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| 4S | |
Abbreviation for Scandinavian Simvastatin Survival Study. Related Slides: | |
| a-cells | |
| Cells found in the pancreas that secrete glucagon. In patients with type 2 diabetes, alpha cells often hypersecrete glucagon. | |
| a-glucosidase | |
| An enzyme that catalyzes the release of glucose from certain types of carbohydrates known as glucosides. | |
| a-glucosidase inhibitor | |
| A pharmacologic agent that inhibits the activity of a-glucosidase. Oral use of these agents results in a significant delay in the digestion of carbohydrates, with a significant decrease in the rise in plasma glucose after a mixed carbohydrate meal. | |
| A1C | |
| Formerly HbA1c. An abbreviation for hemoglobin A1C. (See glycosylated hemoglobin.) | |
| abciximab | |
| A glycoprotein IIb/IIIa receptor agonist that inhibits platelet aggregation. | |
| acanthosis nigricans | |
| A skin disease characterized by a hyperpigmentation and thickening of the skin. It may be associated with severe hyperinsulinemia and insulin resistance. | |
| acarbose | |
| An a-glucosidase inhibitor used in the treatment of type 2 diabetes mellitus. (See a-glucosidase inhibitor). | |
| Acarbose | |
| 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 cannot be controlled by diet and exercise alone. may also be used in combination with a when diet and exercise plus either or a does not result in adequate glycemic control. In addition, may be used in combination with or metformin. | |
| ACCORD | |
Full Name: Action to Control Cardiovascular Risk in Diabetes ACCORD was designed to determine 1) whether lowering blood glucose to a level closer to normal than called for in current guidelines reduces cardiovascular (CVD) risk (2) the effects of lowering blood pressure in the context of good blood sugar control, and (3) the effects of lowering LDL cholesterol and blood triglycerides and increasing HDL cholesterol compared to an intervention that only lowers LDL cholesterol, all in the context of good blood sugar control. | |
| ACE | |
| Abbreviation for angiotensin-converting enzyme. | |
| ACE inhibitor | |
| See angiotensin-converting enzyme inhibitor. | |
| ACT NOW | |
Full Name: Actos Now for Prevention of Diabetes A randomized, double-blind, placebo-controlled, parallel assignment, safety/efficacy study designed to examine whether pioglitazone versus placebo can reduce the conversion rate of impaired glucose tolerance to type 2 diabetes mellitus. ACT NOW commenced in 2004. A total of 600 participants were expected to enroll in this study. | |
| ADA Guidelines | |
| 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. | |
| adipose tissue | |
| A collection of fat cells. | |
| ADMIRAL | |
| Abbreviation for Abciximab before Direct Angioplasty and Stenting in Myocardial Infarction Regarding Acute and Long-Term Follow-up. | |
| adrenaline | |
| See epinephrine. | |
| adrenergic | |
| Refers to a type of nerve fiber of the autonomic nervous system. | |
| adrenergic blocking agent | |
|
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. | |
| advanced glycosylation endproduct (AGE) | |
| 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. | |
| AFCAPS/TexCAPS | |
| Abbreviation for Air Force/Texas Coronary Atherosclerosis Prevention Study. | |
| AGE | |
| Abbreviation for advanced glycosylation endproduct. | |
| alanine transaminase and alanine aminotransferase (ALT) | |
| 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. | |
| albumin | |
| albuminuria | |
| 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 | |
| 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. | |
| ALLHAT | |
| Abbreviation for Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. | |
| ALT | |
| Abbreviation for alanine transaminase and alanine aminotransferase. | |
| Amaryl | |
| (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 cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with when 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 cannot be controlled by diet and exercise alone. Glipizide, glyburide, or may be used in combination with when monotherapy fails to reduce symptoms and/or blood glucose levels. | |
| amyloid | |
| Protein deposits seen at autopsy in the pancreatic b-cells of up to 90% of patients with type 2 diabetes. | |
| angiotensin receptor blocker (ARB) | |
| 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. | |
| angiotensin-converting enzyme (ACE) | |
| 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 | |
| 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. | |
| Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) | |
| The ASCOT multicenter trial compared two antihypertensive treatment strategies to prevent coronary heart disease (CHD) in hypertensive patients (N=19,342) with no history of CHD. | |
| Anglo-Scandinavian Cardiac Outcomes Trial–Lipid-Lowering Arm (ASCOT-LLA) | |
| The lipid-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial was a randomized, double-blind, placebo-controlled study undertaken to examine whether lipid lowering with a statin provides additional benefits in treated hypertensive patients with total cholesterol concentrations not conventionally considered dyslipidemic. Despite the presence of 3 or more risk factors, these patients were deemed to be at moderate cardiovascular risk. The primary endpoint was nonfatal myocardial infarction (MI) (including silent MI) and fatal coronary heart disease. | |
