mimetics. 

Exenatide (Byetta^®) is indicated as adjunctive therapy to improve glycemic control in patients with type 2 diabetes mellitus who are taking metformin, a sulfonylurea, a thiazolidinedione, a combination of metformin and a sulfonylurea, or a combination of metformin and a thiazolidinedione, but have not achieved adequate glycemic control. 

Exenatide (Bydureon™) is an extended-release formulation indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes in multiple clinical settings. 

Insulin administered by injection or infusion.

Antihemophilic factor (AHF): A relatively storage-labile factor participating in the extrinsic pathway of blood coagulation.

Glucose concentration in plasma obtained after an 8 to 10 hours overnight fast An FPG level less than 100 mg/dL is normal; one of 101-26 mg/dL is impaired; and one greater than or equal to 126 mg/dL indicated diabetes if it is reproducible and not found during an acute illness.

The test is taken after fasting for 8 to 10 hours, typically overnight. An FPG level less than 110 mg/dL is normal; one between 110 and 126 mg/dL indicates impaired glucose tolerance; and one greater than 126 mg/dL supports a provisional diagnosis of diabetes.

An oral medication of the fibrate class, it is mainly used with diet changes (restriction of cholesterol and fat intake) to reduce the amount of cholesterol and triglycerides (fatty substances) in blood. Like other fibrates, fenofibrate acts on PPAR-alpha to reduce cholesterol levels.

Abbreviation for free fatty acid.

The insoluble protein formed from fibrinogen by the proteolytic action of thrombin during the normal clotting of blood. Fibrin forms the essential portion of blood clots.

A coagulation protein in blood, also known as factor I, that is converted to fibrin by the action of an enzyme in blood thrombin.

The dissolution of fibrin by enzymatic action.

Lipid laden macrophages with a characteristic vacuolated appearance due to the presence of complex lipids; a component of atherosclerotic plaques.

Abbreviation for fasting plasma glucose.

The fraction of plasma fatty acids that is not in esterified form of glycerol esters. Also know as non-esterified fatty acids.

Carbohydrate intolerance that comes on or is first recognized during pregnancy. Gestational diabetes increases the risk of perinatal morbidity in the infant and the later development of diabetes in both infant and mother.

Abbreviation for glomerular filtration rate.

Abbreviation for glucose-dependent insulinotropic polypeptide.

Sulfonylurea

(Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells.

First-Generation Agents
Tolbutamide (Orinase^®), tolazamide (Tolinase^®), or chlorpropamide (Diabinese^®). Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Second-Generation Agents
Glipizide (Glucotrol^®), glyburide, or glimepiride. Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Glipizide, glyburide, or glimepiride may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Glipizide is an oral drug that is used for treating patients with type 2 diabetes. It belongs to the sulfonylurea class of drugs.

A measure of the amount of urine filtered from the blood by the kidney in a given period of time. A decrease in GFR accompanies the development of diabetic nephropathy.

Abbreviation for glucagon-like peptide-1.

A hormone produced in the pancreas that signals the liver to release stored sugar into the bloodstream. Glucagon is often oversecreted in patients with type 2 diabetes, especially at mealtime.

A human incretin hormone that is released from intestinal L cells after the ingestion of carbohydrates and fat. GLP-1 exerts multiple effects to mediate the body's ability to self-regulate blood glucose. The effects include enhancing glucose-dependent insulin secretion, suppressing glucagon secretion, reducing food intake and regulating gastric emptying. Animal studies suggest GLP-1 may have the ability to stimulate beta-cell proliferation and neogenesis.

A process by which glucose is synthesized from amino acids, lactate, and/or glycerol. Gluconeogenesis takes place mainly in the liver and provides a source of glucose when there is no intake of exogenous calories and endogenous glycogen stores are reduced (e.g., prolonged fasting, intense exercise).

The rate of glucose uptake from the blood by the peripheral tissues, such as skeletal muscle.

Maintenance of a steady but not excessive supply of glucose using mechanisms that regulate the appearance/disappearance of glucose in the bloodstream.

See oral glucose tolerance test.

The gastrointestinal hormone gastric inhibitory polypeptide is released from the gut after a meal and stimulates insulin secretion.

(Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells.

