GLOSSARY

The pharmacologic agents discussed are approved for use in the United States by the U.S. Food and Drug Administration (FDA) unless otherwise noted. Consult individual package inserts for use outside of the United States.

70/30 insulin

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Premixed insulin that is 70 percent intermediate-acting (NPH) insulin and 30 percent rapid-acting (regular) insulin.

A1C

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A minor component of hemoglobin to which glucose is bound.

AACE

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Abbreviation for the American Association for Clinical Endocrinology.  

AACE 2015 Diabetes Guidelines

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Guidelines for glycemic control from the American Association of Clinical Endocrinologists

Abciximab

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An oral antiplatelet agent of the glycoproetin (Gp) IIb/IIIa inhibitor class.

Acarbose

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An oral antihyperglycemic agent of the alpha-glucosidase class.

ACCORD

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ACCORD was a randomized, multicenter, double 2X2 factorial trial in 10,251 patients with type 2 diabetes mellitus designed to test the effects on major cardiovascular disease (CVD) events of intensive glycemia control, of fibrate treatment to increase HDL-cholesterol and lower triglycerides, and of intensive blood pressure control, each compared to an appropriate control. All 10,251 participants were in an overarching glycemia trial.

ACS

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Abbreviation for acute coronary syndrome, any constellation of symptoms attributed to obstruction of the coronary arteries.

ADA

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Abbreviation for American Diabetes Association

ADA EASD

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Abbreviation for the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) Guidelines. ADA/EASD releases a joint position statement that provides clinical practice recommendations for managing hyperglycemia in type 2 diabetes.

ADA EASD Guidelines

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See American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) Guidelines

ADA Endocrine Society

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Joint consensus report from ADA and The Endocrine Society that discusses classification of hypoglycemia in diabetes and the impact of hypoglycemia on glycemic targets

ADA Guidelines

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Published annually in the journal Diabetes Care, the American Diabetes Association (ADA) guidelines are diabetes-related clinical practice recommendations covering diabetes diagnosis, diabetes treatment, and diabetes management.

Adipose tissue

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A collection of fat cells.

Adrenaline

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See epinephrine. 

Adrenergic blocking agent

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

ADVANCE Study

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Abbreviation for the Action in Diabetes and Vascular Disease: Pretarax and Diamicron Modified Release Controlled Evaluation study.

Advanced glycosylation end-product (AGE)

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The nonezymatic 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.

Alanine transaminase and alanine aminotransferase (ALT)

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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.

Albiglutide

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An injectable antihyperglycemic agent of the glucagon-like peptide-1 (GLP-1) class.

Albumin

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The major protein component of blood and many animal tissues.

Albuminuria

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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.

Aldosterone

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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. 

Alirocumab

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An injectable monoclonal antibody of the PCSK9 inhibitor class for the treatment of an inherited form of dyslipidemia called familial hypercholesterolemia (FH). Marketed as Praluent®.

Alogliptin

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An oral antihyperglycemic agent of the dipeptidyl peptidase-4 (DPP-4) inhibitor class.

Alpha cells

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Cells found in the pancreas that secrete glucagon. In patients with type 2 diabetes, alpha cells often hypersecrete glucagon.

Alpha-glucosidase

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An enzyme that catalyzes the release of glucose from certain types of carbohydrates known as glucosides.

Alpha-glucosidase inhibitors

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A class of oral antihyperglycemic agents used to treat type 2 diabetes that work by preventing the digestion of carbohydrates, reducing the effect of carbohydrates on blood sugar.

Amylin mimetics

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Class of agents for the treatment of type 2 diabetes.

Amyloid

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

Angina

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Chest pain due to lack of blood to the heart muscle.

Angiotensin-converting enzyme (ACE)

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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.

Angiotensin-converting enzyme (ACE) inhibitor (ACEI)

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

Angiotensin-receptor blocker (ARB)

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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 treatment with an ACE inhibitor cannot be tolerated by the patient.

Antibody

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

Anticoagulant

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A substance that prevents coagulation (clotting) of blood.

Antihyperglycemic agents

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Agents that treat diabetes by lowering blood glucose levels.

Antihyperlipidemic agents

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Agents that aim to lower blood cholesterol levels.

Antiplatelets

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A class of agents that decrease platelet aggregation.

apolipoprotein B (apoB)

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The B apolipoproteins are the primary apolipoproteins of low-density lipoproteins (LDL) and in lesser amounts in chylomicrons.

apolipoprotein E (apoE)

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A class of apolipoprotein that occurs in the chylomicrons and intermediate-density lipoproteins (IDL) that bind to a specific receptor on liver and peripheral cells. It is necessary for the normal catabolysm of triglyceride-rich lipoprotein constituents.

Arteriosclerosis

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

Artery

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A blood vessel that carries blood from the heart to other parts of the body.

Aspart insulin

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A type of insulin that starts to lower blood glucose within 5 to 10 minutes after injection and has its strongest effect 30 minutes to 3 hours after injection, depending on the type used.

Aspartate transaminase and aspartate aminotransferase (AST)

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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

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Aspirin, or acetylsalicylic acid (acetosal), is a drug in the family of salicylates, often used as an analgesic (to releve minor aches and pains), antipyretic (to reduce fever), and anti-inflammatory (to reduce inflammation). 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 statees (eg, in cancer).

Atherogenesis

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The formation of atheromatous lesions in the arterial intima.

Atherosclerosis

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

Atherosclerosis Risk in Communities (ARIC) Study

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A prospective epidemiological trial conducted in four US communities that investigated the etiology and natural history of atherosclerosis; the etiology of clinical athersclerotic diseases; and variation in cardiovascular risk factors, medical care, and disease by race, gender, location, and date.

