Diabetes Glossary
A
A1C
A blood test that estimates the quantity of sugar attached to your red blood cells. A1C provides an estimate of your average blood sugar level over the past two to three months (expressed as a percentage). An A1C of 6.5% or higher is consistent with the diagnosis of diabetes. Sometimes referred to as HbA1c, or hemoglobin A1C.
Acanthosis nigricans
A skin condition characterized by dark, velvety patches of skin, usually found in areas such as the neck, armpits, groin, elbows, or knees. It often occurs in association with insulin resistance, obesity, or hormonal disorders, and can be a sign of conditions associated with insulin resistance like type 2 diabetes.
Afrezza
See inhaled insulin.
ALT
A blood test (short for alanine transaminase) that is a part of a set of comprehensive metabolic tests used to measure liver enzymes. When the liver is damaged, ALT (along with AST) may increase in the blood.
Amylin
A hormone released along with insulin from beta cells, which decreases glucose levels after meals.
Analog insulin
A newer and more expensive type of insulin that generally leads to less hypoglycemia and weight gain. Similar to insulin produced in the human body, but with structural modifications to make them either more rapid-acting or more long-acting than older insulins.
Anti-VEGF medications
Anti-vascular endothelial growth factor (VEGF) medications, administered as injections, are the first line of treatment for diabetic macular edema. They prevent the growth of abnormal blood vessels in the eye, which cause the leakage of fluid that can lead to vision problems.
Artificial pancreas
AST
Short for aspartate transaminase, AST is a blood test that is a part of a set of comprehensive metabolic tests used to measure liver enzymes. When the liver is damaged, AST (along with ALT) may increase in the blood.
Atherosclerosis
A condition caused by the buildup of fats, cholesterol and other substances in the artery walls, which is called plaque. Plaque can cause arteries to narrow, reducing or blocking blood flow.
Autoimmune disease
A condition where the body's immune system mistakenly attacks and damages its own cells or tissues. Type 1 diabetes is an autoimmune disease.
Automated insulin delivery (AID) system
A medical device that uses continuous glucose monitors, insulin pumps, and smart algorithms to automatically adjust insulin delivery to help keep a person’s glucose levels in range. Also known as an artificial or bionic pancreas or hybrid closed-loop system.
Automated insulin delivery (AID) system
A medical device that uses continuous glucose monitors, insulin pumps, and smart algorithms to automatically adjust insulin delivery to help keep a person’s glucose levels in range. Also known as an artificial or bionic pancreas or hybrid closed-loop system.
B
Basal-bolus insulin therapy
Insulin therapy that uses two types of insulin injections (basal insulin with a long-acting insulin analog as well as bolus insulin with a rapid-acting insulin analog) to try to mimic the body's natural insulin production.
Beta cells
A type of islet cell in the pancreas that makes the hormone insulin, which lowers blood glucose levels. In type 1 diabetes, beta cells are destroyed by an autoimmune attack on the pancreas. With type 2 diabetes, beta cells produce less insulin than needed and are less efficient in releasing insulin. Substantial weight loss soon after the diagnosis of type 2 diabetes can cause remission of the diabetes.
Biosimilars
Similar versions of an original biologic medicine that have the same clinical effects.
Blood glucose
Blood glucose comes from the food that we eat and serves as our body’s main source of energy. Your blood sugar level refers to the amount of glucose in your blood at a specific moment in time. Also informally called blood sugar.
Blood glucose meter (BGM)
A fingerstick device that measures the concentration of glucose in the blood. It typically consists of a small electronic device that, together with a test strip, displays the blood sugar level at that moment in time. The user also purchases a set of test strips that contain chemicals to react with blood from the fingerstick. The meter gives a blood glucose reading in mg/dL (US standard) or mmol/l (European standard). Also called a glucometer.
Blood sugar
See blood glucose.
Body mass index (BMI)
A quick, low-cost, population-wide health measure used to estimate whether someone may be of normal weight, underweight, overweight, or have obesity. It is calculated by taking a person's body weight (in kilograms) divided by the square of their height (in meters).
Bolus
A specific dose of insulin administered to quickly lower blood sugar levels, typically in response to food intake or elevated glucose levels. May include a mealtime bolus (given before meals to cover carbohydrates consumed) or correction bolus (used to correct high blood sugar levels, regardless of food intake).
Bolus insulin
See prandial insulin.
C
Cannula
A short, thin, and flexible tubing at the end of the infusion set that is inserted into the subcutaneous tissue to deliver insulin.
Carbohydrate
One of the three main macronutrients (along with proteins and fats) and serve as a primary source of energy for the body. Carbohydrates can be classified into three main categories: sugar (simple carbohydrates), starches (complex carbohydrates), and fiber. Sometimes abbreviated CHO.
