Download Encyclopedia of Diabetes PDF

TitleEncyclopedia of Diabetes
File Size3.7 MB
Total Pages465
Table of Contents
A History of Diabetes
Entries A to Z
	I: Important Organizations
	II: Diabetes Periodicals
	III: Diabetes Research and Training Centers
	IV: Diabetes Endocrinology Research
	V: Diabetes Control Programs in U.S. States and Territories
	VI: World Health Organization Worldwide Collaborating Centers for Diabetes
	VII: Web Sites that Include Diabetes Information
	VIII: Worldwide Percentage of Incident Patients with ESRD Due to Diabetes, 2003-2007
	IX: Important but Often Overlooked Key Issues in Diabetes
	X: Body Mass Index Charts and Curves for Children and Young Adults Under Age 20
	XI: Joslin Diabetes Center Clinics and Affiliates
Document Text Contents
Page 2



Second Edition

Page 232

glycosuria/glucosuria 203

monitoring so that they can make adjustments
to their diet and medication and report extreme
changes to their physician.

Dietary control Few people enjoy having to
think critically about what they should or should
not eat and how and why it may affect their
blood glucose levels. Yet this is another essential
aspect of good glycemic control for people with
both Type 1 and Type 2 diabetes. Thus nutri-
tional education is critical as well as support
from family and friends.

Lifestyle changes Another aspect of good
glycemic control is for the person with diabe-
tes to make basic lifestyle changes in order to
avoid behaviors that can worsen glucose lev-
els. For example, smoking is known to cause
many severe problems for people with diabetes.
However, since people with diabetes have a
higher risk than the general population without
diabetes for developing hypertension, stroke,
cardiovascular disease, and many other blood
vessel–related diseases that are aggravated by
smoking, it is critical and lifesaving for anyone
who has diabetes to stop smoking as soon as

obesity is a risk factor for the development of
Type 2 diabetes and after diagnosis will increase
insulin resistance and thus worsen overall glyce-
mic control. Most people with impaired glucose
tolerance or Type 2 diabetes or hypertension
or hyperlipidemia (or any combination of those
problems) will improve their condition by losing

Regular daily exercise is another way for
people with diabetes to maintain healthy glyce-
mic control.

See also blood glucose monitoring,

Harris, Maureen I. “Frequency of Blood Glucose Mon-
itoring in Relation to Glycemic Control in Patients
with Type 2 Diabetes.” Diabetes Care 24, no. 6 (June
2001): 979–982.

Hunt, Linda M., et al. “How Patients Adapt Diabetes
Self-Care Recommendations to Everyday Life.”
Journal of Family Practice 46, no. 3 (March 1998):

glycogen Stored glucose within the body,
found primarily in the liver and the muscles.
When needed by the body, it is transformed
through glycogenolysis, back into glucose. Con-
versely, glycogenesis is the process by which glu-
cose is converted into glycogen.

Glycogen can be thought of as stored glucose.
It is comprised of strands that are bound end to
end in a branching form, much like the branches
on a Christmas tree. Two enzymes are impor-
tant in this process. Glycogen synthase controls
synthesis and glycogen phosphorylase controls
breakdown of glycogen. Working together, these
enzymes control the glucose balance.

During times between meals when glucose
is needed, the body breaks down stored gly-
cogen to normalize the blood glucose level.
At one time, it was thought that an excessive
breakdown of liver glycogen was the major
determinant of the fasting blood glucose level
in patients with Type 2 diabetes. However,
special liver studies (in vivo nuclear magnetic
resonance spectroscopy) have determined that
the predominant contributor to the increase in
fasting glucose is due to gluconeogenesis; that is
the formation of new glucose.

The average person has about 18 hours of gly-
cogen stores in the liver before the body needs
to begin making new glucose or burning fat (i.e.,

glycosuria/glucosuria Glucose in the urine,
which is an abnormal sign, and an indicator of
diabetes. People with undiagnosed diabetes have
a typically sweet taste to their urine, attractive to
insects and which has been noted since ancient

Generally, glucose will “spill over” into the
urine in this condition, if the glucose blood lev-
els are greater than 180 mg/dL. In people who
have diabetes, their kidneys adapt and glucose
may not show up in the urine until levels are
greater than 250–300 mg/dL. As a result relying
on urine testing only is an inadequate method of
screening for and monitoring diabetes.

