Diabetes Mellitus - Glossary of Terms

Acromegaly
Occurs due to excessive growth hormone production by the pituitary gland due to a pituitary adenoma. Also known as pituitary gigantism. The main signs include thickening of the skin, soft tissues and bones of the head and feet. There is also hypertension and insulin resistance

Adult-onset diabetes
Former term for type 2 or non-insulin-dependent diabetes.
Albuminuria: A condition in which the urine has more than normal amounts of a protein called albumin. Albuminuria may be a sign of diabetic nephropathy (kidney disease).

Alpha cell
A type of cell in the pancreas. Alpha cells make and release a hormone called glucagon. The body sends a signal to the alpha cells to make glucagon when blood glucose concentrations fall too low. Glucagon reaches the liver and tells it to release glucose into the bloodstream for energy.

Amylin
A hormone formed by beta cells in the pancreas. Amylin regulates the timing of glucose release into the bloodstream after eating by slowing the emptying of the stomach.

Amyloid
Deposition of a protein called amyloid, derived from amylin, in cells of the pancreas, causing dysfunction of these cells. This acts like scar tissue and produces a diffusion barrier, which results in a secretory and an absorptive defect to insulin.

Beta cell
A cell that makes insulin. Beta cells are located in the islets of the pancreas.

Blood glucose meter
A small, portable machine that can be used to check blood glucose concentrations. After pricking the skin with a lancet, a drop of blood is placed on a test strip in the machine. The meter (or monitor) soon displays the blood glucose concentration as a number on the meter's digital display.

Blood glucose monitoring
Checking blood glucose concentrations on a regular basis in order to help manage diabetes. A blood glucose meter (or blood glucose test strips that change color when touched by a blood sample) is usually used for blood glucose monitoring.

Blood sugar
See glucose

Cachexia
A profound and marked state of general ill health and malnutrition (weight loss).

Cataract
Clouding of the lens of the eye.

Chronic pancreatitis
Chronic inflammation of the pancreas, which can be severe and life threatening disease during acute episodes. The clinical signs include vomiting and a painful abdomen.

Coma
A sleep-like state in which a person or animal is not conscious. May be caused by Hyperglycemia (high blood glucose) or hypoglycemia (low blood glucose) in diabetics.

Complications
Harmful effects of diabetes, such as damage to the eyes, nervous system or kidneys. In humans, studies show that keeping blood glucose concentrations, as well as blood pressure and low-density lipoprotein cholesterol concentrations, close to normal can help prevent or delay these problems.

C peptide
"Connecting peptide," a substance the pancreas releases into the bloodstream in equal amounts to insulin. A test of C-peptide levels shows how much insulin the body is making.

Dehydration
The loss of too much body fluid through frequent urinating, sweating, diarrhea or vomiting.

Diabetes insipidus
A metabolic disorder resulting in deficient secretion of antidiuretic hormone (ADH or vasopressin). This results in the failure of tubular reabsorption of water in the kidney. Polyuria (urine has a very low specific gravity) and polydipsia results. There is no glucose present in the urine.

Diabetes mellitus
A condition characterized by Hyperglycemia resulting from the body's inability to use blood glucose for energy. In insulin-dependent (type 1) diabetes, the pancreas no longer makes insulin and therefore blood glucose cannot enter the cells to be used for energy. In non-insulin dependent (type 2) diabetes, either the pancreas does not make enough insulin or the body is unable to use insulin correctly.

Diabetic ketoacidosis (DKA)
An emergency condition in which extremely high blood glucose levels, along with a severe lack of insulin, result in the breakdown of body fat for energy and ketones accumulate in the blood and urine. Signs of DKA include vomiting, fruity breath odor, and rapid breathing. Untreated DKA can lead to coma and death.

Diabetic retinopathy
Diabetic eye disease; damage to the small blood vessels in the retina. Loss of vision may result.

Diabetogenic
Causing diabetes. For example, some drugs, such as progestogens and corticosteroids, cause blood glucose levels to rise, resulting in diabetes.
DKA: See diabetic ketoacidosis

Dosage adjustment
see dose adjustment

Dose adjustment
A change in the amount of insulin given to a diabetic dog or cat based on factors such as blood glucose concentrations, diet and exercise.

Endocrine gland
A group of specialized cells that release hormones into the blood. For example, the islets in the pancreas, which secrete insulin, are endocrine glands.

