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Diabetes from A to Z

Scientific support: Prof. Dr. Norbert Stefan

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Abdominal obesity

Abnormal fasting glucose

This is the term for fasting blood sugar levels above the normal range but below the threshold for diabetes. In this case, the fasting blood sugar level  is between 100 and 125 mg/dl.


An abscess is an encapsulated collection of pus caused by often bacterial infection.

Acarbose – See alpha-glucosidase inhibitor

Acarbose is a drug in tablet form and is classified as an oral antidiabetic. It is used as part of the blood sugar-reducing therapy of type 2 diabetes.

ACE inhibitors

ACE inhibitors belong to the blood pressure-reducing class of drugs. They inhibit the activity of the "Angiotensin Converting Enzyme“ (ACE). This blocks the development of vasoconstrictor angiotensin II. Among other things, angiotensin II increases blood pressure.


Acetone is a metabolic product that can develop, for example, in cases of insulin deficiency. Without insulin, the body cannot generate enough energy from sugar (glucose). In this case, the body’s cells use fat to generate energy. This leads to the production of ketone bodies, including acetone. If they accumulate in the blood, acidosis can develop.

Adenosine triphosphate (ATP)

This chemical compound is the most important energy store of the human body cells.


Adrenaline is a stress hormone that, among other things, increases heartrate, oxygen consumption, and fat burning, and dilates the bronchial tubes. The hormone also increases the blood sugar level by inhibiting the release of insulin, reducing the effects of insulin, and promoting the conversion of  the liver's sugar stores (glycogen) into glucose .


Albumin is a blood protein that is produced in the liver. Albuminuria is the excretion of albumin with the urine. This can be a sign of kidney disease . Albumin is normally not excreted by the kidneys. See also microalbuminuria and macroalbuminuria.

Alpha cells

Alpha cells are the cells that produce the blood sugar-releasing hormone glucagon. They are arranged in small cell clusters in the pancreas. These cell clusters are known as the islets of Langerhans.

Alpha-glucosidase inhibitors

Alpha-glucosidase inhibitors are oral antidiabetics and are used in tablet form to reduce blood sugar levels. They delay the breakdown of carbohydrates by inhibiting the intestinal enzymes responsible for breaking down carbohydrates. This means sugar is more slowly absorbed by the blood and the blood sugar increase after a meal is reduced.
Alpha-glucosidase inhibitors have a limited effect on blood sugar levels and are nowadays rarely used in diabetes therapy.

Amino acids

Amino acids are the building blocks for protein production. The proteins in the body are made up of 20 different types of amino acids. The body is able to produce most of these. Some of the amino acids must be obtained from food. These are known as essential amino acids.


The anamnesis or medical history is when the physician compiles information about the onset and course of an illness, among other things.

Android fat distribution

Angina pectoris

The sudden onset of a dull pain in the chest. The symptoms can radiate into other parts of the body, e.g., the arms. Coronary heart disease (CHD) is often the underlying cause. This means the blood vessels of the heart are narrowed, which obstructs blood flow.


This is a term to describe vascular diseases. In the case of diabetes, a distinction is made between microangiopathy and macroangiopathy.


Antigens are usually foreign protein structures but can also be carbohydrates, fats, or other components. The immune system reacts to antigens by producing antibodies. For example, antigens can be found on the surface of many types of bacteria.


Antibodies are proteins that bind to foreign substances (antigens), such as pathogens, to tag them.  The immune system can then initiate a counterattack to combat the intruders.


Antioxidants are plant-based substances that protect cells and genetic information from reactive oxygen species.  Antioxidants can be found in many types of fruits and vegetables.


Arteries are blood vessels that transport oxygen-rich blood from the heart throughout the body.


Arteriosclerosis is incorrectly described as “vascular calcification”. There is a pathological build-up of deposits along the inner walls of the blood vessels, causing them to narrow and harden. These deposits are also known as plaques. Vascular narrowing can result in vascular occlusion, e.g., a heart attack. Arteriosclerosis develops slowly and often over many years.


ASH stands for alcoholic steatohepatitis. ASH is fatty liver inflammation caused by excessive alcohol consumption.

Autoimmune disease

Autoimmune diseases cause the immune system, the body’s defense system, to stop functioning. The immune system is then incapable of differentiating between the body's own cells and foreign intruders, such as bacteria or viruses. In the case of type 1 diabetes, the insulin-producing cells in the pancreas are destroyed.


Bariatric surgery

Bariatric surgery is the surgical treatment of extreme obesity, also known as adiposity. The surgery consists of a gastrointestinal procedure. The aim is to reduce food intake or the absorption of energy-rich nutrients. An example of a surgical procedure to treat obesity is gastric bypass.

Basal insulin

Basal insulin is responsible for the basic insulin requirement, independent of meals, even at night. Depending on the type, basal insulin is injected, at least once daily. NPH insulin and the insulin analogs glargine, detemir and degludec are available for this purpose.

Basal metabolic rate

The basal metabolic rate is the term used to describe the energy required to maintain vital function when resting. The basal metabolic rate depends on body weight, height, age, gender, climate, body temperature, and muscle mass.

Basal rate

When using insulin pump therapy, the basal rate meets the individual basic insulin requirement. It is independent of meals.

Basal-supported oral therapy (BOT)

Basal-supported oral therapy, known as BOT, is a type of insulin therapy. It combines the use of oral antidiabetics with insulin injections. A long-acting basal insulin is used. BOT is a form of therapy that can be used for people with type 2 diabetes. It is prescribed when blood sugar levels cannot be adequately reduced despite changes to lifestyle and the use of oral antidiabetics. The advantages of this therapy may include less weight gain and fewer hypoglycemic events compared with treatment using only insulin.

Basic bolus concept

This is a type of insulin therapy that uses long-acting insulin to meet the basic insulin (basic) and mealtime insulin (bolus) requirements.

Beta blockers

Beta blockers are a type of medicine used to treat cardiovascular diseases, such as high blood pressure, cardiac insufficiency, or angina pectoris.

Beta cells

Beta cells are the cells that produce the blood sugar-reducing hormone insulin. They are arranged in small cell clusters in the pancreas. These cell clusters are known as the islets of Langerhans. During the course of  type 1 diabetes, the beta cells are destroyed by the body's immune system. In type 2 diabetes, beta cells initially produce increased amounts of insulin to counteract insulin resistance until they become exhausted and the insulin production dries up.



Biomarkers are biological properties that can be measured and evaluated in blood and tissue samples. Biomarkers indicate both pathological and healthy processes in the body. Hence, every laboratory value is a classic biomarker.


A biopsy is a diagnostic procedure to collect a tissue or cellular sample for laboratory testing.

Blood sugar value, blood sugar level

The blood sugar value describes the amount of sugar (glucose) present in the blood. It is influenced by factors such as food intake, physical activity, and especially by the hormones insulin and glucagon.

Body mass index (BMI)

The body mass index (BMI) describes the ratio of body weight to body height. BMI is calculated as follows:

BMI = Body weight in kilograms : Height in meters squared

The BMI is a guideline value used to determine if someone is overweight or not. The following categories are used, although age also plays a role:

  • Underweight: Less than 18.5 kg/m²
  • Normal weight (optimal weight): 18.5 to 24.9 kg/m²
  • Overweight: 25 to 29.9 kg/m²

A BMI of 30 kg/m² or above indicates obesity (adiposity). Because BMI does not distinguish between fat and muscle mass, it cannot be used as an indicator of fat mass in athletes with high levels of muscle mass, for example.