Page 233

204 government, federal

Occasionally, people without diabetes have a
lower than normal renal glucose threshold and
it will spill glucose into the urine even when the
person has normal blood glucose levels.

government, federal The U.S. government and
its role in diabetes research, treatment, and

The federal government performs or pays
for research on diabetes, primarily through the
National Institutes of Health and based on funds
that are provided by Congress. Federal agencies
also provide information to individuals with dia-
betes and their families.

The key federal organizations involved in
diabetes are the Centers for Disease Control
and Prevention, the National Diabetes Informa-
tion Clearinghouse, and the National Institute
of Diabetes and Digestive and Kidney Diseases

There are also several programs important to
many people with diabetes, including medicare
and medicaid. medicare is a federal medical
program that is primarily oriented to people over
age 65 and that also includes many younger
disabled people. Medicaid is a program that
receives some federal funds but that is managed
by the states. It provides medical care to indigent
people of all ages.

Medicare provides coverage for immuni-
zations for flu and pneumonia, which are
important for people with diabetes. Medicare
recipients also receive coverage of syringes and
related material that are needed by individu-
als with diabetes. Medicare also covers some
limited home health care services and very
limited (30 days after hospitalization, as of this
writing) skilled nursing care services. Medicare
also pays for therapeutic shoes for some patients
who need them.

government, state Governments at the state
level and their role in research, treatment, and
payment for diabetes programs.

All state governments have an agency that
is dedicated in part or solely to the subject of
diabetes. Some states place this responsibility
within their state health department while oth-
ers place it under other offices. Some states have
more active programs than others and this may
also vary from year to year.

State governments administer the medicaid
program, receiving some federal money as well.
Medicaid is a program for indigent people who
are eligible for assistance because of old age, dis-
ability, or other reasons.

growth hormone A substance that is naturally
produced by the anterior pituitary gland in
response to stimulation by growth hormone-
releasing hormone (GHRH) produced by the
hypothalamus. In growing children, growth hor-
mone is released in a pulsatile fashion mainly at
night, and it stimulates growth and development
via an array of intermediary hormones.

Growth hormone is also released in response
to hypoglycemia, although its metabolic effects
are slow and most people’s recovery from hypo-
glycemia is mainly mediated via adrenaline and

Natural levels of growth hormone tend to
be slightly higher in overweight patients with
Type 2 diabetes. Excessive growth hormone
production in children can cause gigantism and
excessive levels of growth hormone in adults can
result in acromegaly.

Growth Hormone as Treatment

Growth hormone that was created from recom-
binant processes is administered to children
with documented growth hormone deficiency
due to pituitary tumor or trauma. Females with
Turner’s syndrome may also be given growth
hormone to help them grow taller.

Growth hormone may be administered to
adults to increase their lean body mass, increase
strength, and improve their quality of life. Typi-
cally, growth hormone is given only to adults
with documented growth hormone deficiency.

Page 464

index 435

vitamin B6 333
vitamin B12, in bariatric surgery 45
vitamin C 23, 333
vitamin D, in osteoporosis 290
vitamin E 23, 27, 40, 333
vitamins 21, 23, 27–28, 333

and cataract risk 67
vitrectomy in diabetic retinopathy

vomiting. See nausea and vomiting
von Mering, Joseph. See Mering,

Joseph von
von Noorden, Carl H. See Noorden,

Carl H. von

Wagner, Heidi 129
waist circumference

in metabolic syndrome 272, 273
ratio to hip size 334

warfarin 21
in stroke 316

Warnock, Garth xi
Warshaw, Hope S. 61
water pills. See diuretics
Weber, Michael A. 63
Weber Cullen, Karen 207
Web site resources