| antibody | |
| A protein product of the lymphocyte cells of the blood that is produced in response to a foreign substance called an antigen. | |
| Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) | |
| This study compared lisinopril (an ACE inhibitor) and amlodipine (a calcium channel blocker) with chlorthalidone (a thiazide-type diuretic) to measure their efficacy in reducing clinical complications in normoglycemic (n=17,012) patients, patients with impaired fasting glucose (n=1,399), or with type 2 diabetes (n=13,101). The primary outcome measure was incidence of fatal coronary heart disease and nonfatal myocardial infarction. | |
| apoB | |
|
Abbreviation for apolipoprotein B. | |
| apoE | |
| Abbreviation for apolipoprotein E. | |
| apolipoprotein B (apoB) | |
|
The B apolipoproteins occur primarily in LDL and in lesser amounts in chylomicrons. | |
| apolipoprotein E (apoE) | |
| 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. | |
| apoptosis | |
| Programmed cell death. It is the body’s normal method of disposing of damaged, unwanted, or unneeded cells. | |
| ARB | |
| Abbreviation for angiotensin receptor blocker. | |
| ARIC | |
| Abbreviation for Atherosclerosis Risk in Communities. | |
| arteriosclerosis | |
| A group of diseases (including atherosclerosis) in which the arterial walls become thickened and lose elasticity. It is often associated with hypertension and diabetes. | |
| ASCOT | |
| Abbreviation for Anglo-Scandinavian Cardiac Outcomes Trial. | |
| ASCOT-LLA | |
| Abbreviation for Anglo-Scandinavian Cardiac Outcomes Trial—Lipid-Lowering Arm. | |
| aspartate transaminase and aspartate aminotransferase (AST) | |
| 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 | |
| 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). | |
| ASSENT-3 | |
| Abbreviation for Assessment of Safety and Efficacy of a New Thrombolytic Regimen. | |
| AST | |
| Abbreviation for aspartate transaminase and aspartate aminotransferase. | |
| atherogenesis | |
| The formation of atheromatous lesions in the arterial intima. | |
| atherosclerosis | |
| 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. | |
| autoimmune disease | |
| 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. | |
| autonomic nervous system | |
| The part of the nervous system involved in the regulation of involuntary functions. These include the activities of the heart and glands. | |
| b-adrenergic blocking agent | |
| 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. | |
| b-blocker | |
| See b-adrenergic blocking agent. | |
| b-cells | |
| The insulin and amylin producing cells in the pancreas. These cells fail as type 2 diabetes progresses in the body. | |
| BARI | |
| Abbreviation for Bypass Angioplasty Revascularization Investigation. | |
| BARI 2D | |
Full Name: Bypass Angioplasty Revascularization Investigation in Type 2 Diabetics The BARI 2D trial was a multicenter study that used a 2x2 factorial design, with patients assigned at randomization to initial elective revascularization with aggressive medical therapy or aggressive medical therapy alone with equal probability, and simultaneously assigned at randomization to an insulin providing or insulin sensitizing strategy of glycemic control (with a target value for A1C of <7.0% for all patients). This study was designed to determine in patients with type 2 diabetes and stable CAD: 1) the efficacy of initial elective coronary revascularization combined with aggressive medical therapy, compared to an initial strategy of aggressive medical therapy alone; and 2) the efficacy of a strategy of providing more insulin (endogenous or exogenous), versus a strategy of increasing sensitivity to insulin (reducing insulin resistance), in the management of hyperglycemia, with a target A1C level of < 7.0% for each strategy. BARI 2D commenced in 2000. A total of 2,800 patients were expected to enroll in this study. | |
| biguanide | |
| An antidiabetic agent that acts mainly by suppressing hepatic glucose production and does not directly affect insulin production. | |
| BIP | |
| Abbreviation for Bezafibrate Infarction Prevention. | |
| blood glucose level | |
| 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.) | |
| BMI | |
| Abbreviation for body mass index. | |
| body mass index (BMI) | |
| A calculated value (kg/m2) that describes weight in kilograms (kg) in relation to square of the height in meters (m). | |
| BUN | |
| Abbreviation for blood urea nitrogen. A measure of the kidneys' ability to excrete urea, the chief waste product of protein breakdown. | |
| Byetta | |
Exenatide is an injectable drug that reduces the level of glucose in the blood. It is used for treating type 2 diabetes. Exenatide 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 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. | |
| C-peptide | |
|
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 | |
|
C-reactive protein is an indicator of acute inflammation and is produced by the liver. | |
| CABG | |
|
Abbreviation for coronary artery bypass grafting. | |
| CAD | |
| Abbreviation for coronary artery disease. | |
| CADILLAC | |
| Abbreviation for Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications. | |
| calcium channel blocker (CCB) | |