Bolus insulin

Bolus insulin is the fast-acting insulin that is normally injected directly or using an injection-meal interval at mealtimes. Both human insulin and insulin analogs can be used. Bolus insulin can also be used to correct elevated blood sugar levels when no food is eaten. The bolus dosage is then usually much lower than the bolus dosage taken before mealtimes.

Bread unit (BU)

A bread unit (BU) is an older unit used to calculate the amount of carbohydrates contained in food. The BU is equal to 12 grams of carbohydrates. Nowadays, instead of the BU, the carbohydrate unit (CU) is used. One CU is equal to 10 grams of carbohydrates, making it easier to use in calculations.

Bronchial system

The bronchial system is an extensive system of tubes that carries the air we breathe from the windpipe to the small pulmonary alveoli. This is where the air breathed in is transferred to the blood and carbon dioxide is absorbed from the blood and removed (exhaled) via the bronchial system.


A bypass is a surgically created circumvention of an obstacle. For example, this can include the grafting of blood vessels from other parts of the body. This enables narrow or fully blocked vessels to be “bypassed” to ensure the flow of blood. During a gastric bypass, the stomach is divided. A small part of the stomach is separated and connected directly to the small intestine through which the food pulp flows. After surgery, the food pulp bypasses the remainder of the stomach.



Cachexia is a severe form of emaciation, i.e., pathological weight loss.


A calorie is a unit used to indicate the energy contained in food and the energy requirements of the body. Calorie is often used colloquially when referring to a kilocalorie, i.e., 1000 calories. A kilocalorie is the energy required to heat 1 liter of water from 14.5 degrees Celsius to 15.5 degrees Celsius.


Carbohydrates are sugar molecules of different sizes. We consume carbohydrates with the food we eat. Carbohydrates also act as an energy store in the body. As needed, they are broken down into simple sugars, e.g., glucose.

Carbohydrate unit (CU or CHU)

A carbohydrate unit, abbreviated as CU or CHU, is a unit that enables people with diabetes to determine the amount of carbohydrates in their food. They can use this amount to derive how much insulin they need to inject. 1 carbohydrate unit is equal to 10 grams of carbohydrates.


Cardiometabolic is a specialist medical term and means “relating to the cardiovascular system and the metabolism”. Diabetes mellitus, high blood pressure, fat metabolism disorders, and obesity are examples of cardiometabolic disorders.


Cardiovascular is a specialist medical term and means “relating to the heart and blood vessels”. Cardiovascular diseases are also known as circulatory system diseases.

CGM (Continuous glucose monitoring)

CGM stands for continuous glucose monitoring. A sensor continuously measures the glucose levels in the tissue fluid of the subcutaneous adipose tissue. It should always be taken into account that the glucose value in the tissue fluid does not correspond to the current blood glucose value but rather to the blood glucose value 15 minutes prior. The transmitter, usually located on the abdomen or upper arm under the skin, relays the value to a display device. Some models sound an alarm when the pre-determined warning threshold has been reached, e.g., lower blood sugar levels. Depending on the manufacturer, the sensor must be replaced once a week and calibrated before use.

Charcot foot

Charcot foot is a serious complication associated with long-term diabetes. It leads to destruction of the bone and joint structures of the foot. Charcot foot is a special form of diabetic foot syndrome and can develop in patient suffering from neuropathy  and blood circulatory disorders. Acute Charcot foot is an emergency requiring urgent attention.


Cholesterol is a fat-like substance It can enter the body through food, but is more commonly produced by the body, primarily in the liver. It is a component of the cell walls and a building block of many types of hormones. There are various forms of cholesterol, which can be low-density (LDL) or high-density (HDL). The ratio between these two types of cholesterol correlates to the risk for heart disease. Low LDL levels and high HDL levels are associated with a lower risk of cardiovascular disease.


Cirrhosis is the hardening and scarring of organ tissue. Cirrhosis develops as a result of inflammation and a pathological increase of connective tissue.

CLAMP technique

In the CLAMP technique, a fixed amount of insulin and variable amount of dextrose (glucose) are administered intravenously (directly into the vein) until a normal blood sugar level is achieved. This technique can be used to identify insulin resistance. The glucose infusion rate correlates to insulin sensitivity. The more glucose that can be administered with a pre-defined insulin dosage, the more effective the insulin.


Clearance can be used to describe the detoxification performance of organs such as the kidneys. Therefore, it can be used to examine kidney function. Clearance corresponds to the amount of blood (excluding blood cells) cleared of a certain substance, for example creatinine, in the kidneys within a certain time.

Closed loop system

This is an artificial pancreatic system, i.e., a medical device that automatically measures tissue sugar levels. Tissue sugar is the glucose level in the subcutaneous adipose tissue. A pre-determined amount of insulin is released via a insulin pump. The system consists of a sensor that continuously measures the tissue sugar level, a pump that releases insulin into the body depending on the sugar level, and a mini-computer that analyzes the measurement data from the sensor and controls the pump. These types of systems have been subject to extensive testing in trials for many years; however, they have not yet been approved for sale.

Cohort study

A cohort study is a comparative observational study during which a group of people (cohort) with or without certain characteristics is observed over a predefined period of time. This enables the identification of differences in the onset of the target disease. Cohort studies are particularly helpful in determining the specific risk factors of a disease. For example, if one group are smokers and the other group are non-smokers, then it can be studied how this affects their health status in the long-term.


Compliance refers to the willingness of a patient to cooperate in the treatment of a disease or in a study.

Continuous glucose monitoring

See CGM.

Conventional insulin therapy (CT)

During conventional insulin therapy (CT), people with diabetes administer themselves individually specified amounts of mixed insulin at scheduled times during the day. Mixed insulin contains both long-acting basal insulin as well as short-acting bolus insulin. Along with the insulin dosage, this treatment form also predetermines the time and size of meals. Only by adhering to a strict mealtime plan can severe blood sugar level fluctuations be avoided and the therapy be successful. Blood sugar levels should always be tested before administering the insulin. Conventional insulin therapy is normally used for people with type 2 diabetes. It is used only in temporarily or in exceptional cases for people with type 1 diabetes.

Coronary heart disease (CHD)

Coronary heart disease is a disease affecting the coronary vessels of the heart. It is usually caused by arteriosclerosis, in which deposits of fat and other substances build up in the arteries. Coronary heart disease causes a size reduction in the cross section of the coronary arteries. This leads to reduced blood flow and oxygen supply. As the disease progresses, the probability of further cardiac disease, such as heart attack, increases.

Correction factor

The correction factor refers to the amount of insulin the body requires to reduce elevated blood sugar levels by approx. 30 to 40 mg/dl (1.6-2.2 mmol/l) per unit of insulin. The individual correction factor must be determined as part of a diabetes training program and by testing under medical supervision.

Correction insulin

Correction insulin refers to the insulin dosage that must be additionally administered to correct elevated blood sugar levels. It is generally administered together with mealtime insulin in a course of intensified insulin therapy.


Cortisone, also known as cortisol, is a hormone produced in the adrenal cortex. Is it produced in high amounts during times of stress and is also known as the stress hormone. It promotes the build-up of glucose, i.e. gluconeogenesis. Cortisone is also released in large amounts to counteract hypoglycemia (low blood sugar levels).