Carbohydrate counting
A method used by individuals with diabetes to manage their blood sugar levels by tracking and calculating the amount of carbohydrates in their meals and adjusting insulin doses accordingly.
Cardiovascular disease (CVD)
Cardiovascular disease includes heart disease and high blood pressure. Having diabetes is a risk factor for CVD. High blood sugar levels can damage the blood vessels and nerves that support the heart over time. The longer one has had diabetes, the more likely one is to be at risk for having heart disease.
Celiac disease
A condition that causes an immune reaction to eating gluten, a protein found in wheat, rye and barley, causing damage to the intestines. People with celiac disease must follow a gluten-free diet, and as many as 10% of people with type 1 diabetes also have celiac disease.
Certified diabetes educator and care specialist (CDCES)
A health professional who has specialized knowledge and experience in diabetes care and management and is accredited by the Certification Board for Diabetes Care and Education (CBDCE).
Cholesterol
A waxy, fat-like substance found in the blood, tissues, and cells of the body. While essential for good health, excess levels of certain types of cholesterol are associated with cardiovascular disease. See HDL cholesterol, LDL cholesterol, VLDL cholesterol.
Chronic kidney disease (CKD)
Also known as chronic renal disease or nephropathy, chronic kidney disease (CKD) occurs when the kidneys cannot properly filter the fluids that pass through them. Increased urine albumin, protein measured by the urine albumin to creatinine ratio (UACR), and decreased kidney function measured by the estimated glomerular filtration rate (eGFR) are the two main tests to determine presence of CKD.
Cirrhosis
Advanced scarring of the liver that can lead to liver failure.
Claim denial
This is when a medical claim is received and processed by an insurance company but has been marked as not payable. When a claim has been denied, you may be able to file for an appeal.
Coinsurance
Coinsurance costs are a percentage of the total price of a health service or medication. For example, if your coinsurance is 20% and you have to get a medication that costs $100, then you would expect to pay $20 while your insurance would cover the other $80. These expenses are less predictable because health services and medication prices can fluctuate.
Combination drugs
Injectable or tablet medications that marry multiple different drugs, often from different drug classes, into a single medication (for example, metformin combined with an SGLT-2 inhibitor into a single pill). Primarily used for type 2 diabetes; can improve drug effectiveness, side effects, cost value, and adherence.
Continuous glucose monitors (CGM)
Continuous glucose monitors measure the body’s glucose levels in real-time by sensing the glucose present in tissue fluid (also called interstitial fluid). While a blood glucose meter (BGM) provides a measurement of the blood glucose level at a specific moment in time (when you prick your finger), CGMs typically provide a new glucose level every five minutes, meaning 288 times per day.
Copay
Copays (short for co-payments) are a fixed amount that you pay for a health service or medication, while your insurer covers the rest of the cost. In some cases, a copay contributes to your deductible.
Correction factor (CF)
Also called insulin sensitivity factor. The amount that a unit of fast-acting insulin will lower a person’s blood sugar. People with diabetes using basal-bolus insulin, an insulin pump, or an automated insulin delivery device may need to use or input a correction factor to calculate a correction bolus amount when their blood sugar is high. (BG level) – (BG target) = X. X ÷ (correction factor) = correction bolus amount.
Cortisol
A steroid hormone that increases blood sugar by making fats and muscles more resistant to insulin. Cortisol levels may be increased by certain medications and during times of stress.
D
Dawn phenomenon
The natural rise in blood sugar levels in the early morning hours (usually 4:00-6:00 a.m.) associated with the increase in levels of hormones (such as growth hormone) in the early morning.
Deductible
A deductible is the amount you pay out-of-pocket before your insurance provider covers medical expenses. For example, if you have a $1,000 deductible, your insurance coverage will not kick in until you’ve paid $1,000 in healthcare expenses for that year.
Dextrose
A simple sugar found in blood that serves as the body’s main energy source; also called glucose.
Diabetes
Diabetes (short for diabetes mellitus) is a health condition in which the pancreas does not produce sufficient amounts of insulin and most of the body’s cells cannot effectively use the sugar from food that is circulating in the blood, resulting in the inability to maintain normal and stable blood sugar levels. See gestational diabetes, monogenic diabetes, maturity-onset diabetes of the young, prediabetes, secondary diabetes, type 1 diabetes, type 2 diabetes.
Diabetes care team
A group of health professionals working together to support the health of a person with diabetes. May include a primary care provider (physician, nurse practitioner or physician assistant), an endocrinologist, a certified diabetes care and education specialist (CDCES), a registered dietitian (RD, RDN), a heart doctor (cardiologist), a foot doctor (podiatrist), an eye doctor (optometrist or ophthalmologist), a kidney doctor (nephrologist), a dentist, a pharmacist, and a mental health professional.