First-Generation Agents
Tolbutamide (Orinase^®), tolazamide (Tolinase^®), or chlorpropamide (Diabinese^®). Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Second-Generation Agents
Glipizide (Glucotrol^®), glyburide, or glimepiride. Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Glipizide, glyburide, or glimepiride may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Abbreviation for insulin-sensitive glucose transporter protein expressed predominantly in striated muscle and fat cells.

Sulfonylurea

(Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells.

First-Generation Agents
Tolbutamide (Orinase^®), tolazamide (Tolinase^®), or chlorpropamide (Diabinese^®). Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Second-Generation Agents
Glipizide (Glucotrol^®), glyburide, or glimepiride. Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Glipizide, glyburide, or glimepiride may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Glyburide is an oral drug that is used for treating patients with type 2 diabetes. It belongs to the sulfonylurea class of drugs.

The presence of sugar in the blood. (See hyperglycemia, hypoglycemia.)

A polysaccharide made up of multiple units of glucose. It is the major storage form of carbohydrate in animals and is found primarily in the liver, kidney and muscle. When needed, glycogen is broken down to glucose, which can be released from liver and kidney (but not muscle) into the circulation.

Hemoglobin to which a carbohydrate has been attached through a non-enzymatic, time- and concentration-dependent fashion. The fraction of hemoglobin that is glycosylated hemoglobin reflects blood glucose levels during the previous 3 to 4 months. Hemoglobin A_1c (A1C) is a form of glycosylated hemoglobin commonly used to assess chronic blood glucose control in people with diabetes. Normal A1C levels are generally 4% to 6%. Diabetes treatment typically aims for a reduction of A1C to a target level of less than 7% to reduce the risk of long-term diabetic complications. The American Diabetes Association recommends a target A1C of less than 7%.

An absorbable a-glucosidase inhibitor used in the treatment of type 2 diabetes mellitus.

Miglitol (Glyset^®) is indicated as monotherapy as an adjunct to diet and exercise to lower blood glucose in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Miglitol may also be used in combination with a sulfonylurea when diet and exercise plus either miglitol or a sulfonylurea alone does not result in adequate glycemic control.

Abbreviation for glucose tolerance test. OGTT refers to an oral glucose tolerance test. IVGTT refers to an intravenous glucose tolerance test.

Abbreviation for hemoglobin A_1c (See glycosylated hemoglobin.) 

Abbreviation for high-density lipoprotein cholesterol.

Abbreviation for hyperglycemic hyperosmolar nonketotic coma.

Concentration of cholesterol circulating in high-density lipoprotein particles. HDL is produced in the liver and plays a role in cholesterol transport, including reverse transport from peripheral tissues to the liver. HDL-C is often referred to as "good cholesterol." High HDL-C levels are considered protective against heart disease. Conversely, low HDL-C levels have been correlated with an increased risk of coronary artery disease.

Abbreviation for hepatic nuclear factors.

Abbreviation for homeostasis model assessment for b-cell function.

  Abbreviation for homeostasis model assessment-insulin resistance. 

An empirical mathematical formula based on fasting plasma glucose and fasting plasma insulin levels that was developed as a surrogate measurement of b-cell function:

HOMA-bCF = 20 x fasting plasma insulin (µIU/mL)
                  fasting plasma glucose (mmol/L) - 3.5

An empirical mathematical formula based on fasting plasma glucose and fasting plasma insulin levels that was developed as a surrogate measurement of in vivo insulin sensitivity:

HOMA-IR = fasting plasma insulin (µIU/mL) x fasting plasma glucose (mmol/L)
                                                             22.5

A metabolite of the amino acid methionine; chronically elevated blood levels of homocysteine are linked to atherosclerosis, probably through damage to the endothelium.

An enzyme present in fat cells that breaks down stored triglycerides into free fatty acids and glycerol. The activity of this enzyme is increased in people with insulin resistance.

Elevated blood glucose levels. Acute symptoms include frequent urination, increased thirst, and weight loss. If left untreated, hyperglycemia results in chronic diabetes complications: cardiovascular disease, neuropathy, retinopathy, and nephropathy.

A life-threatening condition seen in patients with diabetes mellitus. It is characterized by extreme hyperglycemia, hyperosmolarity, and dehydration in the absence of ketoacidosis.