Together with insulin, C-peptide is produced by the beta cells in the pancreas. It is part of what is known as proinsulin, the precursor of insulin. In certain cases, the C‑peptide value is determined to ascertain how well the beta cells are still functioning.

C-reactive protein (CRP)

C-reactive protein (CRP) is a protein that appears at elevated levels in the blood in cases of inflammation.


Creatinine is a metabolic product of the muscles that is excreted via the kidneys. Increased creatinine levels in the blood can be a sign of kidney damage. People with reduced muscle mass, such as old people, may have reduced creatinine levels. For this reason, even if the creatinine levels in the blood are normal, kidney function is impaired. In contrast, elevated creatinine levels are often observed when there are muscle injuries.

Creatinine clearance

Creatinine clearance can be used to assess kidney function. The term “clearance” refers to the detoxification performance of the kidneys. The calculation requires the creatinine concentration in blood plasma and urine, the amount of urine collected (over a 24-hour period) and a correction factor. When the respective creatinine clearance value is available, the glomerular filtration rate can be estimated.



This blood sugar-reducing drug is given to adults with type 2 diabetes when the commonly administered active ingredient metformin  is not well-tolerated and lifestyle changes did not reduce the blood sugar level sufficiently. Dapagliflozin is a SGLT-2 inhibitor. It can be taken in combination with other blood sugar-reducing agents.

Dawn phenomenon

The dawn phenomenon refers to the increase in blood sugar levels during the early hours of the morning. This increase is caused by hormones that are released in greater quantities by the body at that time. This causes the liver to produce more sugar (glucose),resulting in an increase in the amount of insulin required. For some people, their diabetes cannot be adequately managed using conventional or intensified insulin therapy. This is one of reasons for insulin pump therapy. Using an insulin pump and increasing the basal rate early in the morning can compensate for the morning rise in blood glucose. Using long-acting insulin in the evening as part of intensified insulin therapy or increasing the dose can help counteract the early-morning blood sugar increase.


Degludec is a long-acting insulin analog containing modified individual components (amino acids) of the molecular structure of human insulin. This makes its effects last significantly longer. It is one of the basal insulins.


Detemir is a long-acting insulin analog (see insulin analogs) to which individual components (amino acids) of the molecular structure of human insulin have been added. This makes its effects last significantly longer. It is one of the basal insulins.


See glucose.

Diabetes insipidus

This is a disorder of the body’s water balance with unnatural levels of urine production (between 5 and 20 liters per day). The disease is accompanied by an increased feeling of thirst and, correspondingly, the intake of more liquids. The cause is a urine concentration disorder in the kidneys. This can usually be traced back to a deficiency or the lack of production of a certain type hormone  that inhibits the excretion of water by the kidneys.

Diabetic coma

A diabetic coma is a life-threatening metabolic imbalance caused by a lack of insulin in people with diabetes. The resulting extremely high blood sugar levels can cause the patient to lose consciousness. People who have fallen into a diabetic coma require urgent medical attention and intensive care treatment. There are two main forms: The ketoacidotic coma, which is more common in people with type 1 diabetes. People with type 2 diabetes are more likely to suffer a hyperosmolar coma.

Diabetic foot

Diabetic foot, also known as diabetic foot syndrome, is a complication of diabetes. Due to nerve and circulatory disorders, people with diabetes often also lose sensation in their feet. This can result in foot problems, such as impaired wound healing.


A diabetologist is a medical specialist (e.g., a specialist for internal medicine or gynecologist) with an additional qualification for the medical treatment of people with diabetes.


Dialysis is a method of treatment to remove urinary substances from the blood. These substances are usually excreted via the kidneys. Dialysis, also known as blood cleansing, involves removing toxins from the blood using an artificial kidney or by flushing sterile fluids through the peritoneum. This treatment becomes necessary when the kidney function is severely impaired and the kidneys are no longer able to carry out this task.


This is the specialist term for double sugars. This compound, a carbohydrate, is comprised of two simple sugars (monosaccharides). An example of this is the classic household sugar known as sucrose, which is comprised of the simple sugars glucose and fructose.

Disease management program (DMP)

A disease management program is a treatment program for chronically ill people. It is offered by health insurance providers and participation is free. The program consists of training, regular visits to the physician, and predetermined examinations. People with diabetes can usually register for the program by asking their treating physician.


Deoxyribonucleic acid (DNA) is a long-chain molecule in which genetic information is stored. DNA consists of sugar molecules, phosphate, and 4 bases (adenine, guanine, cytosine, and thymine). The order of the bases determines the genetic code. DNA is made up of 2 strands running in opposite directions and joined together like a zipper. Two bases always fit perfectly together. Adenine only links with thymine and guanine only links with cytosine.

Doppler ultrasound

Using a Doppler ultrasound, a physician can make blood flow and possible narrowing of the arteries visible on a screen.

Double sugars (disaccharides)

A double sugar is a larger sugar molecule comprised of two linked single sugar molecules. An example of a disaccharide is sucrose – classic household sugar.

DPP-4 inhibitors (gliptins)

DPP-4 inhibitors are oral antidiabetics, i.e., medication in tablet form that is used to treat patients with type 2 diabetes. Dipeptidyl peptidase-4, also known as DPP-4, is an enzyme that breaks down certain types of protein.  When the enzyme is inhibited, certain gastrointestinal hormones in the blood are broken down more slowly, which has a positive effect on the release of insulin. As a result, the blood sugar level after meals is reduced, but not when in a fasting state. It also reduces the production of sugar in the liver.


Duloxetine is a drug used for pain management associated with diabetic neuropathy, a complication of diabetes.



An edema is the collection of excess fluid in the tissue.


Elastography is a special type of diagnostic imaging.  It is a further advancement of the ultrasound. It examines the stiffness of the organ tissue.

Electrocardiogram, ECG

This method is used to measure the electrical activity of the heart. The ECG is carried out either resting (lying down) or during exertion (on a bicycle ergometer). It allows conclusions to be drawn regarding heartrate and heart rhythm. Furthermore, the excitation processes within the heart muscle can be measured. Excitation processes are electric cardiac currents that power the heartbeat. This allows information to be collected on any changes to the heart's form or structure.


This examination tests the electrical function of the nerves and can identify possible nerve damage.

Emergency BU (Emergency bread unit)

The term describes emergency bread units, or snacks containing carbohydrates, that can be quickly absorbed by the body. They enable the rapid counteraction of impending hypoglycemia (low blood sugar levels) . Dextrose tablets, muesli bars, or fruit juice are good examples.

Energy balance

The energy balance is the ratio between energy use and energy intake. The energy balance is positive when the energy intake is greater than the energy use. This is the case during physical growth. After the growth phase is complete, a positive energy balance leads to weight gain. Weight loss is only possible with a negative energy balance, i.e., when energy intake is less than energy use.


This blood sugar-reducing drug is given to adults with type 2 diabetes when the commonly administered active ingredient metformin  is not well-tolerated and lifestyle changes did not reduce the blood sugar level sufficiently. Empagliflozin is a SGLT-2 inhibitor. It can be taken in combination with other blood sugar-reducing agents.


Enzymes are proteins that trigger or speed up chemical reactions. Enzymes are involved in almost all metabolic reactions in the body.


The field of epidemiology studies the distribution and causes of diseases within the population. Epidemiological diabetes research examines how many people within a certain period of time develop diabetes and how many people in the population are living with diabetes. The geographic distribution of the disease is often analyzed. Factors such as age, gender, and social class are also important aspects in describing the development of diabetes.