| Antihypertensive agent. | |
| cardiac index (CI) | |
| 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. | |
| cardiomyopathy | |
| 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) | |
| Disease of the heart and blood vessels. | |
| CARDS | |
| Abbreviation for Collaborative Atorvastatin Diabetes Study. | |
| CCB | |
| Abbreviation for calcium channel blocker. | |
| CHARM | |
| Abbreviation for Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity. | |
| CHD | |
| Abbreviation for coronary heart disease. | |
| CHICAGO | |
Full Name: A Study of Pioglitazone HCl Versus Glimepiride in Subjects With Type 2 Diabetes Measuring the Progression of Atherosclerosis (CHICAGO) A double-blind, randomized, comparator-controlled study in subjects with type 2 diabetes comparing the effects of pioglitazone HCl versus glimepiride on the rate of progression of atherosclerotic disease as measured by carotid intima-media thickness. This study commenced in 2003. A total of 462 participants were expected to enroll in this study. | |
| cholesterol | |
| 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.) | |
| CHS | |
| Abbreviation for Cardiovascular Health Study. | |
| chylomicron | |
| 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. | |
| CI | |
| Abbreviation for cardiac index. | |
| coagulation | |
| The sequential process by which multiple coagulation factors of the blood interact, resulting in the formation of an insoluble fibrin clot. | |
| Collaborative Atorvastatin Diabetes Study (CARDS) | |
| The Collaborative Atorvastatin Diabetes Study was a primary cardiovascular prevention study using atorvastatin in patients with type 2 diabetes. Patients aged 40 to 75 years were randomized to atorvastatin 10 mg (n=1,428) or placebo (n=1,410) given once daily. The primary endpoint was occurrence of first acute cardiovascular event. | |
| congestive heart failure (CHF) | |
| A failing heart leads to congestion in the pulmonary or systemic circulation or both. | |
| continuous subcutaneous insulin infusion (CSII) | |
| 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 disease (CAD) | |
| 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. | |
| coronary heart disease (CHD) | |
| Disease of the arteries around and supplying blood to the heart muscle. | |
| CREATE-ECLA | |
| Abbreviation for Clinical Trial of Reviparin and Metabolic Modulation in Acute Myocardial Infarction Treatment Evaluation-Estudios Cardiologicos Latin America. | |
| creatinine clearance test | |
| 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. | |
| CRP | |
| Abbreviation for C-reactive protein. | |
| CSII | |
| Abbreviation for continuous subcutaneous insulin infusion. | |
| CVD | |
| Abbreviation for cardiovascular disease. | |
| dawn phenomenon | |
| A tendency for the body to require more insulin in the early hours of the morning than during the late evening and nighttime. | |
| DBP | |
| Abbreviation for diastolic blood pressure. | |
| DCCT | |
| Abbreviation for the Diabetes Control and Complications Trial. | |
| DiaBeta | |
| (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 cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with when 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 cannot be controlled by diet and exercise alone. Glipizide, glyburide, or may be used in combination with when monotherapy fails to reduce symptoms and/or blood glucose levels. | |
| Diabetes Control and Complications Trial (DCCT) | |
| A 10-year study of more than 1,400 people with type 1 diabetes that was sponsored by the National Institutes of Health. It showed that team management to achieve tight blood glucose control significantly reduces the risk of diabetic retinopathy, neuropathy, and nephropathy. | |
| diabetes mellitus | |
| 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) | |
| The US Diabetes Prevention Program was designed to compare incidence rates of diabetes among groups of individuals (N=3,234) with impaired glucose tolerance randomized to placebo, intensive lifestyle modification with diet and exercise, or metformin. | |
| diabetic coma | |
| 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. | |
| diabetic ketoacidosis (DKA) | |
| 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.) | |
| diabetic nephropathy | |
| 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. | |
| diabetic neuropathy | |
| 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. | |
| diabetic retinopathy | |
| Damage to retinal capillaries resulting from poorly controlled diabetes that can cause vision problems, including blindness. | |
| Diabinese | |
Sulfonylurea (Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells. | |
| dipeptidyl peptidase-IV (DPP-IV) | |
| A naturally occurring enzyme responsible for the inactivation of GLP-1, as well as numerous other proteins. | |
| dipeptidyl peptidase-IV (DPP-IV) inhibitor | |
| A new class of agents under development that inhibit the activity of DPP- IV. | |
| DKA | |
| Abbreviation for diabetic ketoacidosis. | |
| DPP | |
| Abbreviation for Diabetes Prevention Program. | |
| DPP-IV | |
| Abbreviation for dipeptidyl peptidase-IV. | |
| DREAM | |
|
Full name: The DREAM (Diabetes Reduction Assessment With Ramipril and Rosiglitazone Medication) Trial | |
| dyslipidemia | |
| 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. | |
| EDIC | |