Atherosclerotic cardiovascular disease (ASCVD)

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Coronary death, nonfatal myocardial infarction, or fatal or nonfatal stroke

Atorvastatin

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A drug in the statin (HMG-CoA reductase inhibitor) class that is indicated to treat high cholesterol as an adjunct to diet, and to reduce cardiovascular disease.

ATP III

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The Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III, or ATP III) provides recommendations for cholesterol testing and management from the National Cholesterol Education Program (NCEP). It is similar to Adult. It focuses on the role of the clinical approach to prevention of coronary heart disease (CHD) and identifies low-density lipoprotein (LDL) as the primary target of cholesterol-lowering therapy.

Autoimmune disease

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

Bariatric surgery

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Bariatric surgery, or weight-loss surgery, includes a variety of procedures aimed at reducing weight among people who are obese. The size of the stomach is reduced with a gastric band or via excision of a portion of the stomach, or by re-secting and re-routing the small intestines to a stomach pouch. 

 

Basal insulin

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A type of long-acting insulin that works to control insulin levels over a 24-hour period.

Basal rate

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The amount of insulin required to manage normal daily blood glucose fluctuations.

Beta-adrenergic blocking agents

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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.

Beta-cells

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A type of cell found in an area of the pancreas called the islets of Langerhans, beta-cells make and release insulin. These cells fail as type 2 diabetes progresses in the body.

Bezafibrate

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An oral medication of the fibrate class, it is mainly used with dietary 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.

Biguanides

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A class of oral antihyperglycemic agents that act mainly by suppressing hepatic glucose production and do not directly affect insulin production.

Bile-acid sequestrants

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A class of lipid-lowering agents that may be used for glucose lowering (in some cases, use may be off-label).

Blood glucose level

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The concentration of glucose ("blood sugar") in the bloodstream. Blood glucose (plasma) 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 (FPG) level of <100 mg/dL is considered normal based on clinical recommendations from the American Diabetes Association. Elevated levels of glucose may be indicative of diabetes. See fasting plasma glucose test, hyperglycemia, oral glucose tolerance test.

Blood pressure (BP)

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Pressure exerted by circulating blood upon the walls of blood vessels.

Blood urea nitrogen (BUN)

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A product of metabolism that is excreted in the urine. It is measured in the blood as an indirect measure of how well the kidney is functioning. Increased BUN levels in the blood may indicate kidney damage.

Body mass index (BMI)

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

Bromocriptine

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An oral antihyperglycemic agent of the dopamine receptor agonist class. Bromocriptine may also be used to treat hyperprolactinemia, acromegaly, and Parkinson’s Disease; refer to full prescribing information for indications and usage.

Calcium channel blocker

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An agent used to decrease elevated blood pressure in patients with hypertension.

Canagliflozin

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An oral antihyperglycemic agent of the sodium-glucose co-transporter 2 (SGLT2) inhibitor class.

Cardiometabolic disease

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A disease state that collectively represents diabetes, cardiovascular disease, and obesity. Cardiometabolic disease includes hypertension, type 2 diabetes, dyslipidemia, and excess body fat—individually and collectively, risk factors for cardiovascular disease.

 

Cardiomyopathy

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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.

Cardiovascular disease (CVD)

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A constellation of diseases that affect the heart or blood vessels (veins and arteries), including atherosclerosis, arteriosclerosis, coronary heart disease (CHD), coronary artery disease (CAD), stroke, and heart failure, among others.

Carotid intima-media thickness (CIMT)

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A measurement of the thickness of the two inner layers of the carotid artery (the intima and the media).

CCB

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Abbreviation for calcium channel blocker.

Cerebrovascular disease

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Group of brain dysfunctions related to disease of the blood vessels supplying the brain. Hypertension is the most important risk factor.

Cholesterol

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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.)

Cholesterol-absorption inhibitors

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Class of lipid-lowering agents that prevents the uptake of cholesterol from the small intestine into the circulatory system.

Cholestyramine

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A bile-acid sequestrant used to treat elevated cholesterol.

Chronic kidney disease (CKD)

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Condition characterized by the retention of fluids and harmful wastes as a result of the kidneys no longer work properly. See also diabetic nephropathy.

Chylomicron

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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.

CIMT

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Abbreviation for carotid intima-media thickness.

Clopidogrel

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An oral antiplatelet agent of the thienopyridine class used to inhibit blood clots in coronary artery disease (CAD), peripheral vascular disease (PVD), and cerebrovascular disease.

Coagulation

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

Cognitive dysfunction

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Loss of intellectual functions, such as thinking, remembering, and reasoning of sufficient severity to interfere with daily functioning. Patients with cognitive dysfunction have trouble with verbal recall, basic arithmetic, and concentration. Cognitive dysfunction is known to be a consequence of hypoglycemia.

Colesevelam

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A bile-acid sequestrant used to treat elevated cholesterol and improve glycemic control in adults with type 2 diabetes.

Colestipol

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A bile-acid sequestrant used to treat elevated cholesterol.

Collaborative Atorvastatin Diabetes Study (CARDS)

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A study that compared treatment with the cholesterol-lowering agent, atorvastatin, with placebo among patients with type 2 diabetes but without overt cardiovascular disease (CVD).

Combination therapy

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The combination of different antihyperglycemic medications glucose levels among patients with type 2 diabetes.

Continuous subcutaneous insulin infusion (CSII)

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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.