Excess mortality

Excess mortality means an above-average death rate. In the context of diabetes, excess mortality shows how many deaths can be traced back to diabetes in comparison to people who do not have diabetes.


Fasting glucose (fasting blood sugar)

The fasting glucose level or fasting blood sugar level are the terms used to describe the blood sugar level on an empty stomach, i.e., after at least 8 hours without eating.


Alongside carbohydrates and proteins, fats are an important source of energy in the body. Dietary fats are made up of glycerin and fatty acids.

Fat distribution

In addition to obesity, the way fat is distributed throughout the body also poses a health risk. Accumulation of fat in the abdomen is associated with a high risk of diabetes and cardiovascular diseases. In contrast to fat stored on the hips, abdominal fat is metabolically very active. The abdominal (abdomen=stomach) or male (android) fat distribution (apple-shaped) stands in contrast to the less risky hip deposited female (gynoid) fat distribution. This is known as pear-shaped. Fat distribution can be determined using the waist-to-hip ratio. Men are deemed apple-shaped when the waist-to-hip ratio exceeds 0.90. For women, the threshold is 0.85.

Fatty acids

Fatty acids are components of the fats found in food. Depending on whether they are chemically linked by single bonds only or also contain one or more chemical double bonds, there are categorized as saturated or unsaturated fatty acids. Saturated fatty acids can be found in foods such as butter, cheese, and meat. Unsaturated fatty acids are found in olive oil, rapeseed oil, or nuts, for example.

Fatty liver

Fatty liver describes an increased fat content within the liver tissue. It can be a precursor to liver cirrhosis (hardening of the liver).  It is considered a risk factor for the onset of type 2 diabetes.


Dietary fibers are food components that the body is unable or only partially able to digest, e.g., cellulose. They give a feeling of fullness and promote healthy bowel movements. They also delay the absorption of sugar and cholesterol by the intestinal tract. Most dietary fibers are complex carbohydrates,  also known as polysaccharides.


Fibrosis is a pathological increase in connective tissue within an organ.


Fructosamine values are used to examine metabolic adjustment in people with diabetes. Fructosamines are proteins in the blood onto which blood sugar (glucose) has been deposited. Because these proteins have a life expectancy of approx. 20 days, the fructosamine value reflects the metabolic adjustment over the course of the last 1 to 3 weeks. The higher the blood sugar level, the higher the fructosamine concentration. In some cases, the fructosamine value is determined alongside the HbA1c value; however, it cannot replace it.


Fructose is a simple sugar that is found in fruit and honey, among other things. It is also a component of household sugar (sucrose). Fructose causes a slower increase in blood sugar level than glucose and is metabolized independently of insulin. However, a certain amount of fructose is converted into glucose, meaning that people with diabetes should only consume fructose in moderation. It is just as energy-rich as household sugar or glucose.


Gastroparesis, Diabetic

Gastroparesis is paralysis of the stomach and can be a complication of diabetes. It develops upon damage to autonomic nervous system of the gastrointestinal tract (polyneuropathy). It can result in severe blood sugar level fluctuations in the form of severe low blood sugar levels (see reactive hypoglycemia).


A gene is a carrier of hereditary information. It is the term for a section of DNA that contains genetic information. This functions as a code for human cells, which they require, in particular, for the production of proteins.

Gestational diabetes

Pregnancy diabetes (gestational diabetes) is a type of diabetes that develops during pregnancy. Pregnancy diabetes is one of the most common diseases accompanying pregnancy. This form of metabolic disorder usually disappears after giving birth. However, the disease increases the risk that the mother will later develop type 2 diabetes.


Glargine is a long-acting insulin analog to which individual components (amino acids) of the molecular structure of human insulin have been added.  This significantly prolongs the effect of the insulin. It is one of the basal insulins.


Glimepiride is an oral antidiabetic from the class of sulfonylureas and is used in the treatment of type 2 diabetes. This blood-reducing active ingredient increases the release of insulin in the body.


Glinides are oral antidiabetics. They increase the release of insulin by the pancreas. This increased production improves the absorption of sugar from food by the body's cells. Insulin release is faster and is less prolonged than with sulfonylureas. Therefore, glinides are taken at mealtimes.


Gliptins are oral antidiabetics used in the treatment of type 2 diabetes. They belong to the drug class of DPP-4 inhibitors. The gliptins include active ingredients such as sitagliptin, vildagliptin, or saxagliptin are gliptins.


Glitazones are oral antidiabetics. They improve blood sugar levels by increasing the insulin sensitivity of the fatty tissue, muscles, and liver. This increase in sensitivity allows more blood sugar to be absorbed and processed by the cells. Due to the side effects, glitazones are only used in exceptional cases in the treatment of type 2 diabetes.

Glomerular filtration rate

The glomerular filtration rate is a marker for how well the kidneys are working. The name comes from the word glomeruli. These are very thin vessels in the kidneys that are responsible for filtering the blood.


The abbreviation GLP-1 stands for Glucagon-like Peptide. This is a hormone produced in the gastrointestinal cells as soon as new food arrives in the digestive tract. The gastrointestinal cells then release GLP-1 into the blood. GLP-1 simulates the pancreas to release more insulin. At the same time, GLP-1 inhibits the release of glucagon, the counterpart of insulin, by the pancreas. GLP-1 plays a role in reducing blood sugar levels. GLP-1 also inhibits the emptying of the stomach, meaning that a feeling of fullness occurs quicker. In the long-term, this usually results in weight loss. However, GLP-1 is rapidly broken down in the blood by the enzyme dipeptidyl peptidase-4 (DDP-4). Therefore, people with diabetes are treated using medication that inhibits DDP-4 so that the concentration of GLP-1 in the blood remains high for as long as possible. These types of medications are known as DDP-4 inhibitors.


Glucagon is a hormone in the pancreas. It is produced in the alpha cells in the islets of Langerhans. This hormone increases blood sugar levels and is considered the counterpart of insulin.


This is the production of new glucose in the liver and, to a lesser extent, in the kidneys, using fats, protein building blocks, and lactic acid. For example, gluconeogenesis maintains the energy supply to the brain and muscles when not enough carbohydrates are consumed.


Glucose is a specialist term for dextrose. Glucose is a simple sugar and belongs to the carbohydrate nutrient group. Carbohydrates are broken down in the intestines to create glucose. The glucose is then transferred to the blood (blood sugar). Glucose is the most important supplier of energy for the human body and its organs. It is absorbed via insulin into the cells, which use it as fuel.

Glucose tolerance, Impaired

This is when the blood sugar level does not drop sufficiently within a certain time after consuming sugar, but type 2 diabetes is not yet present. Impaired glucose tolerance is defined as a blood sugar level between 140 mg/dl (7.8 mmol/l) and 200 mg/dl (11.1 mmol/l) 2 hours after drinking a solution with 75 g glucose as part of an oral glucose tolerance test. People with these blood sugar levels have an elevated risk of developing diabetes or cardiovascular diseases. Lifestyle changes, together with a balanced diet and physical activity, can help improve impaired glucose tolerance.


This is the increased excretion of glucose with the urine via the kidneys.

Glycemic index

The glycemic index is a scale to determine how a food containing carbohydrates will affect the blood sugar levels. It explains how quickly and how severely the blood sugar level will increase after eating. Dextrose (glucose) acts as the reference value, as it triggers the greatest increases in blood sugar levels. It has the highest glycemic index value at 100.