Diabetes self-management education and support (DSMES)
Programs that help people with diabetes learn how to manage their condition to prevent or delay serious diabetes complications like heart disease, kidney disease, amputations, and vision loss. The team providing DSMES may include certified diabetes care and education specialists (CDCES), diabetes nurse educators (CDE), registered dietitians (RD), and registered dietitian nutritionists (RDN).
Diabetes-related retinopathy (DR)
DR means “disease of the retina caused by diabetes.” This is caused by high blood sugar levels over time, which leads to damage of the retina (the back of your eye, which captures the image you see, kind of like the sensor of a digital camera). If left untreated, DR can cause vision loss or blindness. Also called diabetic retinopathy.
Diabetic foot disease (DFD)
A range of foot-related complications that can occur when blood sugar levels are chronically high, including neuropathy, ulcers, and infections that, if left untreated, can lead to severe complications, including amputation. DFD is often associated with neuropathy and reduced blood circulation to the lower extremities.
Diabetic ketoacidosis (DKA)
Ketoacidosis, or diabetic ketoacidosis in people with diabetes, occurs when a person does not have enough insulin to control the breakdown of its fat stores (into ketones) for energy, resulting in high levels of ketones in the blood. Ketones are acidic molecules, so an increased level of ketones can cause the blood to become more acidic, which prevents the body from functioning normally. Elevated ketones can be detected in the blood by a blood ketone meter and in the urine by ketone test strips. Elevated ketones may require immediate treatment to prevent DKA, which can be life threatening.
Diabetic macular edema (DME)
A complication of diabetic retinopathy that occurs when chronically high glucose levels damage the blood vessels in the retina, an area near the back of the eye. When fluid from damaged blood vessels leaks into the retina, it causes swelling (edema). Also called diabetes-related macular edema.
Diabetic neuropathy
A type of nerve damage that can occur if you have diabetes. High blood glucose over time can injure nerves throughout the body. Diabetes-related neuropathy most often damages nerves in the legs and feet. Depending on the affected nerves, diabetic neuropathy symptoms include pain and numbness in the legs, feet and hands. Also called diabetes-related neuropathy.
DPP-4 inhibitors
A type of medication that people with type 2 diabetes can use to lower blood sugar levels. DPP-4 (dipeptidyl peptidase-4) inhibitors lead to more GLP-1 hormone that lasts longer in the bloodstream, stimulating insulin production and decreasing production of glucagon when glucose levels are high, thus lowering the body’s glucose levels.
E
End-stage renal disease (ESRD)
See kidney failure.
Endocrinologist
A physician who specializes in treating people who have endocrine problems such as type 1 diabetes, type 2 diabetes, obesity, or thyroid disease.
Endocrinology
A branch of medicine that deals with the endocrine system, the system that controls hormones in the body.
Estimated glomerular filtration rate (eGFR)
The rate at which fluids are filtered through the kidneys, and the main measurement used to determine kidney function.
F
Fasting blood glucose
A test that measures blood sugar levels after an overnight fast. Sometimes used in diagnosing diabetes. Also called fasting blood sugar or fasting plasma glucose.
Flexible spending account (FSA)
An FSA is used to put money aside that is not taxed to help pay for medical expenses. FSAs, along with HSAs, can be used for any kind of health insurance, and all FSA funds must be used in the same calendar year. Also see health savings account (HSA).
Food and Drug Administration (FDA)
A federal agency responsible for regulating and ensuring the safety and efficacy of prescription and over-the-counter medications, medical devices, and biologics such as vaccines and gene therapy products, among other categories.
Formulary
A list of prescription medications that a health insurance plan covers. This varies depending on health insurance plan, and often contains different levels of coverage called tiers, with lower tiers meaning lower out-of-pocket costs for subscribers. Also see non-formulary drugs.
G
Gastroparesis
A condition characterized by delayed emptying of the stomach, commonly seen in individuals with long-standing diabetes and diabetic neuropathy. It can lead to symptoms such as bloating, nausea, and erratic blood sugar levels.
Gestational diabetes mellitus (GDM)
Gestational diabetes can develop during pregnancy, if a woman’s body cannot produce enough insulin to keep blood sugar levels in a target range. Gestational diabetes is usually temporary, and blood sugar levels will usually normalize after childbirth. Women who have had GDM may have the condition with future pregnancies and are also at increased risk for type 2 diabetes later in life.
Glitazones
GLP-1
1) A hormone produced by the body that helps regulate blood sugar, appetite, and digestion. It does so by stimulating insulin secretion (thus lowering blood glucose levels), suppressing appetite, and slowing digestion by delaying gastric emptying, inhibiting gastric acid and secretion of pancreatic enzymes.
2) An abbreviated term used to refer to GLP-1 receptor agonist medications.