Coronary artery bypass graft (CABG)

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Also referred to as coronary artery bypass surgery, CABG is a surgery performed to alleviate angina (chest pain due to lack of blood to the heart muscle) and reduce the risk of death from coronary artery disease (CAD).

Coronary artery calcium (CAC)

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Calcium that develops the walls of the coronary (heart) arteries. These calcium deposits are called calcifications; they are early signs of coronary heart disease. 

 

Coronary artery disease (CAD)

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A disorder of the arteries of the heart, usually resulting from atherosclerosis, a disorder of the arteries in which deposits (plaques) of cholesterol, lipids, and cellular debris line the inner layers of anterial walls.

Coronary heart disease (CHD)

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Narrowing or blockage of the coronary arteries typically caused by atherosclerosis, a disorder of the arteries in which deposits (plaques) of cholesterol, lipids, and cellular debris line the inner layers of anterial walls.

Coronary plaque

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Atheromatous plaque that accumulates in the walls of the coronary arteries, resulting in coronary artery disease (CAD).

 

Coronary revascularization

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Any cardiology procedure, including coronary artery bypass graft (CABG), percutaneous coronary angiography (PTCA), or stenting, that is intended to increase blood flow to the coronary arteries.

C-peptide

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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 (CRP)

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A protein found in the blood; levels of this protein rise in response to inflammation. Although inflammation is a normal response to many physical states, its presence plays a role in the initiation and progression of cardiovascular disease (CVD).

Creatinine

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A waste product derived from the activity of the muscles that is normally excreted by the kidneys. Excess creatinine in the blood signals that the kidneys are losing their ability to function normally.

Creatinine clearance test

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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.

CYCLOSET® (bromocriptine mesylate)

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See bromocriptine. Refer to full prescribing information.

Dabigatran

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An oral anticoagulant from the class of the direct thrombin inhibitors.

Dapagliflozin

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An oral antihyperglycemic agent of the sodium-glucose co-transporter 2 (SGLT2) inhibitor class.

Dawn phenomenon

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

DCCT

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Abbreviation for the Diabetes Control and Complications Trial. DCCT was a landmark clinical trial, which showed that control of blood glucose to a level as normal as possible slows the onset and progression of microvascular complications, including retinopathy, nephropathy, and neuropathy.

DiaBeta® (glyburide)

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See glyburide. Refer to full prescribing information.

Diabetes complications

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See microvascular complications of diabetes and macrovascular complications of diabetes.

Diabetes mellitus

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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.)

Diabetes Prevention Program (DPP)

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A randomized, controlled trial that investigated whether lifestyle changes or metformin therapy compared with placebo could prevent or delay the onset of type 2 diabetes among patients with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). Over 2.8 years of follow-up versus placebo, lifestyle intervention reduced the incidence of type 2 diabetes by 58%; metformin reduced the incidence of type 2 diabetes by 31%.

Diabetes Self-Management Education (DSME)

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Process of facilitating knowledge, skill, and ability needed for diabetes self-care

Diabetic coma

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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, death will occur.

Diabetic ketoacidosis

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A serious condition that develops when the body produces high levels of acids called ketones in the blood.

Diabetic retinopathy

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

Diastolic blood pressure (DBP)

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The time when the heart is in a period of relaxation and dilatation (expansion)

Dipeptidyl peptidase-4 (DPP-4)

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A naturally occurring enzyme responsible for the activation of glucagon-like peptide (GLP)-1, as well as numerous other proteins. Also referred to as dipeptidyl peptidase-IV (DPP-IV).

Dipeptidyl peptidase-4 (DPP-4) inhibitors

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A class of oral antihyperglycemic agents that inhibit the activity of DPP-4. Also referred to as dipeptidyl peptidase-IV (DPP-IV) inhibitors.

Direct thrombin inhibitors

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A class of anticoagulation agents that directly inhibit the enzyme, thrombin.

Diuretics

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Antihypertensive agents that help rid the body of sodium and water. The sodium, in turn, takes water with it from your blood. Three types: loop diuretic, thiazide-type diuretics, and potassium-sparing diuretics.

Dopamine receptor agonists

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A class of agents that activate post-synaptic dopamine receptors. Agents in this class may be used to treat type 2 diabetes, as well as hyperprolactinemia, acromegaly, and Parkinson’s Disease; refer to full prescribing information for indications and usage.

DPP-4

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Abbreviation for dipeptidyl peptidase-4. Also referred to as dipeptidyl peptidase-IV (DPP-IV).

DPP-4 inhibitors

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A class of oral antihyperglycemic agents that inhibit the activity of DPP-4.

Dual PPAR agonist

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Investigational compound with insulin-sensitizing and glucose-lowering effects, as well as metabolic and lipid effects.

Dulaglutide

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An injectable antihyperglycemic agent of the glucagon-like peptide-1 (GLP-1) class.

DURATION

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A series of clinical trials comparing extended-release exenatide, and injectable agent for the treatment of type 2 diabetes, with other antihyperglycemic agents. 

Dyslipidemia

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An abnormal amount of lipids, including cholesterol and fat, in the blood. 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.

EASD

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Abbreviation for the European Association for the Study of Diabetes.

ELIXA

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Cardiovascular safety study of the investigational GLP-1 receptor agonist, lixisenatide. ELIXA is an acronym for Evaluation of Cardiovascular Outcomes in Patients With Type 2 Diabetes After Acute Coronary Syndrome During Treatment With Lixisenatide.

Empagliflozin

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An oral antihyperglycemic agent of the sodium-glucose co-transporter 2 (SGLT2) inhibitor class, marketed as Jardiance® (empagliflozin), that is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. Refer to full prescribing information.