Glycogen is the stored form of dextrose (glucose). The body can convert dextrose into glycogen and store it primarily in the liver and muscles. If the blood sugar level is low or the body has increased energy requirements, then the stored glycogen can be converted back into dextrose. This is then provided to the organs and cells as an energy source. Glycogen is a polysaccharide.


This term is used to describe the breaking down of the stored sugar form glycogen into glucose, especially in the liver and muscles. When glycogen is required by the body as an energy source, the hormones adrenaline and glucagon help transform the glycogen into glucose.

Growth hormone

This hormone is produced in the pituitary gland. This hormone promotes growth during childhood and cell renewal in adults. For example, growth hormone increases blood sugar levels due to the increased generation of glucose (gluconeogenesis).

Gynoid fat distribution



The HbA1c is also known as the long-term blood sugar value or blood sugar memory. Hb stands for the red blood pigment hemoglobin in the red blood cells. Sugar attaches itself to this red blood pigment. The higher the blood sugar level, the more sugar accumulates. Because the life cycle of a red blood cell (and correspondingly the hemoglobin) is 3 months, the average body sugar level during the last 3 months can be determined using the HbA1c value. Therefore, the HbA1c value is a marker for the quality of the blood sugar level management.

The HbA1c value increases physiologically as we age. To prevent the complications of diabetes, guidelines recommend the maintenance of graduated HbA1c target values that take age and possible comorbidities into account (between 6.5 and 8 percent).

Heart scintigraphy

A heart scintigraphy produces an image of the blood circulation in the heart muscles. During this examination, carried out under resting and exertion conditions, a low-radioactive substance is injected into an arm vein. It accumulates in the heart muscles and a special camera takes images of the heart.


Hepatitis is inflammation of the liver. It has various causes.

Hereditary predisposition

Hereditary predisposition describes the inborn susceptibility or predisposition to a particular disease.

High blood sugar

This is a term for increased blood sugar levels, see hyperglycemia.


Hormones are messenger substances that are produced in glandular tissues and transported via the blood circulatory system. They use signals to control various processes in the body, e.g., they regulate the blood sugar level.

Human insulin

Human insulin is a medication used in the treatment of diabetes.  It is identical to the insulin naturally produced in the pancreas. It is produced using genetically-modified bacteria and yeasts.


Hydramnios, also known as polyhydramnios, is a common complication associated with gestational diabetes. The term is used to describe a pathological increase of amniotic fluid to an amount exceeding 2 liters. Too much amniotic fluid can cause severe abdominal tension or breathing difficulties, among other things. It can also result in premature membrane rupture and trigger the premature onset of contractions.

Hyperglycemia (high blood sugar levels)

Hyperglycemia is the specialist term for high blood sugar levels associated with diabetes or prediabetes. A fasting blood sugar level of 200 mg/dl (11.1 mmol/l) or higher indicates the existence of diabetes.


Hyperlipidemia is an excess of lipids or fats in the blood, such as elevated total or LDL cholesterol or elevated triglyceride levels. This puts people at risk of cardiovascular diseases.


Hypertension is the specialist medical term for high blood pressure. High blood pressure is present when values of 140/90 mmHg or higher are measured repeatedly. High blood pressure increases the risk of heart attack, stroke, kidney failure, and other diseases. The risk of such diseases is further increased when high blood pressure is coupled with diabetes. The risk of high blood pressure can be reduced by adopting a healthy lifestyle, e.g., a healthy diet and more physical activity.

Hypoglycemia (low blood sugar levels)

Hypoglycemia is the specialist term for low blood sugar levels. A low blood sugar level is the most common side effects of treatment with insulin and/or certain types of blood sugar-reducing medications. It develops when the amount of insulin or antidiabetic tablets does not correspond to the available amount of carbohydrates, for example, in the following situations:

  • Incorrect estimate of the amount of carbohydrates consumed
  • Waiting too long between injecting and eating
  • After physical activity
  • After drinking alcohol
  • During gastrointestinal diseases
  • As a result of drug interactions

Hypoglycemia unawareness

This is the impaired ability to identify the warning symptoms of low sugar levels. It is especially prevalent in patients with type 1 diabetes.


The hypothalamus is a region of the brain that acts as the interface between the hormonal and nervous system. The hypothalamus can receive nerve signals and then activate the pituitary gland, triggering the release of certain hormones into the bloodstream. Many nerve cells in the hypothalamus are able to directly perceive glucose, enabling them to act as a sensor for blood sugar levels.



IGT stands for impaired glucose tolerance.

Incretin mimetics

Incretin mimetics, for example exenatide or liraglutide, are blood sugar-reducing medications used in the treatment of type 2 diabetes. This active ingredient class is also known as GLP-1 analogs or GLP-1 receptor agonists. They are similar in their composition to the GLP-1 hormone. They increase the release of insulin while inhibiting the release of glucagon. They also delay the emptying of the stomach. Low blood sugar levels are usually only a concern when incretin mimetics are administered simultaneously with insulin, sulfonylureas or glinides, because incretin mimetics only trigger the release of insulin in the event of high blood sugar levels. Similar to insulin, incretin mimetics are injected under the skin.


This term refers to the administering of a pharmaceutical agent into the body. The pharmaceutical agent can be injected under the skin, into a vein, or into a muscle.

Injection-meal interval

The injection-meal interval is the time between administering insulin and eating a meal. Special attention must be paid to the injection-meal intervals when using human insulin.


Insulin is the body’s own essential hormone. It is a messenger substance produced in the beta cells of the pancreas and then released into the blood. It enables the absorption of sugar (glucose) by the cells. Insulin inhibits the release of glucose from the liver into the blood. This causes the blood sugar levels to drop. Severe metabolic disorders can develop without insulin. The amount of sugar in the blood increases resulting in the onset of diabetes.

Insulin analogs

Insulin analogs are a medication used in the treatment of diabetes. They are produced by switching and modifying certain building blocks of insulin. This enables the time and duration of effect to be changed. This makes for a better control of insulin therapy. They are produced using genetically modified bacteria and yeasts.

Insulin pen

An insulin pen is a device that looks like a fountain pen, which is used to administer insulin.

Insulin pump

An insulin pump is a device used in the treatment of diabetes. An insulin pump remains attached to patient’s body and only administers short-acting insulin. It is continuously administered via a cannula (known as a needle) into the subcutaneous adipose tissue. If additional insulin is required, e.g., before a meal, this can be administered by pressing a button. This removes the need for multiple injections throughout the day.

Insulin purging

Insulin purging is when no insulin or not enough insulin is injected to stop sugar from food being adsorbed by the body. It is then excreted via the kidneys. This results in weight loss. However, the consequences of extremely high blood sugar levels include damage to the blood vessels, kidneys, and nerves. In the worst case, this can result in the development of highly dangerous ketoacidosis.

Insulin resistance

This is when the effect of the blood sugar-reducing hormone insulin is less than expected. Insulin resistance is a precursor and a disease mechanism of type 2 diabetes. Insulin resistance causes the cells, especially in the muscles, liver, and fatty tissue, to no longer sufficiency react to the hormone insulin. This means that the insulin can no longer effectively transport sugar from the blood into the cells. To achieve the same levels of insulin effectiveness as healthy people, people with insulin resistance must produce more insulin.