| Abbreviation for Epidemiology of Diabetes Interventions and Complications study. | |
| end-stage renal disease (ESRD) | |
| 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. | |
| endogenous insulin | |
| 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. | |
| endothelial dysfunction | |
| 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 | |
| A vasoconstricting polypeptide, produced by endothelial cells that also may function as a neurotransmitter. | |
| endothelium | |
| The layer of endothelial cells lining the cavities of the heart and of the blood and lymph systems. | |
| Epidemiology of Diabetes Interventions and Complications (EDIC) | |
| The Epidemiology of Diabetes Interventions and Complications study is a 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 in patients with type 1 diabetes. Ninety-seven percent of the original DCCT cohort joined the EDIC follow-up (N=1,394). | |
| epinephrine | |
| 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. | |
| ESRD | |
| Abbreviation for end-stage renal disease. | |
| euglycemia | |
| A state of normal blood glucose concentration (also referred to as normoglycemia). | |
| euglycemic clamp studies | |
| 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. | |
| exchange lists | |
| 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 | |
Exenatide is an injectable drug that reduces the level of glucose in the blood. It is used for treating type 2 diabetes. Exenatide 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 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. | |
| exogenous insulin | |
| Insulin administered by injection or infusion. | |
| Factor VIII | |
| Antihemophilic factor (AHF): A relatively storage-labile factor participating in the extrinsic pathway of blood coagulation. | |
| fasting plasma glucose (FPG) | |
| 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. | |
| fasting plasma glucose (FPG) test | |
| 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 | |
| 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. | |
| FFA | |
| Abbreviation for free fatty acid. | |
| fibrin | |
| 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. | |
| fibrinogen | |
| A coagulation protein in blood, also known as factor I, that is converted to fibrin by the action of an enzyme in blood thrombin. | |
| fibrinolysis | |
| The dissolution of fibrin by enzymatic action. | |
| FIELD study | |
| Abbreviation for the Fenofibrate Intervention and Event Lowering in Diabetes study. In this study, investigators carried out a multinational, randomized controlled trial of 9,795 patients 50 to 75 years of age with type 2 diabetes. The patient population consisted of 2,131 individuals with previous CVD and 7,664 without. Following a placebo or fenofibrate run-in phase, patients were randomly assigned to treatment with micronized fenofibrate 200 mg daily (n=4,895) or to matching placebo (n=4,900). | |
| foam cell | |
| Lipid laden macrophages with a characteristic vacuolated appearance due to the presence of complex lipids; a component of atherosclerotic plaques. | |
| FPG | |
| Abbreviation for fasting plasma glucose. | |
| free fatty acid (FFA) | |
| The fraction of plasma fatty acids that is not in esterified form of glycerol esters. Also know as non-esterified fatty acids. | |
| gestational diabetes | |
| 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. | |
| GFR | |
| Abbreviation for glomerular filtration rate. | |
| GIP | |
| Abbreviation for glucose-dependent insulinotropic polypeptide. | |
| Glimepiride | |
| Glimepiride is an oral drug that is used for treating patients with type 2 diabetes. It belongs to the sulfonylurea class of drugs. | |
| Glimepiride | |
Sulfonylurea (Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells. | |
| Glipizide | |
| Glipizide is an oral drug that is used for treating patients with type 2 diabetes. It belongs to the sulfonylurea class of drugs. | |
| glomerular filtration rate (GFR) | |
| 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 | |
| Abbreviation for glucagon-like peptide-1. | |
| glucagon | |
| 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) | |
| 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. | |
| gluconeogenesis | |
| 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). | |
| glucose disposal rate | |
| The rate of glucose uptake from the blood by the peripheral tissues, such as skeletal muscle. | |
| glucose homeostasis | |
| 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 (GTT) | |
| See oral glucose tolerance test. | |
| glucose-dependent insulinotropic polypeptide (GIP) | |
| The gastrointestinal hormone gastric inhibitory polypeptide is released from the gut after a meal and stimulates insulin secretion. | |
| Glucotrol | |
| (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 cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with when 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 cannot be controlled by diet and exercise alone. Glipizide, glyburide, or may be used in combination with when monotherapy fails to reduce symptoms and/or blood glucose levels. | |
| GLUT-4 | |
| Abbreviation for insulin-sensitive glucose transporter protein expressed predominantly in striated muscle and fat cells. | |
| Glyburide | |
Sulfonylurea (Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells. | |
| Glyburide | |