EMPA-REG OUTCOME

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The cardiovascular outcomes trial (CVOT) for the SGLT2 inhibitor, empagliflozin. The study randomized 7,020 subjects with type 2 diabetes and established CVD who were on standard care to empagliflozin 10 mg, empagliflozin 25 mg, or placebo. Follow-up occurred over a median of 3.1 years.

Endocrine Society Diabetes and Pregnancy Guidelines

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Guidelines for diabetes and pregnancy from the Endocrine Society

Endogenous insulin

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

Endothelial dysfunction

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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.

Endothelin

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

Endothelium

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

End-stage renal disease (ESRD)

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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.

Epidemiology of Diabetes Interventions and Complications (EDIC)

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Long-term observational follow-up (mean 17 years) to the Diabetes Control and Complications Trial (DCCT), which studied whether the use of intensive therapy as compared with conventional therapy affected the incidence of cardiovascular disease (CVD) in patients with type 1 diabetes.

Epinephrine

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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.

Eptifibatide

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An oral antiplatelet agent of the glycoproetin (Gp) IIb/IIIa inhibitor class.

ESRD

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Abbreviation for end-stage renal disease.

Euglycemia

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

Euglycemic clamp studies

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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.

Evolocumab

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An injectable monoclonal antibody of the PCSK9 inhibitor class for the treatment of an inherited form of dyslipidemia called familial hypercholesterolemia (FH). Marketed as Repatha®.

EXAMINE

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Cardiovascular safety study of the DPP-4 inhibitor, alogliptin. EXAMINE is an acronym for EXamination of CArdiovascular OutcoMes: AlogliptIN vs. Standard of CarE in Patients with Type 2 Diabetes Mellitus and Acute Coronary Syndrome.

Exchange lists

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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

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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 (GLP)-1 receptor agonist and belongs in a class of drugs called incretins.

Exogenous insulin

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Insulin administered by injection or infusion. 

Ezetimibe

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A cholesterol-absorption inhibitor used to treat elevated cholesterol.

Familial hypercholesterolemia (FH)

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A genetic disorder characterized by high cholesterol levels, specifically levels of LDL-C, and early cardiovascular disease.

Fasting plasma glucose (FPG)

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Glucose concentration in plasma obtained after an 8- to 10-hour overnight fast. A fasting plasma glucose (FPG) level <100 mg/dL is considered normal; 101-125 mg/dL, indicates impaired glucose tolerance (IGT); ≥126 mg/dL, frank diabetes if the level is reproducible and not found during an acute illness.

Fasting plasma glucose (FPG) test

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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.

Fenofibrate

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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.

Fibrates

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Class of lipid-lowering agents.

Fluvastatin

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A drug in the statin (HMG-CoA reductase inhibitor) class that is indicated to treat high cholesterol as an adjunct to diet, and to reduce cardiovascular disease.

Free fatty acid (FFA)

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

Galvus® (vildagliptin)

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See vildagliptin. Refer to full prescribing information.

Gastric banding

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A weight-loss procedure hat involves placing an inflatable silicone device around the top portion of the stomach to treat obesity.

 

Gastric bypass surgery

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A type of weight-loss surgery that re-sects and re-routes the small intestines to a stomach pouch. 

Gemfibrozil

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An oral medication of the fibrate class, it is mainly used with dietary 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-al

Gestational Diabetes Mellitus (GDM)

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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.

Glimepiride

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A type of oral antihyperglycemic agent of the sulfonylurea class that stimulates insulin secretion from the pancreatic beta-cells. It is indicated as an adjunct to diet and exercise to lower blood glucose levels among patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Refer to full prescribing information.

Glimepiride and rosiglitazone

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Combination sulfonylurea and thiazolidinedione for glycemic control in type 2 diabetes. Rosiglitazone use restricted in the United States.

Glipizide

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A type of oral antihyperglycemic agent of the sulfonylurea class that stimulates insulin secretion from the pancreatic beta-cells. It is indicated as an adjunct to diet and exercise to lower blood glucose levels among patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Refer to full prescribing information.

Glipizide and metformin

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Combination sulfonylurea and biguanide for glycemic control in type 2 diabetes.

Gliptins

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See dipeptidyl peptidase-IV (DPP-IV) inhibitors

Glomerular filtration rate (GFR)

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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.

GLP-1

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Abbreviation for glucagon-like peptide-1.

Glucagon

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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.

Glucagon-like peptide-1 (GLP-1)

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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.

Glucagon-like peptide-1 (GLP-1) receptor agonists

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Class of injectable treatments for type 2 diabetes that acts as an agonist of the GLP-1 receptor.

Gluconeogenesis

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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).

Glucophage® (metformin)

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See metformin. Refer to full prescribing information.

Glucose disposal rate

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

Glucose homeostasis

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

Glucose tolerance test

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See oral glucose tolerance test.

Glucose-dependent insulinotropic polypeptide (GIP)

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

Glucosuria

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The excretion of glucose into the urine.

Glucotrol® (glipizide)

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See glipizide. Refer to full prescribing information.

GLUCOVANCE® (glyburide and metformin)

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See glyburide and metformin. Refer to full prescribing information.

Glumetza® (metformin)

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See metformin. Refer to full prescribing information.

Glyburide

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A type of oral antihyperglycemic agent of the sulfonylurea class that stimulates insulin secretion from the pancreatic beta-cells. It is indicated as an adjunct to diet and exercise to lower blood glucose levels among patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Refer to full prescribing information.

Glycated hemoglobin

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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 A1c (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%.