Elevated blood levels of insulin. Since insulin levels are distributed in the population in a continuous fashion, there is no widely agreed upon definition of hyperinsulinemia.

Elevated blood lipid levels.

High blood pressure. In adults, a systolic blood pressure greater than 140 mm of mercury or a diastolic blood pressure greater than 90 mm of mercury is indicative of hypertension.

Elevated blood triglyceride levels. Hypertriglyceridemia is more common among insulin resistant patients with or without diabetes than among patients without diabetes or insulin resistance.

Elevated levels of uric acid or urates in the blood.

Low blood glucose levels. Symptoms include adrenergic symptoms (tremor, sweating, palpitations - mediated by increased epinephrine) and neuroglycopenic (mood change, confusion, dizziness or disequilibrium, lethargy, compa - mediated by inadequate energy supply the brain) moodiness, numbness in the arms and hands, confusion and shakiness, or dizziness. If left untreated, hypoglycemia can cause sudden loss of consciousness.

Abbreviation for islet amyloid polypeptide.

Abbreviation for intercellular adhesion molecule 1.

Abbreviation for insulin-dependent diabetes mellitus. This term is no longer recommended for use. (See type 1 diabetes.)

Abbreviation for impaired fasting glucose.

Abbreviation for impaired glucose tolerance.

Abbreviation for ischemic heart disease.

An inflammatory lymphokine produced by T cells, fibroblasts and activated macrophages.

A level of fasting plasma glucose that is higher than normal but lower than that associated with diabetes. It is defined as being greater than or equal to 100 mg/dL but less than 126 mg/dL.

A metabolic state between normoglycemia and diabetes defined by a plasma glucose level at the 2-hour point during a 75-g oral glucose tolerance test that is greater than or equal to 140 mg/dL but less than 200 mg/dL.

A hormone released by the gut in response to food that helps to regulate glucose levels in the body. GLP-1 is an example of an incretin hormone.

The observation that oral glucose administration results in greater insulin secretory response than the same glucose amount administered intravenously.

A new class of agents under development to treat diabetes. Incretin mimetics mimic the enhancement of glucose-dependent insulin secretion, as well as other glucoregulatory actions of incretin hormones.

An anabolic hormone produced by the b-cells of the islets of Langerhans in the pancreas. Insulin is the major hormone that regulates plasma glucose concentrations by regulating rates of glucose production (suppressive effect) and utilization (stimulatory effect). Insulin also regulates lipid and protein metabolism. Relative or absolute insulin deficiency causes impaired glucose levels and diabetes.

A small, computerized, programmable device about the size of a beeper that delivers insulin infusions to the body via catheters placed in subcutaneous tissue. Delivery by insulin pump can replace insulin injection. (See continuous subcutaneous insulin infusion.)

Reduced effectiveness of insulin to mediate its metabolic effects. Insulin resistance generally refers to glucose metabolism, but can be used to describe reductions in other aspects of insulin action. Insulin resistance is a primary abnormality that places people at risk for type 2 diabetes. Additional conditions may be associated with insulin resistance, including cardiovascular disease, hyperinsulinemia, dyslipidemia, hypertension, abdominal obesity, and clotting abnormalities, among others.

Term for a set of clinical manifestations that tend to cluster together in people who are obese and, often, insulin resistant. (See metabolic syndrome.)

On-and-off pain in the leg muscles, usually occurring while walking or exercising. The pain results from an insufficient supply of blood to the muscles, caused by narrowing of the blood vessels feeding the muscle.

Abbreviation for insulin resistance syndrome.

Heart disease characterized by deficiency of the blood supply to the heart muscle, generally due to atherosclerosis in the coronary arteries.

Clusters of endocrine cells in the pancreas that produce insulin and glucagons, as well as somatostatin and pancreatic polypeptide.

Sitagliptin/metformin HCl (Janumet^™) is indicated as an adjunct to diet and exercise to improve glycemic control in adult patients with type 2 diabetes mellitus who are not adequately controlled on metformin or sitagliptin alone or in patients already being treated with the combination of sitagliptin and metformin.