| Glyburide is an oral drug that is used for treating patients with type 2 diabetes. It belongs to the sulfonylurea class of drugs. | |
| glycemia | |
| The presence of sugar in the blood. (See hyperglycemia, hypoglycemia.) | |
| glycogen | |
| 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. | |
| glycosylated hemoglobin | |
| 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%. | |
| Glyset | |
| 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 cannot be controlled by diet and exercise alone. may also be used in combination with a when diet and exercise plus either or a alone does not result in adequate glycemic control. | |
| GTT | |
| Abbreviation for glucose tolerance test. OGTT refers to an oral glucose tolerance test. IVGTT refers to an intravenous glucose tolerance test. | |
| Guidelines | |
| Management of the patient with type 2 diabetes requires a multidisciplinary team approach. In addition, the primary care provider must take a systematic approach to the evaluation and management of the patient. The goals of therapy are to correct the metabolic abnormalities of diabetes and to prevent the development of and complications. Whether a new patient is being evaluated or an established patient is being followed up, recognized treatment guidelines and recommendations for ensuring good diabetes care should be kept in mind. | |
| HbA1c | |
| Abbreviation for hemoglobin A1c (See glycosylated hemoglobin.) | |
| HDL-C | |
| Abbreviation for high-density lipoprotein cholesterol. | |
| HHNC | |
| Abbreviation for hyperglycemic hyperosmolar nonketotic coma. | |
| HI-5 | |
Full Name: Hyperglycemia: Intensive Insulin Infusion In Infarction The HI-5 study was a multicenter open-label randomized controlled clinical trial conducted at six hospitals in the state of New South Wales, Australia. The goal of the current study was to determine whether improved glycemic control, achieved through an insulin/dextrose infusion with a variable rate of insulin, reduces mortality among hyperglycemic patients with acute myocardial infarction. HI-5 commenced in 2001. A total of 240 subjects were recruited into this study. | |
| high-density lipoprotein cholesterol (HDL-C) | |
| 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. | |
| HNF | |
| Abbreviation for hepatic nuclear factors. | |
| HOMA-BCF | |
| Abbreviation for homeostasis model assessment for b-cell function. | |
| HOMA-IR | |
Abbreviation for homeostasis model assessment-insulin resistance. | |
| homeostasis model assessment–B-cell function (HOMA-BCF) | |
| 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 | |
| homeostasis model assessment–insulin resistance (HOMA-IR) | |
| 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 | |
| homocysteine | |
| 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 | |
| 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. | |
| hyperglycemia | |
| 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 hyperosmolar nonketotic coma (HHNC) | |
| 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 | |
| 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 | |
| Elevated blood lipid levels. | |
| hypertension | |
| 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. | |
| hypertriglyceridemia | |
| Elevated blood triglyceride levels. Hypertriglyceridemia is more common among insulin resistant patients with or without diabetes than among patients without diabetes or insulin resistance. | |
| hyperuricemia | |
| Elevated levels of uric acid or urates in the blood. | |
| hypoglycemia | |
| 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. | |
| IAPP | |
| Abbreviation for islet amyloid polypeptide. | |
| ICAM-1 | |
| Abbreviation for intercellular adhesion molecule 1. | |
| IDDM | |
| IFG | |
| Abbreviation for impaired fasting glucose. | |
| IGT | |
| Abbreviation for impaired glucose tolerance. | |
| IHD | |
| Abbreviation for ischemic heart disease. | |
| IL-6 (interleuken-6) | |
| An inflammatory lymphokine produced by T cells, fibroblasts and activated macrophages. | |
| impaired fasting glucose (IFG) | |
| 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. | |
| impaired glucose tolerance (IGT) | |
| 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. | |
| incretin | |
| 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 | |
| The observation that oral glucose administration results in greater insulin secretory response than the same glucose amount administered intravenously. | |
| incretin mimetics | |
| 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. | |
| insulin | |
| 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 pump | |
| 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 | |
| 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. | |
| insulin resistance syndrome | |
| Term for a set of clinical manifestations that tend to cluster together in people who are obese and, often, insulin resistant. (See metabolic syndrome.) | |
| intermittent claudication | |
| 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. | |
| IRIS | |
Full Name: Insulin Resistance Intervention After Stroke Trial A randomized, double-blind, placebo-controlled, efficacy study to determine if pioglitazone is effective in preventing future strokes or heart attacks among non-diabetic persons who have had a recent ischemic stroke. The IRIS trial commenced in 2005. A total of 3,136 participants are expected to enroll in this study. | |