Glycemia

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

Glycogen

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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.

Glycoprotein IIb/IIIa inhibitors

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A class of antiplatelet agents.

Glycosuria

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See glucosuria.

Heart attack

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Damage to the heart muscle caused when blood vessels supplying the muscle are blocked. See also myocardial infarction.

Heart failure

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Inability of the heart to provide sufficient pump action to distribute blood flow to meet the needs of the body.

Heparin

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An injectable anticoagulant medication.

High-density lipoprotein cholesterol (HDL-C)

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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.

HMG-CoA reductase inhibitors

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Agents used to lower serum cholesterol as a means of reducing the risk for cardiovascular disease (CVD). Also see Statins.

Homeostasis model assessment-beta-cell function (HOMA-BCF)

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An empirical mathematical formula based on fasting plasma glucose (FPG) and fasting plasma insulin levels that was developed as a surrogate measurement of beta-cell function.

Homeostasis model assessment-insulin resistance (HOMA-IR)

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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.

Homocysteine

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

Hormone-sensitive lipase

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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.

Human recombinant insulin

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Bio-engineered insulin very similar to insulin made by the body. The DNA code for making human insulin is put into bacteria or yeast cells and the insulin made is purified and sold as human insulin.

Hypercalcemia

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An elevated level of calcium in the blood

Hypercholesterolemia

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Levels of cholesterol in the blood that are higher than normal.

Hyperglycemia

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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.

Hyperglycemic hypersmolar nonketotic coma

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

Hyperinsulinemia

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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.

Hyperlipidemia

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An elevation of any or all lipids or lipoproteins in the blood, hyperlipidemia is the most common form of dyslipidemia.

Hypertension

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A condition in which the blood pressure in the arteries is elevated. Primary hypertension refers to elevated blood pressure with no underlying causes; often referred to as essential hypertension. Secondary hypertension is caused by other conditions.

Hypertriglyceridemia

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An elevation of triglycerides in the blood, hypertriglyceridemia is ofen associated with atherosclerosis.

Hyperuricemia

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Elevated levels of uric acid or urates in the blood.

Hypoglycemia

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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.

Hypotension

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Low blood pressure or a sudden drop in blood pressure.

IDegLira

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An investigational combination of ultra–long-acting insulin degludec and the GLP-1 receptor agonist, liraglutide.

IDF

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Abbreviation for the International Diabetes Federation. The IDF has created several guideline papers for the management of type 2 diabetes.

IFG

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Abbreviation for impaired fasting glucose. IFG is 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. See also Prediabetes.

IGT

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Abbreviation for impaired glucose tolerance. IGT is 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. See also Prediabetes.

IHD

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Abbreviation for ischemic heart disease.

IMPROVE-IT

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Double-blind, randomized trial of 18,144 individuals with ACS who were assigned combination simvastatin + ezetimbe or simvastatin alone to determine whether ezetimibe had an effect on a composite of cardiovascular death, myocardial infarction, documented unstable angina requiring hospitalization, coronary revascularization after 1 month of treatment, or stroke.

Incretin

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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.

Incretin effect

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

Incretin mimetics

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A class of agents for the treatment of type 2 diabetes. Incretin mimetics mimic the enhancement of glucose-dependent insulin secretion, as well as other glucoregulatory actions of incretin hormones. The dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists are incretins.

Inflammation

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Part of the biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants.

Insulin

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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.

Insulin analog

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A man-made form of insulin that performs in the human body with the same action as human insulin in terms of glycemic control. Also known as insulin receptor ligand.

Insulin aspart

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A rapid-acting insulin for glycemic control in diabetes.

Insulin detemir

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A long-acting insulin for glycemic control in diabetes.

Insulin glargine

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A long-acting insulin for glycemic control in diabetes.

Insulin glulisine

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A rapid-acting insulin for glycemic control in diabetes.

Insulin lispro

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A rapid-acting insulin for glycemic control in diabetes.

Insulin pump

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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.)

Insulin resistance

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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.

Intensive therapy

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Treatment for diabetes in which blood glucose is kept as close to normal as possible through a combination of diabetes therapies, both oral and injectable.

Interleukin-6 (IL-6)

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

Intermediate-acting insulin

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A type of insulin that starts to lower blood glucose within 1 to 2 hours after injection and has its strongest effect 6 to 12 hours after injection, depending on the type used.

Ischemic heart disease (IHD)

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

Islets of Langerhans

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

JNC 7

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Guidelines for hypertension management from The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7).

JNC 8

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Guidelines for hypertension management from The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 8).

JUPITER Study

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Abbreviation for the Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin study.

Ketoacidosis

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See Diabetic Ketoacidosis

Kidney disease

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See also Nephropathy.

L-cell

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A type of cell foundin the gut that is responsible for the secretion of glucagon-like peptide (GLP)-1.

LDL-C

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Abbreviation for low-density lipoprotein cholesterol, 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.

Lifestyle modifications

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Nonpharmacologic measures that contribute to a healthier lifestyle and may reduce an individual's risk for, or prevent the development of, medical conditions, including type 2 diabetes, hypertension, dyslipidemia, obesity, and cardiovascular disease (CVD).

Linagliptin

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An oral antihyperglycemic agent of the dipeptidyl peptidase-4 (DPP-4) inhibitor class.

Lipid

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A water-insoluble fatty substance. An abnormal amount of lipids in the blood is a condition called dyslipidemia.

Lipoprotein

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

Liraglutide

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A glucagon-like peptide (GLP)-1 receptor agonist, marketed as Victoza, indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.