JANUMET XR® (sitagliptin and metformin hydrochloride extended-release) is a combination dipeptidyl peptidase-IV (DPP-IV) inhibitor and biguanide product indicated as an adjunct to diet and exercise to improve glycemic control among adults with type 2 diabetes in whom treatment with both sitagliptin and metformin extended-release is appropriate. JANUMET XR should not be used to treat type 1 diabetes or diabetic ketoacidosis. Use of JANUMET XR has not been studied in patients with a history of pancreatitis.

Sitagliptin(Januvia^™)is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus. Sitagliptin is also indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with metformin or a PPAR-gamma agonist (e.g., thiazolidinediones) when the single agent alone, with diet and exercise, does not provide adequate glycemic control.

Juvisync    (sitagliptin and simvastatin tablets) is indicated in patients for whom treatment with both sitagliptin and simvastatin is appropriate. Sitagliptin is a dipeptidyl peptidase 4 (DPP 4) inhibitor indicated as an adjunct to diet

A method for analyzing a therapy's efficacy or toxicity by graphically displaying survival or the occurrence of a study endpoint or dropout. The Kaplan-Meier curve displays a statistical estimate of the percent of people receiving a given therapeutic regimen. Plotting the curves for a trial's different treatment arms on the same chart yields a comparison of the various regimens.

Metabolic acidosis caused by increased concentrations of ketones in the bloodstream. (See diabetic ketoacidosis.)

Acidic by-products of fatty acid oxidation (e.g., ß-hydroxybutyrate and acetoacetate).

A type of cell found in the gut that is responsible for the secretion of GLP-1.

Abbreviation for low-density lipoprotein cholesterol.

A measure of the weight of the left ventricle per square meter of body surface. It is obtained by dividing the weight of the left ventricle in grams by the area of the body surface in square meters. Normal range for a healthy adult is 71 ± 8 g/m².

A pearly white area within an artery that causes the intimal surface to bulge into the lumen. Mostly composed of collagen, but also comprised of lipid, cell debris and smooth muscle cells. Also known as atherosclerotic plaque.

Tradjenta™ (linagliptin) is a dipeptidyl peptidase (DPP) IV inhibitor indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. This agent should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis and has not been studied in combination with insulin.

A water-insoluble fatty substance. The profile of blood lipids is altered in patients with diabetes. (See dyslipidemia.)

An organic molecule consisting of a mixture of protein and lipid. Most of the lipids (fat) in the blood are found in lipoprotein complexes.

Victoza® (liraglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. Victoza is not recommended as the first medication to treat diabetes. Victoza is not insulin and has not been studied in combination with insulin. Victoza is not for people with type 1 diabetes or people with diabetic ketoacidosis. It is not known if Victoza is safe and effective in children. Victoza is not recommended for use in children. 

Abbreviation for an approach to analysis of clinical trial data in which the last observation is carried forward.

The concentration of circulating cholesterol partitioned in low-density particles. LDL-C, also known as "bad cholesterol," has been shown to transport lipid from the blood to the tissues. High levels of LDL-C are considered a risk factor for developing coronary artery disease. Treatments that lower cholesterol reduce the risk of coronary artery disease.

Abbreviation for left ventricular mass index.

Any mononuclear phagocyte found in tissue, usually large. Secretes a broad diversity of products, including enzymes, cytokines, lymphokines, and regulatory molecules.

Pertaining to the major blood vessels of the body with internal diameters greater than 100 microns.

Non-ketotic diabetes with onset before age 25 and autosomal dominant pattern of inheritance. Mutations in six different genes have been identified as causes of subtypes of MODY. All appear to affect pancreatic ß-cell function without causing insulin resistance.

A class of antidiabetic agents. (See repaglinide.)

Repaglinide (Prandin^®) is indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Repaglinide is also indicated for use in combination with metformin to lower blood glucose in patients whose hyperglycemia cannot be controlled by exercise, diet, and either repaglinide or metformin alone.

A cluster of complications of obesity including: waist circumference >40 inches in men and >35 inches in women; TG >=150 mg/dL; HDL-C <40 mg/dL in men, <50 mg/dL in women; BP >=130/85 mm Hg; and fasting glucose >=110 mg/dL. Also known as insulin resistance syndrome, dysmetabolic syndrome, and Syndrome X.

(Glucophage) An oral antidiabetic agent of the biguanide class that is used in the treatment of type 2 diabetes mellitus. Metformin acts to reduce elevated blood glucose levels chiefly by decreasing gluconeogenesis and, to a lesser degree, by improving tissue sensitivity to insulin.