| IRS | |
| Abbreviation for insulin resistance syndrome. | |
| ischemic heart disease (IHD) | |
| Heart disease characterized by deficiency of the blood supply to the heart muscle, generally due to atherosclerosis in the coronary arteries. | |
| islets of Langerhans | |
| Clusters of endocrine cells in the pancreas that produce insulin and glucagons, as well as somatostatin and pancreatic polypeptide. | |
| left ventricular mass index (LVMI) | |
| 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. | |
| Janumet | |
| Sitagliptin/metformin HCl (Janumet™) is indicated as an adjunct to diet and exercise to improve glycemic control in adult patients with type 2 who are not adequately controlled on metformin or alone or in patients already being treated with the combination of and metformin. | |
| Januvia | |
| 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 | |
| Kaplan-Meier curve | |
| 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. | |
| ketoacidosis | |
| Metabolic acidosis caused by increased concentrations of ketones in the bloodstream. (See diabetic ketoacidosis.) | |
| ketones | |
| Acidic by-products of fatty acid oxidation (e.g., ß-hydroxybutyrate and acetoacetate). | |
| L-cell | |
| A type of cell found in the gut that is responsible for the secretion of GLP-1. | |
| LDL-C | |
| Abbreviation for low-density lipoprotein cholesterol. | |
| lesion (atherosclerotic) | |
| 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. | |
| lipid | |
| A water-insoluble fatty substance. The profile of blood lipids is altered in patients with diabetes. (See dyslipidemia.) | |
| lipoprotein | |
| 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 | |
| An experimental injectable antihyperglycemic drug, part of a new class of long-acting glucagon-like peptide-1 derivatives that act as incretin mimetics. | |
| LOCF | |
| Abbreviation for an approach to analysis of clinical trial data in which the last observation is carried forward. | |
| low-density lipoprotein cholesterol (LDL-C) | |
| 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. | |
| LVMI | |
|
Abbreviation for left ventricular mass index. | |
| macrophage | |
| Any mononuclear phagocyte found in tissue, usually large. Secretes a broad diversity of products, including enzymes, cytokines, lymphokines, and regulatory molecules. | |
| macrovascular | |
| Pertaining to the major blood vessels of the body with internal diameters greater than 100 microns. | |
| maturity-onset diabetes of the young (MODY) | |
| 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 | |
| meglitinide | |
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 cannot be controlled by diet and exercise alone. 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 or metformin alone. | |
| metabolic syndrome | |
| 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. | |
| metformin | |
| (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. | |
| MI | |
| Abbreviation for myocardial infarction. | |
| microvascular | |
| 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). | |
| miglitol | |
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 cannot be controlled by diet and exercise alone. may also be used in combination with a when diet and exercise plus either or a alone does not result in adequate glycemic control. | |
| MODY | |
| Abbreviation for maturity-onset diabetes of the young. | |
| morbidity rate | |
| Adverse outcomes per unit of observation (for example events per 100 person-years of follow-up). | |
| mortality rate | |
| Deaths per unit of observation (for example, deaths per 100 person-years of observation) | |
| myocardial infarction (MI) | |
| A form of heart attack. In MI, there is necrosis of a portion of the heart muscle, usually due to coronary artery obstruction. | |
| NAVIGATOR | |
Full Name: Long-Term Study of Nateglinide+Valsartan to Delay Type II Diabetes Mellitus This randomized, double-blind, active-controlled, parallel assignment, efficacy study was a test of the safety and effectiveness of two drugs, one for diabetes and one for hypertension, in keeping high normal patients from progressing to illness. People in this study could not have diabetes but are considered borderline based on blood tests. People in the study took one or both of the drugs and did not know which one(s) they were taking. NAVIGATOR commenced in 2002. A total of 9,150 participants were expected to enroll in this study. | |
| nephropathy | |
| Kidney disease. (See diabetic nephropathy.) | |
| neuropathy | |
| Disease of nerves. (See diabetic neuropathy.) | |
| neurotransmitter | |
| A chemical substance that effects the transmission of nerve impulses across axonal junctions. | |
| NGT | |
| Abbreviation for normal glucose tolerance. | |
| NHANES | |
|
Abbreviation for National Health and Nutrition Examination Survey. | |
| NIDDM | |
| Abbreviation for non–insulin-dependent diabetes mellitus. This term is no longer recommended for use. (See type 2 diabetes.) | |
| obesity | |
| A condition characterized by an excessive amount of body fat. Obesity is a risk factor for type 2 diabetes. | |
| OGTT | |
| Abbreviation for oral glucose tolerance test. | |
| oral glucose tolerance test (OGTT) | |
| 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). | |
| ORIGIN | |