Liraglutide 3.0 mg is marketed as Saxenda and is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obese) or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, type 2 diabetes, or dyslipidemia.

LixiLan

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An investigational combination of the GLP-1 receptor agonist, lixisenatide, and long-acting insulin glargine.

Lixisenatide

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An investigational compound of the GLP-1 receptor agonist class for the treatment of type 2 diabetes

Long-acting insulin

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Insulin suspension with a prolonged action. An injection takes effect within 8 hours, reaches a peak of action in 16 to 24 hours, and has a duration of action of more than 36 hours.

Look AHEAD

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Compared the effects of intensive lifestyle management with diabetes education on weight loss and cardiovascular outcomes among overweight/obese patients with type 2 diabetes.

Lorcaserin hydrochloride

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Agent used to treat obesity.

Lovastatin

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A drug in the statin (HMG-CoA reductase inhibitor) class that is indicated to treat high cholesterol as an adjunct to diet, and to reduce cardiovascular disease.

Low molecular weight heparin

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A class of anticoagulation agents.

Macrovascular complications of diabetes

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Complications from diabetes can be classified broadly as microvascular or macrovascular disease. Macrovascular complications include heart disease, stroke, and peripheral vascular disease (PVD).

Medical nutrition therapy for type 2 diabetes

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Approach to treating type 2 diabetes and associated symptoms via the use of a specifically tailored diet devised and monitored by a registered dietician. The goal of medical nutrition therapy (MNT) is reducing the risk of diabetes complications.

Mediterranean diet

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A style of diet typical of Mediterranean countries (Greece, southern France, Italy, Spain) that emphasizes high consumption of fruits, vegetables, grains, beans, nuts; medium amounts of fish and seafood; medium-to-low amounts of poultry, eggs, cheese and yogurt; low amounts of meat and sweets; and moderate amounts of red wine.

Meglitinides

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A class of oral antihyperglycemic agents.

Metabolic syndrome

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Medical conditions that, when taken together, increase the risk for type 2 diabetes and/or cardiovascular disease (CVD). Defining criteria from the American Heart Association and National Cholesterol Education Program include: 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 or treatment of previously diagnosed hypertension; and fasting plasma glucose (FPG) ≥100 mg/dL or previously diagnosed type 2 diabetes.

Metformin

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An oral antihyperglycemic agent of the biguanide class used to treat type 2 diabetes.

Micronase® (glyburide)

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See glyburide. Refer to full prescribing information.

Microvascular complications of diabetes

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Complications from diabetes can be classified broadly as microvascular or macrovascular disease. Microvascular complications include neuropathy (nerve damage), nephropathy (kidney disease), and vision disorders (retinopathy, glaucoma, cataract and corneal disease).

Miglitol

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An absorbable alpha-glucosidase inhibitor indicated as monotherapy as an adjunct to diet and exercise to lower blood glucose among patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone.

Monogenic diabetes

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Maturity onset diabetes of the young (MODY) refers to any of several hereditary forms of diabetes caused by mutations in an autosomal dominant gene disrupting insulin production.

Monounsaturated fat

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A type of fat found in a variety of foods and oils. Diets rich in monounsaturated fats (MUFAs) improves cholesterol levels, which can decrease cardiovascular disease (CVD) risk.

Morbidity rate

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

Mortality rate

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

Myocardial infarction

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

Myocardial perfusion

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Blood flow to the heart muscle.

Naltrexone/Bupropion

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A combination drug treatment for obesity

Nateglinide

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An oral antihyperglycemic agent of the meglitinide class that is used to treat type 2 diabetes.

Nephropathy

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Kidney disease resulting from chronic 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.

Neuropathy

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Damage to the nervous system resulting from chronic poorly controlled diabetes. Four different forms of neuropathy can be distinguished: peripheral sensorimotor neuropathy, autonomic neuropathy, mononeuritis simplex, and polyradiculopathy. Peripheral sensorimotor and autonomic neuropathies are much more common than mononeuritis simplex and polyradiculopathy. 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.

NHANES

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Abbreviation for the National Health and Nutrition Examination Survey, a program of studies designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews and physical examinations.

Niacin

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Lipid-lowering agent; also called nicotinic acid.

Normoglycemia

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

Obesity

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

Omega-3 fatty acids

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Lipid-lowering agents; also called n-3 fatty acids.

Oral glucose tolerance test (OGTT)

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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.

ORIGIN

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A randomized, double-blind trial with a 2X2 factorial design that enrolled 12,537 patients who were at high risk for CV events and who had IFG, IGT, or newly diagnosed diabetes. The factorial design of ORIGIN allowed for examination of two interventions in a single study. Via two arms, the study investigated whether insulin replacement therapy with insulin glargine targeting fasting normoglycemia (FPG ≤95 mg/dL) reduces CV outcomes more than standard approaches, and whether the addition of omega-3 fatty acids reduces CV death.

Orlistat

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Agent used to treat obesity.

Overweight

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An above-normal body weight; having a body mass index (BMI) of 25 to 29.9 kg/m2.

Oxidative stress

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The stress associated with defense against elevated and prolonged exposure to chemical species capable of an oxidizing reaction. The factorial design of ORIGIN allowed for investigation of two interventions in a single study. Via two arms, the study investigated whether insulin replacement therapy with insulin glargine targeting fasting normoglycemia (FPG ≤95 mg/dL) reduces

PAD

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Abbreviation for peripheral artery disease. PAD refers to arteriosclerosis of the vessels distant from the heart, often seen as impaired circulation to the legs

PAI-1

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Abbreviation for plasminogen activator inhibitor (PAI) type 1.