Insulin receptor

An insulin receptor is the binding site for insulin on the surface of the cell. These binding sites are found especially in muscle, liver, and fat cells. The binding of insulin with the receptor “opens the door” of the cells and allows for the increased absorption of glucose by the cells.

Insulin unit

An international unit, abbreviated I.U., corresponds to 0.042 milligrams of pure insulin. 1 milligram of insulin corresponds to approx. 28 insulin units.

Intensified conventional insulin therapy (ICT)

Intensified conventional insulin therapy (ICT) is the separate application of fast-acting bolus insulin and long-acting insulin (basal insulin) to meet the basic insulin requirements. Human insulins or insulin analogs are used as short-acting insulin. The long-acting insulins are either NPH delayed-onset insulins or long-acting insulin analogs.


Interleukins are messenger substances in the body. They regulate the reactions of the immune system. Certain types of interleukins promote inflammation while others have anti-inflammatory effects.

Interventional study

An interventional study is a study during which the research team assigns different treatments (e.g., treatment using types of medication) to the participants. The research team applies the different treatments to the participants, observes, and examines any changes. Scientists want to find out how effective certain measures are, for example, those used in the treatment of diabetes.


This is the administration of a medication in the form of an injection or infusion into the vein.

Intravenous glucose tolerance test (ivGTT)

This test is used to diagnose diabetes and is carried out in cases in which an oral glucose tolerance test is not possible. During an intravenous glucose tolerance test, the physician injects a dextrose solution directly into the blood. They then measure how much insulin is produced by the beta cells in the pancreas. The test is used to examine how well the insulin production of the beta cells is functioning.

iscCGM, intermittently scanned CGM

isCGM is a measurement system used to determine tissue sugar levels in the subcutaneous adipose tissue without the need for device calibration. The isCGM system consists of a sensor and a reader. It is attached to the upper arm with the help of an adhesive and is left in the same position for up to 14 days. A filament is attached to the sensor and placed under the skin. This filament continuously measures the tissue sugar between the cells in the subcutaneous adipose tissue. The measurements can be accessed at any time using the reader/scanner device.

Islet cells

Islets of Langerhans

The islets of Langerhans are cell clusters located in the pancreas, which is where the hormones glucagon and insulin are produced. They are primarily made up of alpha cells and beta cells.



A joule is the unit of measurement for the nutritional value of food. 1 joule corresponds to 0.239 kilocalories. The energy content of food is indicated using two type of units: Kilojoule (kJ) and kilocalorie (kcal).



Diabetic ketoacidosis is an acute complication that affects those with type 1 diabetes in particular. It is caused by a large increase in blood sugar levels resulting from a lack of insulin. An insulin deficiency or a large increase in the amount of insulin required can also occur during a serious infection with fever, vomiting, and/or diarrhea or during the onset of serious conditions such as heart attack, stroke or unidentified hyperthyroidism. If there is not enough insulin available, then sugar cannot be transferred from the blood into the cells. As a result, the cells do not have enough energy for metabolic processes. The body then begins to burn fat to meet its energy needs. The fat is broken down into fatty acids and these are then incompletely broken down into what are known are ketone bodies. The elevated concentration of ketone bodies leads to dangerous hyperacidity of the blood. Ketoacidosis develops with the following range of possible symptoms:

  • Increased urination (polyuria),
  • increased thirst (polydipsia),
  • visual impairment,
  • bodily dehydration (exsiccosis),
  • muscle cramps,
  • and nausea and vomiting.

A diabetic ketoacidosis coma can also develop, which, in the worst-case scenario, may result in death.


Ketonemia describes the increase of ketone bodies in the blood.

Ketone bodies

Ketone bodies are substances that are produced in increased amounts during the breakdown of fat as a result of lack of insulin. For example, they include acetone. Above a certain concentration, they can cause ketoacidosis.

Ketone test

A ketone test can be used to detect excess ketone body production in the blood or urine. They may also indicate a serious metabolic imbalance, ketoacidosis, which can affect people with type 1 diabetes in particular. Test strips for a ketone urine test, which display the result using staining, can be found at the pharmacy.


This is the term for when ketone bodies are excreted with the urine. Especially in cases of type 1 diabetes with insulin deficiency, ketonuria can be a sign of ketoacidosis. The excretion of the ketones with the urine can be measured using test strips (ketone test).

Kussmaul breathing

When suffering from ketoacidosis, a characteristic acetone-like smell (comparable with nail polish remover or rotten fruit) can be detected in the breath. The smell develops from metabolic products (ketone bodies) released in the body when fat is broken down to generate energy. Since glucose cannot enter the cells of most organs without insulin, alternative metabolic pathways must be found. The patient’s breathing is also stimulated to enable the increased carbon dioxide (CO2) resulting from hyperacidity to be exhaled. This type of breathing is named after the physician Adolf Kußmaul, who was the first to report it in 1874.


Lactic acidosis

Lactic acidosis is rare and is usually associated with the use of metformin when attention is not paid to the contraindications. Blood sugar is normally broken down in the presence of oxygen. When this is not the case, there is a buildup of lactic acid. It cannot be broken down to the same extent as normal by the liver. The symptoms of lactic acidosis are non-specific but can include weakness, nausea, and abdominal pain. The patient can fall into an unconscious state within a few hours accompanied by a deep and rapid breathing pattern. This is known as Kussmaul breathing.

Latent autoimmune diabetes in adults (LADA)

LADA is a special form of type 1 diabetes that develops in adulthood. In this form of diabetes, the insulin deficiency develops relatively slowly. Initially, it is often incorrectly diagnosed as type 2 diabetes because the symptoms are similar. However, people with LADA have islet cell antibodies (ICA) and/or antibodies against the enzyme glutamate decarboxylase (GAD) in their blood serum. The presence of these antibodies is evidence that the immune system is turning against the body. This prevents the production of insulin.

Legacy effect

This describes the long-term reduction of the complications of diabetes associated with good blood sugar management, especially in the early stages of the disease.


Leptin is a hormone produced in the fatty tissue. It plays a role in the sensations of hunger and fullness. It relays the fullness status of the fatty tissue to the brain and is involved in the regulation of the body’s fat mass. High leptin levels in the blood suppress the appetite of people with a normal body weight. This is not the case if the person is overweight. Therefore, it is assumed that obesity is accompanied by leptin resistance.


Lipohypertrophy is an area of increased fatty tissue at an insulin injection site. A lump develops because the tissue is hardened and swollen. The injection of insulin promotes the growth of fat cells at the site. The absorption of the insulin at the swollen site begins to change over time. For this reason, the injection site should be changed regularly.

Liver enzymes

These are enzymes, i.e. proteins, that are characteristic of the liver cells. In the event of liver disease, they can provide essential information regarding the type and extent of the disease.

Long-term blood sugar value (HbA1c)

This value provides information on blood sugar levels during the previous 8 to 12 weeks. This is the long-term memory for blood sugar levels and is indicated using the HbA1c value.

Low blood sugar

This is a term for reduced blood sugar levels, see hypoglycemia.


Lymphocytes are a type of white blood cell. They combat dangerous foreign substances in the body and are a component of the immune system. Elevated or reduced levels point to various types of diseases.



Macroangiopathy is pathological damage to the major blood vessels (arteries). This often leads to the buildup of deposits on the walls of the large arteries in various organs, such as the heart and brain, but also in the legs.