Full Name: Outcome Reduction With Initial Glargine Intervention trial A multicenter, international randomized, 2x2 factorial design study to evaluate the effects of lantus (Insulin Glargine) versus standard care, and of omega-3 fatty acids versus placebo, in reducing cardiovascular morbidity and mortality in high risk people with impaired fasting glucose, impaired glucose tolerance, or early type 2 diabetes mellitus. The ORIGIN trial commenced in 2003. A total of 12,500 patients were expected to enroll in this study. | |
| Orinase | |
| (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 cannot be controlled by diet and exercise alone. Tolbutamide, tolazamide, or chlorpropamide may be used in combination with when 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 cannot be controlled by diet and exercise alone. Glipizide, glyburide, or may be used in combination with when monotherapy fails to reduce symptoms and/or blood glucose levels. | |
| oxidative stress | |
| The stress associated with defense against elevated and prolonged exposure to chemical species capable of an oxidizing reaction. | |
| PAI-1 | |
| See plasminogen activator inhibitor (PAI) type 1. | |
| pancreas | |
| 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. | |
| PCI | |
|
Abbreviation for percutaneous coronary intervention. | |
| PCOS | |
| Abbreviation for polycystic ovary syndrome. | |
| PDX | |
| Abbreviation for a transcription factor that regulates insulin production. | |
| peripheral artery disease | |
| Arteriosclerosis of the vessels distant from the heart, often seen as impaired circulation to the legs. | |
| peripheral vascular disease (PVD) | |
| Any disorder affecting the blood vessels of the extremities. People with type 2 diabetes are at increased risk for developing PVD. | |
| PERISCOPE | |
Full Name: Pioglitazone Effect on Regression of Intravascular Sonographic Coronary Obstruction Prospective Evaluation (PERISCOPE) A double-blind, randomized, comparator-controlled study in subjects with type 2 diabetes comparing the effects of pioglitazone HCl versus glimepiride on the rate of progression of coronary atherosclerotic disease as measured by intravascular ultrasound. PERISCOPE commenced in 2003. A total of 440 participants are expected to enroll in this study. | |
| peroxisome proliferator-activated receptor (PPAR) | |
| 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. | |
| pioglitazone | |
| (ACTOS) An oral antidiabetic agent of the thiazolidinedione class that is used to treat type 2 diabetes. | |
| Pioglitazone In Prevention Of Diabetes (PIPOD) | |
| The Pioglitazone In Prevention Of Diabetes study is an open-label trial conducted to assess the effect of pioglitazone on beta-cell function, insulin resistance, and diabetes rates in women who completed the TRIPOD study. | |
| PIPOD | |
| Abbreviation for Pioglitazone In Prevention Of Diabetes study. | |
| plasma | |
| The clear fluid portion of the blood that is free of any type of blood cell. | |
| plasminogen activator | |
| A term used for a group of proteins that convert plasminogen into plasmin. It includes prourokinase, | |
| plasminogen activator inhibitor (PAI) type 1 | |
| An endothelial derived protein in blood that inhibits conversion of plasminogen to plasmin by inhibiting plasminogen activator. The inhibition limits clot propagation. | |
| platelet | |
| A blood particle involved in coagulation and the maintenance of hemostasis. | |
| polycystic ovary syndrome (PCOS) | |
| 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. | |
| polydipsia | |
| Increased thirst, a symptom of uncontrolled diabetes. | |
| polyuria | |
| The excretion of large volumes of urine, a symptom of uncontrolled diabetes. | |
| postprandial | |
| Occurring after a meal. | |
| PPAR | |
| 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 | |
| Pramlintide, an analogue of human amylin, is an injectable antihyperglycemic drug for use in patients with diabetes treated with insulin. | |
| Prandin | |
| 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 cannot be controlled by diet and exercise alone. 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 or metformin alone. | |
| Precose | |
| 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 cannot be controlled by diet and exercise alone. may also be used in combination with a when diet and exercise plus either or a does not result in adequate glycemic control. In addition, may be used in combination with or metformin. | |
| PROactive study | |
|
Abbreviation for Prospective Pioglitazone Clinical Trial in Macrovascular Events. A ramdomized, double-blind outcome study measuring the effect of pioglitazone on the secondary prevention of macrovascular complications in patients with type 2 diabetes who are managed with diet and/or oral blood glucose-lowering drugs who have a history of macrovascular disease. Design includes a total of 5,238 petients from 19 countries. | |
| proinsulin | |
| 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. | |
| proteinuria | |
| Protein in the urine. This may be a sign of kidney damage. | |
| PTCA | |
|
Abbreviation for percutaneous transluminal coronary angioplasty. | |
| PVD | |
| Abbreviation for peripheral vascular disease. | |
| QALY | |
| Abbreviation for quality-adjusted life-years. | |
| quality-adjusted life-years (QALY) | |