Abbreviation for myocardial infarction.

Pertaining to the finer portion of the blood vessels of the body, sometimes described as having an internal diameter of 100 microns or less (i.e., capillaries).

An absorbable a-glucosidase inhibitor used in the treatment of type 2 diabetes mellitus.

Miglitol (Glyset^®) is indicated as monotherapy as an adjunct to diet and exercise to lower blood glucose in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Miglitol may also be used in combination with a sulfonylurea when diet and exercise plus either miglitol or a sulfonylurea alone does not result in adequate glycemic control.

Abbreviation for maturity-onset diabetes of the young.

Adverse outcomes per unit of observation (for example events per 100 person-years of follow-up).

Deaths per unit of observation (for example, deaths per 100 person-years of observation).

A form of heart attack. In MI, there is necrosis of a portion of the heart muscle, usually due to coronary artery obstruction.

Kidney disease. (See diabetic nephropathy.)

Disease of nerves. (See diabetic neuropathy.)

A chemical substance that effects the transmission of nerve impulses across axonal junctions.

Abbreviation for normal glucose tolerance.

Abbreviation for non-insulin-dependent diabetes mellitus. This term is no longer recommended for use. (See type 2 diabetes.)

A condition characterized by an excessive amount of body fat. Obesity is a risk factor for type 2 diabetes.

Abbreviation for oral glucose tolerance test.

Measurement of plasma glucose concentrations at defined intervals after a standardized oral dose of D-glucose. In adults, the recommended dose is 75 grams and the recommended blood sampling times are immediately before the glucose dose and 120 minutes after the dose. Normal values are fasting <100 mg/dl and 2-hours <140 mg/dl. (See impaired fasting glucose, impaired glucose tolerance and diabetes for results that define those conditions).

(Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells.

First-Generation Agents
Tolbutamide (Orinase^®), tolazamide (Tolinase^®), or chlorpropamide (Diabinese^®). Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Second-Generation Agents
Glipizide (Glucotrol^®), glyburide, or glimepiride. Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Glipizide, glyburide, or glimepiride may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

The stress associated with defense against elevated and prolonged exposure to chemical species capable of an oxidizing reaction.

See plasminogen activator inhibitor (PAI) type 1.

A mixed exocrine and endocrine organ located in the abdomen. The exocrine portion of the gland makes digestive enzymes that are secreted into the gastrointestinal track in response to feeding. The endocrine pancreas is contained in the Islets of Langerhans, which contain cells that make insulin and glucagon, two main regulators of blood glucose levels.

Abbreviation for percutaneous coronary intervention.

Abbreviation for polycystic ovary syndrome.

Abbreviation for a transcription factor that regulates insulin production.

Arteriosclerosis of the vessels distant from the heart, often seen as impaired circulation to the legs.

Any disorder affecting the blood vessels of the extremities. People with type 2 diabetes are at increased risk for developing PVD.

A nuclear protein receptor that, when activated and linked to a co-activator protein, binds to DNA and acts to regulate transcription of a large number of genes, including some genes involved in adipose tissue, lipid and glucose metabolism. The antidiabetic drugs known as thiazolidinediones have been shown to bind to and activate PPAR.

(ACTOS) An oral antidiabetic agent of the thiazolidinedione class that is used to treat type 2 diabetes.

The clear fluid portion of the blood that is free of any type of blood cell.

A term used for a group of proteins that convert plasminogen into plasmin. It includes prourokinase, u-plasminogen activator (urokinase), and t-PA.

An endothelial derived protein in blood that inhibits conversion of plasminogen to plasmin by inhibiting plasminogen activator. The inhibition limits clot propagation.

A blood particle involved in coagulation and the maintenance of hemostasis.

A disease of the ovaries, also known as Stein-Leventhal syndrome. It is commonly characterized by hirsutism, obesity, menstrual abnormalities, infertility, and enlarged ovaries. Obesity, insulin resistance and hyperinsulinemia are risk factors for PCOS. Women with PCOS are at increased risk for developing impaired glucose tolerance and type 2 diabetes.

Increased thirst, a symptom of uncontrolled diabetes.

The excretion of large volumes of urine, a symptom of uncontrolled diabetes.