Pancreas

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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.

Pancreatitis

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Inflammation of the pancreas

PCI

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Abbreviation for percutaneous coronary intervention.

PCOS

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Abbreviation for polycystic ovary syndrome, 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.

PCSK9 inhibitors

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Injectable class of monoclonal antibodies that work by inactivating a protein in the liver called proprotein convertase subtilisin kexin 9 (PCSK9).

Percutaneous coronary intervention (PCI)

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Non-surgical procedure used to treat the stenotic (narrowed) coronary arteries of the heart found in coronary heart disease (CHD).

Peripheral vascular disease (PVD)

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

Phentermine/Topiramate

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A treatment for chronic weight management, marketed as Qsymia® (phentermine and topiramate extended release), that is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial BMI of ≥30 kg/m2 (obese) or ≥27 kg/m2 (overweight) in the presence of at least one weight-related comorbidity (hypertension, type 2 diabetes, dyslipidemia). Refer to full prescribing information.

Physical activity

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Any body movement that works the muscles and requires more energy than resting. Exercise, such as aerobic or “cardio” activities or muscle-strengthening activities, is a type of physical activity.

Pioglitazone

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

Pioglitazone and glimepiride

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Combination sulfonylurea and thiazolidinedione (TZD) oral medication for glycemic control in type 2 diabetes.

Pioglitazone and metformin

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Combination sulfonylurea and biguanide for glycemic control in type 2 diabetes.

Pitavastatin

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A drug in the statin (HMG-CoA reductase inhibitor) class that is indicated to treat high cholesterol as an adjunct to diet.

Plasma

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

Plasminogen activator

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

Plasminogen activator inhibitor (PAI) type 1

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

Platelet

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

Polydipsia

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Increased thirst, a symptom of uncontrolled diabetes.

Polyunsaturated fat

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A type of fat found mostly in plant-based foods and oils. Diets rich in polyunsaturated fats (PUFAs) have been found to improve cholesterol levels, which can decrease cardiovascular disease (CVD) and type 2 diabetes risk. PUFAs may also help decrease the risk of type 2 diabetes.

Polyuria

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

Postprandial

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Occurring after a meal.

Postprandial glucose

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The level of sugar in the blood after a meal.

PPAR

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Abbreviation for peroxisome proliferator-activated receptor. PPAR is 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. There are three known subtypes of PPARs-PPAR-alpha, PPAR-gamma, and PPAR-delta. Also referred to as PPAR ligand.

Pramlinitide

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Injectable amylin mimetic for the treatment of type 2 diabetes.

Prasugrel

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An oral antiplatelet agent of the thienopyridine class used to inhibit blood clots in coronary artery disease (CAD), peripheral vascular disease (PVD), and cerebrovascular disease.

Pravastatin

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A drug in the statin (HMG-CoA reductase inhibitor) class that is indicated to treat high cholesterol as an adjunct to diet, and to reduce cardiovascular disease.

Prediabetes

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A condition in which blood sugar is high, but not high enough to be diagnosed as type 2 diabetes.

Primary prevention

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Actions taken before the onset of a disease; primary prevention aims to prevent a disease from occurring.

PROactive

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Abbreviation for the Prospective Pioglitazone Clinical Trial in Macrovascular Events study.

Proinsulin

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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.

Prospective Pioglitazone Clinical Trial in Macrovascular Events (PRO active) study

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Multicenter, double-blind, placebo-controlled, randomized study designed to investigate whether the addition of pioglitazone to the usual medication regimen of the high-risk patient with type 2 diabetes and cardiovascular disease (CVD) can reduce total mortality and macrovascular morbidity.

Proteinuria

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

Rapid-acting insulin

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A type of insulin that starts to lower blood glucose within 5 to 10 minutes after injection and has its strongest effect 30 minutes to 3 hours after injection, depending on the type used.

RECORD

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Abbreviation for the Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycemia in Diabetes study. RECORD was a 6-year, randomized, open-label, parallel-group study that evaluated the long-term effects of rosiglitazone in combination with glucose-lowering therapy on cardiovascular outcomes and glycemic control among people with type 2 diabetes.

Renal

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Pertaining to the kidney.

Renin

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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.

Repaglinide

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An oral antihyperglycemic agent of the meglitidine class that 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.

Reperfusion injury

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

Retinopathy

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

Revascularization

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See coronary revascularization.

Rosiglitazone

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An oral antihyperglycemic agent of the thiazolidinedione class that is indicated as an adjunct to diet and exercise to improve glycemic control among adults with type 2 diabetes. Restricted use in the United States.

Rosuvastatin

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A drug in the statin (HMG-CoA reductase inhibitor) class that is indicated to treat high cholesterol as an adjunct to diet, and to reduce cardiovascular disease.

Roux-en-y

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 A type of bariatric, or wight-loss, surgery that involves re-secting and re-routing the small intestines to a stomach pouch. 

 

Saturated fat

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A type of fat that consists of triglycerides containing only saturated fatty acids.

SAVOR-TIMI 53

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Cardiovascular safety study of the DPP-4 inhibitor, saxagliptin. SAVOR-TIMI 53 is an acronym for Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus–Thrombolysis in Myocardial Infarction 53.

Saxagliptin

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An oral antihyperglycemic agent of the dipeptidyl peptidase-4 (DPP-4) inhibitor class.

Saxagliptin and metformin

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Combination dipeptidyl peptidase-4 (DPP-4) inhibitor and biguanide product for glycemic control in type 2 diabetes.