Albumin is a blood protein that is produced in the liver. Macroalbuminuria is the greatly increased excretion of albumin in the urine. The excretion is at levels above 300 milligrams per day. It is a warning sign for diabetic kidney damage.


Macroangiopathy is pathological damage to the major blood vessels (arteries). This often leads to the buildup of deposits on the walls of the large arteries in various organs, such as the heart and brain, but also in the legs.


Macrovascular is a specialist medical term that means “relating to the medium and large blood vessel (arteries)” (see also macroangiopathy).


Malformation is the specialist medical term used to describe the abnormal formation of a part of the body.



Maturity onset diabetes of the young (MODY)

MODY was previously known in Germany as type 3a diabetes. This form of diabetes stems from genetic defects. These defects cause a functional impairment of the beta cells (beta cell dysfunction). MODY affects less than 5% of diabetes suffers worldwide. Generally, MODY is found in familial clusters of adults with normal weight below 25 years of age. Patients with MODY are often initially diagnosed with type 1 or type 2 diabetes. The mutations can only be identified using genetic testing. There are currently 13 types of MODY known to science.

Metabolic decompensation

Metabolic decompensation is when blood sugar levels are within a very low or a very high range. In both situations, quick action is required. In extreme cases, very low blood sugar levels (severe hypoglycemia) and very high blood sugar levels (severe hyperglycemia) can lead to diabetic coma and can be life-threatening. Read here what to do in a diabetes emergency.

Metabolic syndrome

Metabolic syndrome is the term used for a combination of various risk factors for numerous complications. A metabolic syndrome is diagnosed when at least 3 of the following 5 risk factors are evident:

  • A waist circumference measurement exceeding 88 cm in women and 102 in men
  • Elevated triglyceride values exceeding 150 mg/dl
  • HDL cholesterol levels below 40 mg/dl in women and below 50 mg/dl in men
  • A blood pressure level exceeding 130/85 mmHg
  • Elevated fasting blood sugar levels above 100 mg/dl (above 5.6 mmol/l) or the presence of  type 2 diabetes

Metabolism, glucose metabolism

Metabolism is the term for all the processes in the body during which the body absorbs, transforms, and breaks down substances it requires to maintain function.

The term glucose metabolism encompasses all the processes in the body during which glucose is used to generate energy. The intestines, liver, and muscles are important organs for these processes. However, all other bodily functions and organs also require energy and are therefore involved in the glucose metabolism.


Metformin is an oral antidiabetic often used to treat  type 2 diabetes. It belongs to the biguanide class of substances. It improves the insulin sensitivity of the cells and reduces the release of sugar (glucose) from the liver. This results in a fall in blood sugar levels, even in a fasting state. The release of insulin is unaffected by metformin, meaning that therapy with metformin alone presents no risk of  low blood sugar levels.


Albumin is a blood protein that is produced in the liver. Microalbuminuria is a slightly increased excretion of albumin in the urine, in contrast to macroalbuminuria. Excretion is at levels between 20 to 200 mg/l or 30 to 300 mg/day. It can be an early sign of diabetic kidney damage.


Microangiopathy is pathological damage to the smaller blood vessels (arteries). In cases with diabetes, the smaller blood vessels in the eyes (retinopathy), kidneys (nephropathy), nerves (neuropathy), and feet (diabetic foot syndrome) are affected.


Microvascular is a specialist medical term meaning “relating to the smallest blood vessels (capillaries)” (see also microangiopathy).

Mixed insulin

Mixed insulin is a manufactured mix of short- and long-acting insulin to meet both basic requirements and the insulin requirements after meals.


This is the specialist term for what are known as simple sugars.

Multiple sugars

These are very large sugar molecules, comprised of many simple sugars linked together. The storage substances starch and glycogen belong to this category.



NAFLD stands for non-alcoholic fatty liver disease. Fatty liver causes deposits of fat to build up in the liver cells. Fatty liver disease can have serious consequences when the liver becomes inflamed as a result of steatosis (see NASH).


The abbreviation NASH stands for non-alcoholic steatohepatitis. It is a more hazardous form of fatty liver disease (see NAFLD). It causes inflammation of the steatotic liver cells.

Nephropathy, Diabetic

Diabetic nephropathy is a complication of diabetes. It results in increased loss of filter function in the kidneys because high blood sugar levels damage the renal vessels. Diabetic nephropathy is characterized by continuously elevated protein excretion levels in the urine (Microalbuminuria). Later, the creatinine clearance begins to drop.

Neuropathy, Diabetic

NPH insulin

NPH stands for neutral protamine hagedorn. Delayed onset NPH insulins have a long-lasting effect because the human insulin has been bound to the delayed onset substance neutral protamine hagedorn (NPH). Delayed onset NPH insulins are basal insulins and are used to meet the body's basic insulin requirements.



Obesity, also known as adiposity, is extreme overweightness due to an excessive increase in fat levels. Someone is considered obese when their  body mass index (BMI) is above 30 kg/m². The BMI is calculated by dividing body weight (in kg) by height (in meters squared). Obesity is divided into three different severity categories. Obesity increases the risk of type 2 diabetes, especially if the fat is predominantly located in the abdominal region.

Off-label use

Off-label use is when a drug is prescribed for use outside of the scope of application for which it was originally approved. For example, a drug is used off-label when the indications, dosage, or age of the patient deviate from the original scope of approval. This is often the case in the treatment of rare diseases, children, and pregnant or breastfeeding women.

Oral antidiabetics

Oral antidiabetics are a type of medication in tablet form used to reduce blood sugar levels and are used more in the treatment of type 2 diabetes. They are used when a change to the diet or improvements in lifestyle are not sufficient. There are differences in the modes of action of the various oral antidiabetics. The following oral antidiabetics are used in the treatment of type 2 diabetes:

Oral glucose tolerance test (OGTT)

An oral glucose tolerance test (OGTT) is used to determine blood sugar levels. It is carried out when diabetes mellitus is suspected. The sugar tolerance test takes place with the patient resting either lying down or sitting up after an 8- to 12-hour period without food or smoking. To begin the test, the premixed sugar solution with 75 grams of glucose is drunk within 5 minutes. Before drinking the solution, and between 1 and 2 hours after, a venous blood sample is collected. The blood sugar level is then determined. An elevated fasting value (above 126 mg/dl or 7.0 mmol/l) and an elevated 2-hour value (above 200 mg/dl or 11.1 mmol/l) indicate diabetes.


The active ingredient orlistat is a medication in tablet form used to treat obesity. The body needs to break down fats using the enzyme lipase before they can be absorbed and utilized. Orlistat inhibits the enzyme in the intestines, reducing the absorption of fat by approx. 30 percent. The use of this medication can result in an additional weight loss of approx. 2 kilograms. Common side effects are soft stool, an increased urge to empty bowels, and flatulence. There may also be reduced absorption of fat-soluble vitamins.

Oxidative stress

Oxidative stress is a disparity between the production and breakdown of free radicals. Free radicals are highly reactive. It there are more free radicals present than the body can eliminate, then oxidative stress develops. There are various different triggers for oxidative stress. These include smoking, drinking alcohol, medications, or stress. Oxidative stress can result in temporary or permanent damage and accelerate the effects of aging.



The pancreas is an organ located in the upper abdominal region behind the stomach. It releases various substances into the intestine or directly into the blood and therefore plays a role in the digestion of food. It also produces the hormones insulin and glucagon.


Pancreatitis is inflammation of the pancreas.