GLP-1 receptor agonist (GLP-1 RA)
Glucose-lowering medications in the incretin drug class that are used by people with type 2 diabetes. Some GLP-1 medicines have been shown to benefit the heart. Sometimes referred to as a GLP-1 agonist or GLP-1 (not to be confused with the identically named hormone).
Glucagon
1) A hormone that prompts the body to increase blood sugar by releasing stored sugar into your bloodstream or having the liver make sugar.
2) A medicine to treat people with diabetes for severe hypoglycemia at home.
Glucometer
See blood glucose meter.
Glucophage
See metformin.
Glucose tablet
A simple sugar in tablet form that is taken orally to treat hypoglycemia.
Glycemic
Relating to the the concentration of sugar or glucose in the blood.
Glycemic index (GI)
A ranking of carbohydrate-containing foods based on their effect on blood sugar levels that measures how quickly and how much a specific food raises blood glucose compared to a reference food, usually glucose or white bread. A high GI (70 or above) causes a rapid increase in blood sugar, while a low GI (55 or below) leads to a more gradual rise. A helpful tool for managing blood sugar levels, particularly for people with widely fluctuating blood glucose levels, such as those with type 1 diabetes.
Glycemic load (GL)
A measure that estimates how much a food will raise a person's blood glucose, providing a more accurate picture of a food’s real-life impact on blood sugar after meals. Foods with a low glycemic load (10 or less) have a smaller effect on blood sugar levels, while those with a high glycemic load (20 or more) can cause larger spikes in blood sugar.
H
HbA1c
See A1C.
HDL (high-density lipoprotein) cholesterol
Particles of fats and proteins that help remove other types of cholesterol from your bloodstream. Higher levels of HDL cholesterol are associated with a lower risk of heart disease. Often colloquially referred to as "good cholesterol."
Health maintenance organization (HMO)
A type of private insurance plan that usually has high premiums and low deductibles. An HMO plan covers healthcare within a network of hospitals and healthcare professionals. Your providers must be in-network to get your diabetes care covered. If you have a good team of diabetes care professionals in-network, this is often the most cost-effective healthcare option for people with diabetes because you have a lower deductible, which means a lower out-of-pocket cost.
Health savings account (HSA)
A type of savings account used to put money aside that is not taxed to help pay for medical expenses. HSAs are often paired with high deductible health plans.
Heart failure
Heart failure (also known as CHF, or congestive heart failure) occurs when the heart, a muscle, cannot adequately pump blood to meet the body's needs. The condition can leave the heart too weak or too stiff to pump blood properly, and fluid can build up in the lungs and blood can back up in veins, causing shortness of breath and swelling (edema) in the legs.
There are many causes for heart failure. They include narrowed or blocked heart arteries from atherosclerosis, blocked small arteries from diabetes, high blood pressure, heart valve disease, viral inflammation of the heart muscle (myocarditis), irregular heart rhythms (arrhythmias), and other conditions.
High deductible health plan (HDHP)
A type of private insurance plan that typically has low monthly premiums and high deductibles. In 2020, the IRS defined an HDHP as any plan with a deductible of at least $1,400 for an individual and $2,800 for a family. These health plans are ideal for people who don’t anticipate needing regular healthcare. Paying for diabetes care can be difficult with this type of plan because it will have high out-of-pocket costs up front.
Hormone
Chemical made by the body that coordinates different functions by carrying messages through your blood to your organs, skin, muscles and other tissues. Hormones are essential for life and your health, signaling to your body what to do and when to do it.
Human insulins
A class of medications, identical in structure to the insulin produced in the human body, that can either be short-acting or intermediate-acting. Human insulins were developed before and are less expensive than short-acting or long-acting analog insulins. Examples of human insulin include Humulin and Humulin NPH.
Hybrid closed loop system
See automated insulin delivery (AID) system.
Hyperglycemia
Also known as high blood sugar, hyperglycemia is a condition in which a person's blood glucose values are higher than normal. Hyperglycemia is often a result of insufficient insulin, not enough physical activity, or too much food (particularly those high in carbohydrates). It is often defined as a glucose value above 180 mg/dL (10 mmol/L). Over time, hyperglycemia can lead to major long-term health complications.
Hyperlipidemia
Elevated levels of fats (lipids) in the blood, including cholesterol and triglycerides. People with diabetes are at increased risk of developing hyperlipidemia, which can contribute to cardiovascular complications.
Hypertension
A condition when blood flows through the blood vessels with a force greater than normal, which can strain the heart, damage blood vessels, and increase the risk of heart attack, stroke, kidney problems, and death. Also known commonly as high blood pressure.