Occurring after a meal.

Abbreviation for peroxisome proliferator-activated receptor. A member of the nuclear hormone receptor subfamily of transcription factors. There are three known subtypes of PPARs-PPAR-alpha, PPAR-gamma, and PPAR-delta.

Pramlintide, an analogue of human amylin, is an injectable antihyperglycemic drug for use in patients with diabetes treated with insulin.

 class of antidiabetic agents. (See repaglinide.)

Repaglinide (Prandin^®) is indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Repaglinide is also indicated for use in combination with metformin to lower blood glucose in patients whose hyperglycemia cannot be controlled by exercise, diet, and either repaglinide or metformin alone. 

Acarbose (Precose^®) is indicated as monotherapy as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Acarbose may also be used in combination with a sulfonylurea when diet and exercise plus either acarbose or a sulfonylurea does not result in adequate glycemic control. In addition, acarbose may be used in combination with insulin or metformin.

The inactive precursor of insulin. Proteolytic cleavage of proinsulin in secretory granules in the pancreatic ß-cells results in the generation of C-peptide and the active insulin molecule.

Protein in the urine. This may be a sign of kidney damage.

Abbreviation for percutaneous transluminal coronary angioplasty.

Abbreviation for peripheral vascular disease.

Abbreviation for quality-adjusted life-years.

A means of comparing medical interventions that expresses outcomes of interventions as quality-adjusted life-years. QALY is a standardized unit that evaluates quality of life and length of life simultaneously.

Pertaining to the kidney.

An enzyme produced by the kidney that is involved in the regulation of blood pressure. Renin converts angiotensinogen to angiotensin I, the precursor of the potent vasoconstrictor angiotensin II.

A non-sulfonylurea antidiabetic agent that acts by increasing insulin release from the pancreatic b-cells. Repaglinide must be taken in a meal-related regimen since it has a rapid onset of action that could result in hypoglycemia in the absence of ingested food.

Repaglinide (Prandin^®) is indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Repaglinide is also indicated for use in combination with metformin to lower blood glucose in patients whose hyperglycemia cannot be controlled by exercise, diet, and either repaglinide or metformin alone.

Refers to damage to tissue caused when blood supply returns to the tissue after a period of ischemia.

Disease of the retina of the eye. (See diabetic retinopathy.)

(Avandia) An oral antidiabetic agent of the thiazolidinedione class that is used to treat type 2 diabetes.

Saxagliptin (Onglyza^®) is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. Saxagliptin has been studied as monotherapy and in combination with metformin, glyburide, and thiazolidinediones (eg, pioglitazone and rosiglitazone). Saxagliptin has not been studied in combination with insulin.

Abbreviation for systolic blood pressure.

Sitagliptin(Januvia^™)is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus. Sitagliptin is also indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with metformin or a PPAR-gamma agonist (e.g., thiazolidinediones) when the single agent alone, with diet and exercise, does not provide adequate glycemic control.

A type of LDL particle that is associated with insulin resistance, dyslipidemia and increased risk of atherosclerosis.

(Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells.

First-Generation Agents
Tolbutamide (Orinase^®), tolazamide (Tolinase^®), or chlorpropamide (Diabinese^®). Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Second-Generation Agents
Glipizide (Glucotrol^®), glyburide, or glimepiride. Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Glipizide, glyburide, or glimepiride may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

An early name for what is now called the metabolic syndrome. (See Metabolic Syndrome)

Abbreviation for thiobarbituric acid-reactive substances.

Abbreviation for triglyceride.

A class of antidiabetic agents that reduce insulin resistance. Thiazolidinediones improve insulin sensitivity by interacting with a nuclear transcription factor called "peroxisome proliferator-activated receptor." Clinically available members of the thiazolidinedione class are pioglitazone and rosiglitazone. Troglitazone, the first in the class to be launched (March 1997), was taken off the market in March 2000, for rare but severe liver failure that is not caused by currently available members of this drug class.

The enzyme derived from prothrombin that converts fibrinogen to fibrin.

The formation, development or presence of a thrombus.

An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of formation.

A serine endopeptidase synthesized by endothelial cells, the major physiologic activator of plasminogen.

Abbreviation for tumor necrosis factor-a.