Enzyme
Protein made by the body that brings about a chemical reaction, for example, the enzymes produced by the gut to aid digestion.

Euglycemia
A normal concentration of glucose in the blood.

Fructosamine
Fructosamines are stable complexes of carbohydrates and proteins that are produced by an irreversible, nonenzymatic glycosylation of protein. Glucose has a greater affinity for albumin in dogs and for globulins in cats. A single measure of fructosamine indicates the average glucose concentration over the previous 1-2 weeks. Fructosamine measurement may be used to assist in the diagnosis of diabetes mellitus as well as to monitor the effectiveness of insulin therapy in diabetic dogs and cats.

Gland
A group of cells that secrete substances. Endocrine glands secrete hormones. Exocrine glands secrete salt, enzymes, and water.

Glucagon
A hormone produced by the alpha cells in the pancreas. It raises blood glucose. An injectable form of glucagon, available by prescription, may be used to treat severe hypoglycemia.

Gluconeogenesis
Production of glucose from non-carbohydrate precursors, such as pyruvate, amino acids and glycerol. Gluconeogenesis takes place mainly in the liver and maintains blood glucose concentrations during, e.g., starvation and intense exercise.

Glucose
The main sugar found in the blood and the body's main source of energy. Also called blood glucose or blood sugar.
Blood glucose concentration: The amount of glucose in a given amount of blood. It is noted in millimoles per liter (mmol/L), milligrams per deciliter (mg/dL) or grams per liter (g/L).

Glucose tablets
Chewable tablets made of pure glucose used for treating hypoglycemia.

Glucosuria
The presence of glucose in the urine.

Glycemia
blood glucose or blood sugar.

Glycogen
The form of glucose found in the liver and muscles.

Glycosuria
see glucosuria

Glycosylated (glycated) hemoglobin
As the blood glucose concentrtion increases, the proportion of the hemoglobin molecules that bind glucose increases. Glycosylated hemoglobin is the amount of glucose-bound hemoglobin. This measurement reflects how well a diabetic animal is being controlled. This method is used less frequently than fructosamine in diabetic dogs and cats because it reflects the average blood glucose concetration over the previous 8-12 weeks.

Glycosylation
The uncontrolled, non-enzymatic reaction of sugars with proteins. Very important in the complications of diabetes mellitus where abnormally high glucose concentrtions result in the glycosylation of proteins such as in the lens of the eye.

High blood glucose
See Hyperglycemia

Hormone
A chemical produced in one part of the body and released into the blood to trigger or regulate particular functions of the body. For example, insulin is a hormone made in the pancreas that tells other cells when to use glucose for energy.

Hyperadrenocorticism
Also known as Cushing’s disease. It results from an increase in cortisol secretion from the adrenal glands. The characteristic clinical signs result from excessive glucocorticoids concentrations. Hyperadrenocorticism is much more common in dogs than in cats. Animals with Cushing’s disease often have concurrent diabetes mellitus.

Hyperlipidemia
Elevated plasma concentrations of lipids, such as cholesterol, triglycerides and/or lipoproteins

Hyperglycemia
Excessive blood glucose concentrations; a sign that diabetes is not well controlled.

Hyperosmolar hyperglycemic non-ketotic syndrome (HHS)
An emergency condition in which the blood glucose concentration is very high and there are no ketones present in the blood or urine. If HHNS is not treated, it can lead to coma or death.

Hyperthyroidism
A common condition in older cats (rare in dogs) that has characteristic clinical signs related to overproduction of the thyroid hormone thyroxine. Can be concurrent with diabetes mellitus.

Hypoglycemia
A condition that occurs when the blood glucose concentration is lower than normal, usually less than 3.5 mmol/L (63 mg/dL) in dogs and 3 mmol/L (54 mg/dL) in cats. Signs include hunger, nervousness, shakiness, and sleepiness. If left untreated, hypoglycemia may lead to unconsciousness. Hypoglycemia is treated by consuming a carbohydrate-rich food such as a glucose tablet or juice.

Hypokalemia
Abnormally low potassium concentration in the blood. In diabetic cats, this is seen as neuromuscular disorders ranging from weakness to paralysis. Serum potassium concentrations can fall within the normal range if dehydration is severe.