Hypoglycemia
Also known as high blood sugar, a condition where blood glucose levels drop too low, leading to symptoms like shakiness, confusion, and sweating. It is often defined as a value below 70 mg/dL (3.9 mmol/L). Hypoglycemia is sometimes a result of too much insulin in the body. Severe hypoglycemia can result in seizures and loss of consciousness. Some individuals with diabetes do not experience the typical warning signs and symptoms of hypoglycemia. Also see hypoglycemia unawareness.
Hypoglycemia unawareness
Hypoglycemia unawareness occurs when someone doesn’t perceive symptoms of hypoglycemia (such as shakiness, sweating, confusion, heart palpitations, weakness, and nausea) that typically occur when blood sugars fall below 70 mg/dL. This condition puts people at higher risk for severe episodes of hypoglycemia where the assistance of another person or persons is required, but it is also reversible.
I
Immunosuppressant
A medication that suppresses the natural immune responses; often given to kidney or pancreas transplant patients to prevent organ rejection or to patients with autoimmune diseases.
Incretins
1) Naturally occurring hormones in the body that help lower blood glucose after eating.
2) Also called incretin therapies or incretin mimetics, these are classes of drugs that can help people with diabetes lower blood glucose. Some cause weight loss and can reduce heart or kidney risk. They work similarly to the actions of natural incretin hormones, which help lower blood sugar after eating.
Infusion set
A set of medical equipment that carries insulin from an insulin pump to the body; includes the thin plastic or metal tubing that is inserted under the skin (often a cannula).
Inhaled insulin
Human insulin inhalation powder is an ultra-rapid-acting insulin in powder form that is inhaled to help manage blood glucose, currently sold under the brand name Afrezza.
Inpefa
One of the brand names of sotagliflozin, an SGLT-2 inhibitor medication used to reduce the risk of death due to heart failure, hospitalization for heart failure, and urgent heart failure visits in adults with heart failure or type 2 diabetes mellitus, chronic kidney disease, and other cardiovascular risk factors. It can also be used cautiously in people with heart failure who have type 1 diabetes.
Insulin
Insulin is a hormone in the body that allows most cells to take up glucose from the bloodstream to use as energy immediately or store for later use, thus lowering the blood glucose levels. People with type 1 diabetes and some people with type 2 diabetes need to take insulin because their bodies either cannot produce enough insulin (insulin deficiency) and/or cannot respond well to their own insulin (a condition known as insulin resistance).
Insulin on board (IOB)
The amount of insulin that has already been administered and is still active in the body at a given time. IOB helps track how much insulin is still working to lower blood glucose levels after an injection or bolus.
Insulin pen
A pen-shaped device for injecting insulin that is either disposable and pre-filled, or capable of holding replaceable cartridges.
Insulin pump
A device that delivers insulin in the body without the need for manual injections. It administers rapid-acting insulin only in both basal and bolus capacities, and often comes with a built-in bolus insulin dose calculator.
Insulin resistance
A condition where the body's cells become less responsive to the effects of insulin, resulting in elevated blood sugar levels. It is a hallmark of type 2 diabetes.
Insulin sensitivity factor (ISF)
Insulin-to-carb ratio
The amount of carbohydrates covered by one unit of insulin; a calculation used when counting carbohydrates in grams. Sometimes referred to as carb ratio, exchange ratio, ICR, or I:C ratio.
Insurance appeal
The process of asking an insurance company to reconsider its decision to deny paying for a therapy or service. There are two main types of appeals, an internal appeal or an external review.
Interstitial fluid
Fluid between the cells in the human body that is used for continuous glucose monitor readings.
Islet cells
Also called islets of Langerhans, these are groups of cells located in the pancreas that make hormones that help the body break down and use food. Beta cells are a type of islet cell.
J
Juvenile diabetes
A term formerly used for type 1 diabetes. See type 1 diabetes.
K
Ketone test
A test that measures the amount of ketones in the blood or urine. High levels of ketones may indicate presence of diabetic ketoacidosis (DKA).
Ketones
Substances produced when the body breaks down fat for energy in the absence of sufficient insulin. High levels of ketones can lead to diabetic ketoacidosis (DKA), a serious complication of diabetes.
Kidney failure
A condition in which the kidneys no longer work properly. A person with kidney failure needs dialysis or a kidney transplant. Also called end-stage renal disease (ESRD).
Kidneys
A pair of organs in the body that filter wastes from the blood, which are then removed in urine. Over time, elevated blood glucose levels can damage the kidneys.
L
Latent Autoimmune Diabetes in Adults (LADA)
A slowly progressing form of autoimmune diabetes that occurs in adults. Sometimes misdiagnosed as type 2 diabetes. Also referred to as type 1.5 diabetes.
LDL (Low-density lipoprotein) cholesterol
Particles of fats and proteins that transport cholesterol throughout the body. Higher levels of LDL cholesterol are associated with a greater risk of heart disease and stroke. Often colloquially referred to as "bad cholesterol."