Sulfonylurea

(Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells.

First-Generation Agents
Tolbutamide (Orinase^®), tolazamide (Tolinase^®), or chlorpropamide (Diabinese^®). Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

Second-Generation Agents
Glipizide (Glucotrol^®), glyburide, or glimepiride. Indicated as an adjunct to diet and exercise to lower blood glucose levels in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Glipizide, glyburide, or glimepiride may be used in combination with insulin when sulfonylurea monotherapy fails to reduce symptoms and/or blood glucose levels.

See tissue plasminogen activator (t-PA).

Tradjenta™ (linagliptin) is a dipeptidyl peptidase (DPP) IV inhibitor indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. This agent should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis and has not been studied in combination with insulin.

A lipid molecule composed of three fatty acids combined with glycerol. Triglycerides are a main storage form of energy in the form of lipid. They occur in many tissues, especially adipose tissue, and they circulate in a variety of lipoprotein particles. Circulating triglyceride concentrations are often elevated in patients with insulin resistance or poorly controlled diabetes mellitus.

Abbreviation for Troglitazone In Prevention Of Diabetes study.

An oral antidiabetic agent of the thiazolidinedione class that was in clinical use from March 1997 to March 2000 when it was withdrawn for rare but severe liver failure that is not caused by currently available drugs in the thiazolidinedione class.

An inflammatory cytokine produced by macrophages and to a lesser degree by fat cells. TNF-a induces matrix-degrading enzymes necessary for vascular smooth muscle cell migration characteristic of advanced atherosclerotic lesions. TNF-a also inhibits lipoprotein lipase, the major enzyme involved in triglyceride catabolism, and insulin signaling in skeletal muscle.

Diabetes resulting from autoimmune destruction of pancreatic ß-cells (formerly known as insulin-dependent diabetes mellitus or IDDM). T1DM generally occurs before age 30, but can occur at any age. Because of the ß-cell destruction, endogenous insulin is very low or absent. Patients require endogenous insulin to survive and to regulate blood glucose levels. Type 1 diabetes accounts for ~10% of all cases of diabetes.

Diabetes that results from insulin resistance and inadequate insulin secretion (Formerly known as non-insulin-dependent diabetes mellitus or NIDDM). Insulin resistance is generally present before diabetes develops and insulin secretion declines progressively, leading to progressive hyperglycemia. Patients require treatments to reduce insulin resistance and/or increase insulin levels to regulate blood glucose levels. Type 2 diabetes accounts for ~90% of all diabetes cases.

Abbreviation for thiazolidinedione.

Contracting of a blood vessel, resulting in a narrowing of its lumen.

A plasma lipoprotein that is composed mainly of triglycerides and related apoprotein molecules (especially apo B and apo C). VLDL particles transport triglycerides and cholesterol from the liver for storage in and for use by peripheral tissues. Elevations in VLDL levels are commonly associated with obesity, insulin resistance and poorly controlled diabetes.

Victoza® (liraglutide) is a glucagon like peptide 1 (GLP 1) receptor agonist indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. Victoza is not recommended as the first medication to treat diabetes. Victoza is not insulin and has not been studied in combination with insulin. Victoza is not for people with type 1 diabetes or people with diabetic ketoacidosis. It is not known if Victoza is safe and effective in children. Victoza is not recommended for use in children.

Still experimental agent of a novel class of oral antihyperglycemic drugs known as DPP-IV inhibitors, which delay the degradation of incretin hormones by dipeptidyl peptidase-IV.

Abbreviation for very low-density lipoprotein.

Abbreviation for very low-density lipoprotein-cholesterol, the fraction of circulating cholesterol that is contained in VLDL particles.

Abbreviation for very low-density lipoprotein-cholesterol, the fraction of circulating triglycerides that is contained in VLDL particles.

The attribute of factor VIII necessary for the adhesion of platelets to vascular elements.

Abbreviation for vascular smooth muscle cell.

A class of drugs that inhibit the interaction of neurotransmitters with certain nerve fibers of the autonomic nervous system. Administered to alleviate hypertension and other conditions, these drugs decrease the heart rate and force of heart contractions.

See b-adrenergic blocking agent. 

The insulin and amylin producing cells in the pancreas. These cells fail as type 2 diabetes progresses in the body.