Secondary prevention

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Any form of intervention to reduce risk and/or prevent the reoccurrence of a cardiac event in individuals with an existing history of the disease.

SGLT2

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Abbreviation for sodium-glucose co-transporter 2.

SGLT2 inhibitors

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A class of oral antihyperglycemic agents that work by blocking the reabsorption of filtered glucose in the kidneys.

Short-acting insulin

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See rapid-acting insulin.

Simvastatin

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A drug in the statin (HMG-CoA reductase inhibitor) class that is indicated to treat high cholesterol as an adjunct to diet, and to reduce cardiovascular disease.

Sitagliptin

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An oral antihyperglycemic agent of the dipeptidyl peptidase-4 (DPP-4) inhibitor class.

Sitagliptin and simvastatin

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Combination dipeptidyl peptidase-4 (DPP-4) inhibitor and statin for glycemic control and lipid lowering in type 2 diabetes.

Sliding-scale insulin (SSI)

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The progressive increase in the premeal or nighttime insulin dose, based on predefined blood glucose ranges. Sliding scale insulin regimens approximate daily insulin requirements.

Statins

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Agents used to lower serum cholesterol as a means of reducing the risk for cardiovascular disease (CVD). Also known as statins. Also called HMG-CoA reductase inhibitors.

Stroke

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Condition caused by damage to blood vessels in the brain; may cause loss of ability to speak or to move parts of the body. A cerebrovascular disease.

Sulfonylureas

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A class of oral antihyperglycemic agents that stimulates insulin secretion from the pancreatic beta-cells.

Systolic blood pressure (SBP)

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The blood pressure when the heart is contracting

TECOS

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Cardiovascular safety study of the DPP-4 inhibitor, sitagliptin. TECOS is an acronym for Trial Evaluating Cardiovascular Outcomes with Sitagliptin.

Thienopyridine

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A class of ADP receptor/P2Y12 inhibitors used for their antiplatelet activity.

Thrombin

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The enzyme derived from prothrombin that converts fibrinogen to fibrin.

Thrombosis

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The formation, development or presence of a thrombus.

Thrombus

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

Ticagrelor

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An oral antiplatelet agent of the thienopyridine class used to inhibit blood clots in coronary artery disease (CAD), peripheral vascular disease (PVD), and cerebrovascular disease.

Ticlopidine

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An oral antiplatelet agent of the thienopyridine class used to inhibit blood clots in coronary artery disease (CAD), peripheral vascular disease (PVD), and cerebrovascular disease.

Tirofiban

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An oral antiplatelet agent of the glycoproetin (Gp) IIb/IIIa inhibitor class.

TNF-alpha

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

t-PA

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Abbreviation for tissue plasminogen activator, a serine endopeptidase synthesized by endothelial cells, the major physiologic activator of plasminogen.

Tradjenta™ (linagliptin)

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See linagliptin.Refer to full prescribing information.

Trans fats

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A type of fat that occurs naturally in some foods, especially foods from animals. Most trans fats are made during food processing through partial hydrogenation of unsaturated fats. Trans fat can increase LDL-C and decrease HDL-C, leading to increased cardiovascular disease (CVD) risk.

Triglyceride (TG)

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A lipid molecule composed of three fatty acids combined with glyceriol. 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.

Trulicity™ (dulaglutide)

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A glucagon-like peptide (GLP-1) receptor agonist indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.

Type 1 diabetes

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Diabetes resulting from autoimmune destruction of pancreatic beta-cells. Type 1 diabetes typically occurs before age 30 but can occur at any age. Because of the beta-cell destruction, endogenous insulin is very low or absent. Patinets require endogenous insulin to survive and to regulate blood glucose levels.

Type 2 diabetes

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Diabetes resulting from insulin resistance and inadequate insulin secretion. 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 remission

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A reversal of type 2 diabetes characterized by the absence of need to use antihyperglycemic medications to control blood glucose

TZD

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Abbreviation for thiazolidinedione, a class of oral antihyperglycemic agents that reduce insulin resistance.

UKPDS

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Abbreviation for the United Kingdom Prospective Diabetes Study. UKPDS was a landmark randomized, multi-center trial of glycaemic therapies among 5,102 patients with newly diagnosed type 2 diabetes. UKPDS ran for 20 years in 23 clinical sites in the United Kingdom. Data from UKPDS showed that complications of type 2 diabetes could be reduced by improving blood glucose and/or blood pressure control.

VADT

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Abbreviation for the Vetarans Affair Diabetes Trial, which investigated the impact of intensive and standard glucose control on cardiovascular events among military veterans who had a suboptimal response to antihyperglycemic therapy.

Vascular smooth muscle cell

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Type of smooth muscle found within and composing the majority of the wall of blood vessels.

Vasoconstriction

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

Vertical banded gastroplasty

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A type of bariatric, or weight-loss, surgery that restricts the stomach.

 

Very long-acting insulin

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A type of insulin that starts to lower blood glucose within 1 hour after injection and keeps working evenly for 24 hours after injection.

Very low-density lipoprotein (VLDL)

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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.

Very low-density lipoprotein cholesterol (VLDL-C)

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The fraction of circulatin cholesterol that is contained in VLDL particles.

Vildagliptin

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An oral antihyperglycemic agent of the dipeptidyl peptidase-4 (DPP-4) inhibitor class.

VLDL-C

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Abbreviation for very low-density lipoprotein-cholesterol.

von Willebrand factor

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

VSMC

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Abbreviation for vascular smooth muscle cell.

Warfarin

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An oral antiplatelet agent of the glycoproetin (Gp) IIb/IIIa inhibitor class.