Lipoatrophy
Loss of fat beneath the skin, leading to the formation of small indentations. Lipoatrophy can occur as a result of multiple insulin injections at the same site.
Lipodystrophy
A broad term that refers to the breakdown or accumulation of fat beneath the skin, resulting in lipoatrophy or lipohypertrophy. Lipodystrophy may also be triggered by repeated insulin injections in the same area.
Lipohypertrophy
A lump under the skin from an accumulation of fat at the site of many insulin injections; occurs when the same area is repeatedly used for insulin injection or infusion.
Liraglutide
A GLP-1 receptor agonist medication.
Liver
The organ in the body that changes food into energy, removes alcohol and toxins from the blood, and makes bile and glucose.
Long-acting insulin
See basal insulin.
M
Macrovascular disease
A condition that affects large blood vessels, increasing the risk of heart disease, stroke, and peripheral artery disease. It can be a diabetes-related complication.
MASH
A more severe form of MASLD characterized by liver inflammation and damage that, if not treated, may lead to cirrhosis.
MASLD
Short for metabolic associated steatotic liver disease, MASLD is the accumulation of fat in the liver due to metabolic dysfunction. If not treated, it may progress to more severe forms (see MASH).
Maturity-onset diabetes
A term formerly used for type 2 diabetes.
Maturity-onset diabetes of the young (MODY)
A less common type of diabetes. It can be type 2 diabetes in youth and adolescents; it can also be caused by one of several single gene mutations (monogenic diabetes).
Medicaid
A government health insurance program for people and families below a certain income threshold. Medicaid is run by state, so coverage and access will vary depending on which state you live in.
Medical policy guidelines
Guidelines set in place by insurance companies to help determine whether a medical procedure is necessary.
Medical review
The collection and review of medical records and related information to make sure that payment for a procedure or therapy is made only for those that meet all your healthcare plan’s coverage, coding, billing, and medical necessity requirements.
Medicare
A federal government health insurance program for people who are 65 or older. There are 2 main ways to get Medicare. Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). If you want drug coverage, you can join a separate Medicare drug plan (Part D). Medicare Advantage (also known as “Part C”) is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. Most Medicare Advantage plans offer extra benefits Original Medicare doesn’t cover–like vision, hearing, dental, and more. Your Medicare health plan decisions affect how much you pay for coverage, what services you get, what doctors you can use, and your quality of care.
Metabolism
A term that encompasses all of the body's processes to convert or use energy. Your metabolism constantly provides your body with energy for essential body functions like breathing and digestion. Your body needs a minimum number of calories (the basal metabolic rate or BMR) to sustain these functions. Factors like age, sex, muscle mass and physical activity affect metabolism or your BMR.
Metformin
A medication (sold under other names including Glucophage, Glumetza, Fortamet, and Riomet) that is typically the first-prescribed glucose-lowering drug for someone diagnosed with type 2 diabetes.
Microalbuminuria
A kidney condition marked by the presence of small amounts of albumin, a protein, in the urine. Microalbuminuria (urine ACR of greater than 30 mg/g but less than 300 mg/g) may be an early sign of kidney damage.
Microvascular complications
Diabetes-related complications that affect small blood vessels. This includes diabetic retinopathy (eye disease), nephropathy (kidney disease), and neuropathy (nerve disease).
Monogenic diabetes
A rare condition that occurs when a single gene mutation causes diabetes.
Mounjaro
One of the brand names of injectable tirzepatide, a dual GLP-1/GIP receptor agonist medication, when used for the treatment of type 2 diabetes.
N
Nephropathy
Kidney damage that can lead to kidney failure. A common complication of diabetes. See chronic kidney disease.
Nephropathy
Kidney damage that can lead to kidney failure. A common complication of diabetes.
Neuropathy
See diabetic neuropathy.
Non-formulary drugs
Medications that are not listed as covered on a particular health insurance plan. Also see formulary.
NPH insulin
An intermediate-acting human insulin, short for neutral protamine Hagedorn insulin, that begins to lower blood glucose within 1-2 hours of injection, peaks at 6-10 hours after injection, and continues working until 10 hours after injection. Also called “N” insulin.
Nutritionist
A person who specializes in nutrition, but may or may not have certified training and qualifications. See registered dietitian.
O
Obesity
A condition in which a greater than normal amount of fat is in the body; characterized by having a body mass index (BMI) of 30 or greater.
Oral glucose tolerance test (OGTT)
A test that measures the body’s response to sugar; one way to diagnose diabetes.
Out-of-pocket expenses
A person’s share of healthcare expenses, such as a deductible, copay, or coinsurance, that are not covered by insurance.
Overweight
An above-normal body weight; characterized by having a body mass index (BMI) of between 25-30.