Hyponatraemia
Deficiency of sodium in the blood; salt depletion

Hypophosphatemia
An abnormally decreased level of phosphates in the blood.

IDDM (insulin-dependent diabetes mellitus)
Former term for type 1 diabetes.

Injection
Inserting liquid medication or nutrients into the body with a syringe. A person with diabetes may use short needles or pinch the skin and inject at an angle to avoid an intramuscular injection of insulin.

Injection pen
A device for injecting that looks like a fountain pen and holds cartridges that contain the substance for injection. Injection pens can be disposable or be designed for repeated use (with replaceable cartridges). See also Insulin pen.

Injection sites
Places on the body where insulin is usually injected.

Insulin
A hormone that helps the body use glucose for energy. The beta cells of the pancreas make insulin. When the body cannot make enough insulin, insulin is usually given to dogs and cats by injection.

Insulin adjustment
See dose adjustment

Insulinoma
A tumor of the beta cells in the pancreas. An insulinoma may cause the body to make extra insulin, leading to hypoglycemia.

Insulin pen
A device for injecting insulin that looks like a fountain pen and holds cartridges that contain insulin. The correct insulin pen (U40 or U100) and cartridge should be uused for the concentration of insulin to be administered. Injection pens can be disposable or be designed for repeated use (with replaceable cartridges). See also Injection pen.

Insulin receptors
Areas on the outer part of a cell that allow the cell to bind with insulin in the blood. When the cell and insulin bind, the cell can move glucose from the bloodstream and use it for energy.

Insulin resistance
The body's inability to respond to and use the insulin it produces. Insulin resistance may be linked to obesity.

Insulin syringe
Syringes designed for the subcutaneous injection of insulin. The correct insulin syringe (U40 or U100) should be used for the concentration of insulin to be administered (40 IU/mL or 100 IU/mL). See also Syringe.

Intermediate-acting insulin
A type of insulin that starts to lower blood glucose within 1 to 2 hours after injection and has its most marked effect 6 to 12 hours after injection, depending on the type used.
See lente insulin

Islets
Groups of cells located in the pancreas that make hormones that help the body break down and use food. For example, alpha cells make glucagon and beta cells make insulin. Also called islets of Langerhans.

Islets of Langerhans
See islets

Ketoacidosis
See diabetic ketoacidosis

Ketone
A chemical produced when there is a shortage of insulin in the blood and the body breaks down body fat for energy. High levels of ketones can lead to diabetic ketoacidosis and coma. Sometimes referred to as ketone bodies.

Ketonuria
A condition occurring when ketones are present in the urine, a warning sign of diabetic ketoacidosis.

Ketosis
A ketone buildup in the body that may lead to diabetic ketoacidosis. Signs of ketosis are nausea, vomiting, and stomach pain.

Kidney disease
See nephropathy

Lancet
A spring-loaded device used to prick the skin with a small needle to obtain a drop of blood for blood glucose monitoring.

Lente insulin
An intermediate-acting insulin. On average, lente insulin starts to lower blood glucose levels within 1 to 2 hours after injection. Caninsulin is a lente insulin. In dogs, Caninsulin has its most marked effects 3 hours after injection and keeps working for 8 hours after injection. In cats, Caninsulin has its most marked effects 1 to 2 hours after injection it has a shorter duration of action than in dogs.

Low blood sugar
See hypoglycemia

Metoestrus or metestrus

The period of early corpus luteum development, commencing at the end of estrus and lasting until the beginning of diestrus.

mmol/L
Millimoles per liter, a unit of measure that shows the concentrations of a substance in a specific amount of fluid. This unit is used in veterinary and medical journals and a number of countries to report blood glucose test results. In other countries, mg/dL or g/L are used. To convert from mmol/L to mg/dL multiply mmol/L by 18; to convert mmol/L to g/L multiply by 0.18 . Example: 10 mmol/L = 180 mg/dL or 1.8 g/L.

mg/dL
Milligrams per deciliter, a unit of measure that shows the concentration of a substance in a specific amount of fluid. In some countries, blood glucose test results are reported as mg/dL. To convert to mg/dL from mmol/L, multiply mmol/L by 18. Example: 10 mmol/L = 180 mg/dL.

g/L
Grams per liter: a unit of measure that shows the concentration of a substance in a specific amount of fluid. In some countries, g/L are used to report blood glucose test results. To convert from mmol/L to g/L multiply by 0.18. Example: 10 mmol/L = 1.8 g/L.