| 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. | |
| RECORD | |
Full Name: RECORD: Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycemia in Diabetes A long term, open label, randomized study in patients with type 2 diabetes, comparing the combination of rosiglitazone and either metformin or sulphonylurea with metformin plus sulphonylurea on cardiovascular endpoints and glycemia. RECORD commenced in 2001. A total of 4,452 participants were expected to enroll in this study. | |
| renal | |
| Pertaining to the kidney. | |
| renin | |
| 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 | |
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. | |
| reperfusion injury | |
| Refers to damage to tissue caused when blood supply returns to the tissue after a period of ischemia. | |
| retinopathy | |
| Disease of the retina of the eye. (See diabetic retinopathy.) | |
| rosiglitazone | |
| (Avandia) An oral antidiabetic agent of the thiazolidinedione class that is used to treat type 2 diabetes. | |
| saxagliptin | |
| 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. | |
| SBP | |
| Abbreviation for systolic blood pressure. | |
| sitagliptin | |
| 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 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. | |
| small, dense LDL particle | |
| A type of LDL particle that is associated with insulin resistance, dyslipidemia and increased risk of atherosclerosis. | |
| sulfonylurea | |
(Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells. | |
| syndrome X | |
| An early name for what is now called the metabolic syndrome. (See Metabolic Syndrome) | |
| t-PA | |
| See tissue plasminogen activator (t-PA). | |
| TBARS | |
| Abbreviation for thiobarbituric acid-reactive substances. | |
| TG | |
| Abbreviation for triglyceride. | |
| thiazolidinedione | |
| 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. | |
| thrombin | |
| The enzyme derived from prothrombin that converts fibrinogen to fibrin. | |
| thrombosis | |
| The formation, development or presence of a thrombus. | |
| thrombus | |
| An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of formation. | |
| tissue plasminogen activator (t-PA) | |
| A serine endopeptidase synthesized by endothelial cells, the major physiologic activator of plasminogen. | |
| TNF-a | |
| Abbreviation for tumor necrosis factor-a. | |
| Tolinase | |
Sulfonylurea (Glimepiride:Amaryl; Glipizide:Glucotrol; Glyburide:DiaBeta, Micronase, Glynase) A type of oral antidiabetic drug that stimulates insulin secretion from the pancreatic ß-cells. | |
| triglyceride (TG) | |
| 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. | |
| TRIPOD | |
Abbreviation for Troglitazone In Prevention Of Diabetes study. | |
| troglitazone | |
| 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. | |
| Troglitazone In Prevention Of Diabetes (TRIPOD) | |
| The Troglitazone in Prevention of Diabetes study was designed to compare incidence rates of diabetes between groups of Hispanic women with prior gestational diabetes randomized to receive placebo or troglitazone 400 mg/day. Approximately 70% of the study participants had impaired glucose tolerance. | |
| tumor necrosis factor-a | |
| 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. | |
| type 1 diabetes | |
| 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. | |
| type 2 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. | |
| TZD | |
| Abbreviation for thiazolidinedione. | |
| UKPDS | |
| Abbreviation for the United Kingdom Prospective Diabetes Study. | |
| United Kingdom Prospective Diabetes Study (UKPDS) | |
| The largest and longest-running study of patients with type 2 diabetes. Designed to compare the effects of intensive treatment with those of conventional treatment, it has enrolled and evaluated more than 5,000 patients newly diagnosed with type 2 diabetes. The UKPDS was in progress for 20 years and had a mean follow-up of 10 years. | |
| VADT | |
Full Name: Glycemic Control and Complications in Diabetes Mellitus Type 2 (VADT) Sponsored by the Department of Veterans Affairs, this study was a prospective, 2-arm, randomized controlled trial to determine whether glycemic control, achieved through intensification of treatment, was effective in preventing clinical macrovascular complications in patients with type 2 diabetes who are no longer responsive to oral agents alone. VADT commenced in 2000. A total 1,700 patients were expected to enroll in this study. | |
| vasoconstriction | |
| Contracting of a blood vessel, resulting in a narrowing of its lumen. | |
| very low-density lipoprotein (VLDL) | |
| 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. | |
| vildagliptin | |
| 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. | |
| VLDL | |
| Abbreviation for very low-density lipoprotein. | |
| VLDL-C | |
| Abbreviation for very low-density lipoprotein-cholesterol, the fraction of circulating cholesterol that is contained in VLDL particles. | |
| VLDL-TG | |
| Abbreviation for very low-density lipoprotein-triglyceride, the fraction of circulating triglycerides that is contained in VLDL particles. | |
| von Willebrand factor | |
| The attribute of factor VIII necessary for the adhesion of platelets to vascular elements. | |
| VSMC | |
| Abbreviation for vascular smooth muscle cell. | |
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