Ozempic
One of the brand names of injectable semaglutide, a GLP-1 agonist medication, when used for the treatment of type 2 diabetes.
P
Pancreas
A large organ behind the stomach that produces enzymes that digest food as well as hormones such as insulin and glucagon that are critical for converting sugar into energy that can be used in the body.
Pediatric endocrinologist
A physician who specializes in treating children or adolescents with endocrine-related disorders such as type 1 diabetes.
Peripheral neuropathy
Diabetes-related neuropathy, or nerve damage, which affects the arms, hands, legs, feet, and toes.
Pharmacy benefit manager (PBM)
A company that processes prescriptions for insurance companies and works in the middle of the distribution chain to negotiate deals and discounts with pharmacies and drug manufacturers. It also develops and maintains formularies (approved medications) on behalf of insurers.
Phase 1 clinical trial
A small trial that focuses on safety and proper dosage of a therapy in a small group; the first step in testing a new treatment in humans.
Phase 2 clinical trial
A type of clinical trial that follows a phase 1 clinical trial and evaluates the effectiveness and safety of a therapy or treatment in a larger group.
Phase 3 clinical trial
A study that tests the safety and how safe and effective a new treatment is compared with a standard treatment, and the last phase of testing that must be completed before treatment details and trial results are submitted to regulatory bodies (such as the FDA) for approval of the therapy's release on the market. It follows a phase 2 clinical trial, and often takes place at multiple research centers, involving hundreds or thousands of participants.
Phase 4 clinical trial
A study that evaluates the safety and effectiveness of a drug or treatment after it has been approved by the FDA and is available to the public. Also called a post-marketing surveillance trial.
Polydipsia
Excessive thirst.
Polyphagia
Excessive hunger or increased appetite.
Polyuria
Increased urination.
Post-prandial
Referring to the period after a meal; for example, postprandial blood glucose levels.
Prandial insulin
An insulin that is taken with food and acts quickly in the body, helping to manage glucose levels following meals. It has an onset of 30-60 minutes, a peak of 2-4 hours, and an overall duration in the system of less than 5-8 hours. Also called short-acting insulin, bolus insulin, rapid-acting insulin, or mealtime insulin.
Prediabetes
Prediabetes is a potentially reversible condition in which the body has higher than normal blood sugars. Blood sugars may continue to rise, resulting in type 2 diabetes.
Preferred provider organization (PPO)
A type of health insurance plan that partners with a group of clinics, hospitals and doctors to create a network of preferred providers. In contrast to an HMO, PPO plans allow for more flexibility, with the option to see out-of-network providers and specialists without a medical referral. PPOs typically have higher premiums and out-of-pocket costs than HMO plans.
Premium
A fixed amount paid every month to keep health insurance active.
Prior authorization
Approval from a health insurance plan that may be required in order to get treatment or fill a prescription and have it be covered by the healthcare plan; designed to ensure therapies and devices are from the approved formulary and only when medically necessary. Also known as pre-authorization or pre-certification.
Q
Qsymia
The brand name of a fixed-dose combination of phentermine and topiramate used to treat obesity.
R
Rapid-acting insulin analog
See prandial insulin.
Registered dietitian (RD)
A certified healthcare professional who helps to create personalized meal plans and nutritional strategies to manage blood sugar levels. All registered dietitians are nutritionists, but not all nutritionists are registered dietitians. Also can be referred to as a registered dietitian nutritionist (RDN).
Regular insulin
A short-acting human insulin that is less expensive but not as fast-acting as newer rapid-acting insulin analogs. Also called “R” insulin, neutral insulin, or soluble insulin.
Remission
Diabetes remission is a state where blood glucose levels return to normal or near-normal levels without the need for diabetes medication. Remission can occur in some individuals with type 2 diabetes through substantial weight loss, especially if they have not had type 2 diabetes for very long.
Rybelsus
The brand name of oral semaglutide, a GLP-1 agonist medication.
S
Saxenda
The brand name of liraglutide, a GLP-1 agonist medication, for obesity.
Secondary diabetes
A form of diabetes that arises as a consequence of another condition, such as cystic fibrosis or chronic pancreatitis. Also referred to sometimes as type 3c diabetes or pancreatogenic diabetes.
Semaglutide
A GLP-1 receptor agonist medication sold under the names Ozempic injection for type 2 diabetes, Wegovy injection for obesity, and Rybelsus tablets for type 2 diabetes.
SGLT-2 inhibitors
A class of glucose-lowering drugs that cause the kidneys to excrete excess glucose through the urine. SGLT-2 inhibitors have also been shown to benefit the heart and kidneys in people with and without type 2 diabetes. They are currently not approved for people with type 1 diabetes.
Sharps container
A government-approved container for needles and other sharp or spiky medical waste containing blood or insulin.