Nephropathy
Disease of the kidneys. Hyperglycemia and can damage the glomeruli of the kidneys. When the kidneys are damaged, protein leaks out into the urine. Damaged kidneys can no longer remove waste and extra fluids from the bloodstream.

Nerve disease
See peripheral neuropathy

Noninsulin-dependent diabetes mellitus (NIDDM)
Former term for type 2 diabetes.
Oral hypoglycemic agents: Medicines taken by mouth by people with type 2 diabetes to keep blood glucose levels as close to normal as possible. These agents are usually not used in diabetic dogs and cats since these diabetics usually require insulin treatment.

Obesity
By definition, 20% or more extra body fat. Fat works against the action of insulin. Extra body fat is a risk factor for diabetes, particularly in cats.

Pancreas
An organ that makes insulin and enzymes for digestion. The pancreas is located behind the lower part of the stomach and is about the size of a hand.

Peripheral neuropathy
Damage to the nerves supplying the legs. Sometimes seen in diabetic cats.

Polydipsia
Excessive thirst; may be a sign of diabetes mellitus.

Polyphagia
Excessive hunger; may be a sign of diabetes mellitus.

Polyuria
Excessive urination; may be a sign of diabetes mellitus.

Proinsulin
The substance made first in the pancreas and then broken into several pieces to become insulin.

Proteinuria
The presence of protein in the urine, indicating that the kidneys are not working properly.

Rebound Hyperglycemia

A swing to a high level of glucose in the blood after a low level.
See Somogyi effect

Receptors
See insulin receptors

Renal threshold
The blood glucose concentration at which the kidneys start to excrete glucose into the urine.

Secondary diabetes
A type of diabetes caused by another disease or certain drugs or chemicals.

Somogyi effect
Also called rebound Hyperglycemia - when the blood glucose level swings high following lower than normal blood glucose (or hypoglycemia). The Somogyi effect may follow an untreated hypoglycemic episode and is caused by the release of stress hormones.

Sorbitol
A sugar produced by the body in diabetics that can cause damage to the eyes and nerves.
Subcutaneous injection: Putting a fluid into the tissue under the skin with a needle and syringe or other injection device.

Sugar
1. A class of carbohydrates with a sweet taste; includes glucose, fructose, and sucrose. 2. A term used to refer to blood glucose.

Suspension

Syringe
A device used to inject medications or other liquids into body tissues. The syringe for insulin has a hollow plastic tube with a plunger inside and a needle on the end.

Transient diabetes

Type 1 diabetes
A condition characterized by high blood glucose concentrations caused by a complete or absolute lack of insulin. The pancreas then produces little or no insulin. Most diabetic dogs and cats with type 1 diabetes require insulin treatment.

Type 2 diabetes
A condition characterized by high blood glucose concentrations caused by a relative lack of insulin. The pancreas produces insulin but the tissues are not able to respond properly and the individual is considered to be insulin resistant. The most common cause of insulin resistance is obesity. However, insulin resistance can also be caused by some drugs and other diseases pancreatitis or other endocrine disease (such as hyperthyroidism or acromegaly in cats or hypothyroidism or Cushing’s syndrome in dogs). Most diabetic dogs and cats with this type of diabetes require insulin treatment. The underlying disease should be treated.

Unit of insulin
The basic measure of insulin. U40 insulin means 40 units of insulin per milliliter (mL) of solution. Caninsulin is a U40 or 40 IU/mL insulin.

Urine
The liquid waste product filtered from the blood by the kidneys, stored in the bladder, and expelled from the body by the act of urinating.

Urine testing
Also called urinalysis; a test of a urine sample to diagnose diseases of the urinary system and other body systems. In dogs and cats with diabetes, a veterinary surgeon may check for:

  1. Glucose, a sign of diabetes or other diseases.
  2. Protein, a sign of kidney damage, or nephropathy.
    Also see albuminuria
  3. White blood cells, a sign of urinary tract infection.
  4. Ketones, a sign of diabetic ketoacidosis or other conditions.

Urine may also be checked for signs of bleeding. Some tests use a single urine sample. For others, 24-hour collection may be needed. And sometimes a sample is "cultured" to see exactly what type of bacteria grows.