of American Diabetes
Association 152

on Americans with Disabilities
Act 178

on body mass index 113
of Centers for Medicare and

Medicaid Services 254
for children with diabetes 227
on Family and Medical Leave

Act 178
on foot examination 180
on hormone replacement

therapy 213
on kidney disease 305
of NIDDK 254
on thiazolidinediones 261
on travel 324
of Veterans Administration 333
for weight loss 284

weight gain
in alcohol use 15
in Cushing’s syndrome 95
in DCCT study 154–155, 232
in insulin therapy 232, 281

medications associated with 48,
90, 232, 258, 259, 260, 268,
277, 287, 318, 321

in metabolic changes 276
in pregnancy 189–190
in tight glycemic control 154–

weight loss

of adolescents 7
bariatric surgery for 43–47, 117,

247, 282–283
in diabetic nephropathy 135
in impaired glucose tolerance

203, 226
insulin manipulation for 155–

156, 281, 338
Internet-based program for 284
lifestyle adaptations for 246–247
medications for 247, 283
in metabolic syndrome 273
in obesity 90
in prevention of diabetes 125,

as symptom of diabetes 319

Wellbutrin. See bupropion
Whaley-Connell, Adam 133
When a Child Has Diabetes

(Daneman, Frank, Perlman) 227
White, Marney A. 282
“white coat” hypertension 219
Whitehall Study 201
whites/Caucasians 111, 112,

cataracts in 127
death rate from diabetes 98t
diabetic ketoacidosis in 131
diabetic neuropathy in 137
end-stage renal disease in 170
gingivitis in 198
glaucoma in 129
glycemic control in 202
health insurance coverage of

obesity in 284, 285t
school support for 78, 80t
Type 1 diabetes in 6, 68, 334,

Type 2 diabetes in 32, 115, 334,

whole grain foods 178, 335
Williams, Gareth 15–16
Willis, Thomas xiii, xiv

Wing, Rena 65
Wisconsin Epidemiologic Study of

Diabetic Retinopathy (WESDR)

Wolosin, James D. 146
women 112, 336–338

and adolescent females with
diabetes 7, 8

and adolescent females with
eating disorders 154–157

African American 12, 13
alcohol use in 247
Alzheimer’s disease in 21
in assisted living facilities 41
birth control methods for 49
breast-feeding by 53–54
cardiovascular disease in 63, 64,

93, 337, 338
cataracts in 127
of childbearing age 124
complications of diabetes in

122, 337
creatinine levels in 94
cystitis in 96
death rate from diabetes 97, 98t
depression in 101, 105
employment of 166
end-stage renal disease in 170
gestational diabetes in 189–196,

and girls with Type 1 diabetes

69, 69t–76t
Hispanic 207, 207t
hormone replacement therapy in

211–213, 269
hypertension in 215, 216t, 217
insulin pump in 236
menopause in 211–213, 268–269
menstruation in 269
metabolic syndrome in 272,

273, 274t, 275, 275t
osteoporosis in 290, 291
polycystic ovarian syndrome in

296. See also polycystic ovarian

pregnancy in 124, 297–302. See
also pregnancy

sexual problems in 90, 309, 337
thyroid disease in 322
Type 1 diabetes in 325, 336,

337, 338
Type 2 diabetes in 326, 336, 337

Page 465

436 The Encyclopedia of Diabetes

urinary tract infections in 328,

vaginitis in 331–333, 340
Women’s Health Initiative 212
workplace 165–167. See also

World Health Organization xxiv,

50, 97–98, 276, 334
World Heart Federation 273
Wu, Patricia 322

Xenical. See orlistat
xerosis 92, 153, 312
xerostomia 197

yeast infections 340

acidophilus in 269, 340
candidal. See candidal infections
vaginitis in 228, 331–333, 332t

Zestril. See lisinopril
Ziegler, Dan 137–138, 141
zinc 82, 341
Zocor. See simvastatin
Zoloft. See sertraline
Zung Self-Rating Depression Scale

Zyban. See bupropion
Zyprexa. See olanzapine

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