Short-acting insulin
See prandial insulin.
Somogyi effect
Used to describe when a low blood glucose episode overnight leads to high blood sugar in the morning due to a hormonal response to hypoglycemia.
Sorbitol
A common type of sugar alcohol.
Sotagliflozin
An SGLT-2 inhibitor medication used to reduce the risk of death due to heart failure, hospitalization for heart failure, and urgent heart failure visits in adults with heart failure or type 2 diabetes mellitus, chronic kidney disease, and other cardiovascular risk factors. It can also be used cautiously in people with heart failure who have type 1 diabetes.
Sugar alcohols
Sweeteners that cause a lesser increase in blood glucose levels compared to other carbohydrates. Examples include erythritol, hydrogenated starch hydrolysates, isomalt, lactitol, maltitol, mannitol, sorbitol, and xylitol. Also called polyols.
T
Test strips
Small disposable strips inserted into a blood glucose meter to measure blood glucose levels.
Thiazolidenediones (TZDs)
An older type of medication that people with type 2 diabetes can use to lower blood sugar levels by reducing insulin resistance. Also known as glitazones.
Thyroid-stimulating hormone (TSH)
Refers to a blood test that evaluates how well the thyroid gland is working; a marker of autoimmune thyroid disorders. As type 1 diabetes is an autoimmune disorder, people with type 1 need to be screened for other autoimmune processes, like autoimmune thyroid disorders.
Time in range
Time in range is the percentage of time that a person spends with their blood glucose levels in a target range. The range will vary depending on the person, but general guidelines suggest a range of 70-180 mg/dL for most people with diabetes. Time in range can be measured using a continuous glucose monitor (CGM).
Tirzepatide
a dual GLP-1/GIP receptor agonist medication sold under the names Mounjaro for type 2 diabetes and Zepbound for obesity.
Total daily dose
The total number of insulin units delivered (basal and bolus) in the last 24 hours. Also called daily total or daily dose.
Triglycerides
A type of fat that circulates in the blood along with cholesterol; a risk factor for developing diabetes, heart disease and stroke.
Type 1 diabetes
Type 1 diabetes is an autoimmune condition in which the body can no longer produce insulin. People who have family members with type 1 diabetes are more likely to develop it themselves. There are currently no known ways to cure type 1 diabetes.
Type 1.5 diabetes
Type 2 diabetes
Type 2 diabetes is a condition in which the body does not produce enough insulin and has trouble responding to insulin (insulin resistance). It is caused by a combination of factors including aging, excess weight, lifestyle, and genetics. It may be possible to reduce one’s risk of developing type 2 diabetes or to cause remission of ongoing type 2 diabetes with substantial weight loss.
Type 3c diabetes
See secondary diabetes.
TZDs
See thiazolidenediones, glitazone.
U
U-100 insulin
A concentration of insulin where 100 units are contained in 1 milliliter of solution.
U-500 insulin
A concentrated form of insulin that contains 500 units of insulin per milliliter, making it five times more concentrated than the standard U-100 insulin. Typically used in people with severe insulin resistance.
uACR
Urine albumin-to-creatinine ratio (uACR)
A urine lab measurement of the amount of albumin protein that is used as a marker for kidney disease. A uACR of greater than 30 mg/g indicates kidney damage. Sometimes referred to as urinary albumin-creatinine ratio.
V
Vascular
Relating to the body's blood vessels. Vascular complications can occur as a result of diabetes, affecting circulation and leading to conditions like heart disease and stroke.
Victoza
The brand name of liraglutide, a GLP-1 agonist medication, for type 2 diabetes.
VLDL (very low-density lipoprotein) cholesterol
Particles of fats and proteins that carry triglycerides to tissues throughout the body; important for energy storage, gain, and blood pressure regulation. Too much VLDL cholesterol can lead to build-up in arteries, contributing to increased cardiovascular risk.
W
Wegovy
One of the brand names of injectable semaglutide, a GLP-1 agonist medication, for obesity.
X
Xylitol
A naturally occurring sugar alcohol that is used to sweeten sugar-free gum, candy, toothpaste, and desserts without causing tooth decay. Xylitol has 40% less calories than sugar.
Y
Yeast infection
A type of genital infection (vaginal in females, penile in males) caused by an overgrowth of the fungus candida that occurs more commonly in people with diabetes. Also a common side effect in certain diabetes medications such as SGLT-2 inhibitors.
Z
Zepbound
One of the brand names of injectable tirzepatide, a dual GLP-1/GIP receptor agonist medication, for obesity.
Zynquista
One of the proposed brand names for sotagliflozin, an SGLT-2 inhibitor medication being considered by the U.S. FDA for people with type 2 diabetes and chronic kidney disease. Sotagliflozin is currently approved for heart failure as Inpefa. See Inpefa.