Periodontal disease

Periodontitis is the chronic bacterial inflammation of the periodontium. The disease progresses slowly and gradually leads to bone loss. The affected teeth begin to loosen. If left untreated, it leads to tooth loss. Gum inflammation is a precursor to periodontitis.

Peripheral artery disease (PAD)

PAD stands for peripheral artery disease, also known as intermittent claudication. PAD is a disorder affecting blood flow in the pelvis, arms, and legs. PAD frequently results in calcification of the blood vessels of the legs, causing them to become severely narrowed or blocked. Blood then no longer reaches the feet, meaning they do not receive sufficient oxygen or nutrients. The initial stage of the circulatory disorder is usually symptom-free. The first PAD symptoms are aching and cramp-like pain when walking that forces the sufferer to stop.


A placebo is a substance with no active ingredient. Placebos are used as a method for comparison in scientific studies. They allow observations made during the study to be compared with one another. For example, if certain effects are observed both in the placebo group as well as in the group receiving the real active ingredient, then the effects cannot stem from the active ingredient.


(Blood) plasma is the term used to describe all the liquid components of blood. It consists of water, proteins, nutrients, salts, metabolic products, enzymes and hormones. Blood plasma no longer contains blood cells or blood platelets. In contrast to serum, plasma still contains coagulation factors.


This is the legally protected professional title for a medical specialist for foot care.


Polydipsia is pathologically excessive thirst. It is accompanied by excessive fluid intake.

Polyneuropathy, Diabetic

Diabetic polyneuropathy is a disease affecting several nerves that can develop as a result of diabetes mellitus. It can affect both the voluntary (somatic) part of the peripheral nervous system and the involuntary (autonomic) nervous system. The latter, for example, regulates breathing, heartrate, and bowel movements. Damage to these systems is often only noticed once it has already become more pronounced. “Negative symptoms” are when function is reduced: Touch, differences in temperature, and pain stimuli are gradually perceived less and less. In contrast, “positive symptoms” are when sensations are perceived that should not be: This includes numbness, tingling, or many types of pain (burning, searing, stabbing, dull, or piercing). These sensory disturbances often manifest when resting in the evening and improve with movement.


This is the specialist term for what are also known as multiple sugars.


Polyuria is the excretion of excessive amounts of urine (more than 2 liters per day). It can be a sign of diabetes mellitus or diabetes insipidus.


Postprandial means “after eating” or “after a meal” (see also preprandial).


The term prediabetes refers to a state with elevated blood sugar levels (fasting blood sugar 100 to 125 mg/dl (5.6 to 6.9 mmol/l) and/or 2-hour glucose value in the 75 gram oral glucose tolerance test of 140 to 199 mg/dl (7.8 to 11 mmol/l) and/or elevated HbA1c values (5.7 percent to 6.4 percent (38.8 to 46.5 mmol/mol)) that are however below the threshold value for diabetes.


Pregabalin is an active substance used in the pain therapy of diabetic foot syndrome, a complication of diabetes.

Pregnancy diabetes


Preprandial means “before eating” or “before a meal” (see also postprandial).


Prevalence is a specialist medical term for the frequency of a disease. For example, it indicates what percentage of people at a certain point in time or during a period in time are suffering from a specific type of disease.


Prospective means “likely to happen in the future” or “forward looking”. In a prospective study, the outcome analyzed by the research team, e.g., a specific type of disease, has not yet occurred by the start of the study. During the study, the research team investigates when and how frequently the disease occurs. The opposite of prospective is retrospective (see also retrospective).


Prostaglandins are tissue hormones. They play a crucial role in pain, inflammation, and blood coagulation.


Proteins are naturally occurring substances that are comprised exclusively or mainly of amino acids. They are an essential component of all living organisms and, alongside carbohydrates and fats, belong to the basic nutrients. They assume a wide range of tasks in the body.


Proteinuria is when more than 150 milligrams of protein per day is excreted via the urine. An albumin test is often carried out to diagnose the condition (see also albuminuria).



Quercetin is a natural pigment from the flavonoid group of polyphenols. Quercetin can be found in fruits, nuts, seeds, and tea, among other things. Studies with animals showed that the intake of quercetin reduced elevated blood sugar levels and slightly improved the complications of diabetes. Currently, there is no good data on its effectiveness in humans and the possible side effects of quercetin use.


Randomized controlled trial (RCT)

For example, during a randomized controlled trial, the participants are randomly assigned to two different groups. Researchers then use different measures on the groups and then compare them with one another. For example, one group is given a new drug and the other a placebo, i.e., a medication without an active substance. The research team then studies, for example, how the symptoms of a disease change in both groups.

Reactive hypoglycemia

Reactive hypoglycemia is a special form of low blood sugar. It occurs following the excessive release of insulin after eating a carbohydrate-rich meal. There can be numerous causes. For example, it can occur during the early stages of diabetes. Furthermore, it can develop as a result of a stomach emptying disorder stemming from damage to the autonomic nervous system (see polyneuropathy). This is known as diabetic gastroparesis. Reactive hypoglycemia can also develop after stomach surgery.


Remission is the regression or temporary subsidence of the symptoms of a disease.

For example, type 1 diabetes can have a remission phase. In this phase, after the initiation of insulin therapy, the metabolic state can show significant improvement with only very little or no insulin required. The duration of this phase varies.

In the case of type 2 diabetes, symptom remission can occur as the result of lifestyle changes, weight loss, or obesity-surgery, sometimes permanently, but usually only temporarily.

Renal insufficiency

Renal sufficiency is the impaired function or failure of one or both kidneys. This causes an increase in the concentration of urinary substances, such as creatinine, urea, or uric acid in the blood. A difference is made between acute kidney failure and chronic kidney failure.

Renal insufficiency, Acute kidney failure

These are the names given to an acute drop in kidney function. This causes an increase in the concentration of urinary substances, such as creatinine, urea, or uric acid in the blood. Their build up in the body results in signs of intoxication. Furthermore, the fluid and electrolyte balances and the acid-base homeostasis are disrupted. Acute kidney failure requires urgent medical attention, otherwise it can be life-threatening.

Renal insufficiency, Chronic kidney failure

Chronic kidney failure is the result of an irreversible reduction in renal function. Diabetic nephropathy is the most common kidney disease that leads to chronic renal insufficiency.

Restrictive lung disease

For many different reasons, restrictive lung disease causes the lungs to no longer fully expand. The disease manifests in restricted breathing and it can also be a complication of diabetes.

Retinopathy, diabetic

Diabetic retinopathy is damage to the retina associated with diabetes. Approximately 25% of people with type 1 diabetes suffer from retinopathy during their lifetime. On average, it is observed in 12.5% of people with type 2 diabetes, which is only half as many. In one-third of cases, changes to the retina have already occurred when diabetes is diagnosed. Retinopathy is caused by changes to small blood vessels located in the fundus of the eye (see also microangiopathy). This can lead to visual defects or deterioration. In the most severe cases, and without treatment, the retina can become detached. When left untreated, a detached retina can lead to blindness.


Retrospective means “looking to the past” or “with hindsight”. In a retrospective study, the outcome analyzed by the research team, e.g., a specific type of disease, had already occurred by the start of the study. The risk factors for the disease are analyzed using hindsight.



The release of substances by tissue, usually glands.


Serum is the liquid component of blood and contains no solid parts, such as red and white blood cells or blood platelets. It consists of water, proteins, nutrients, salts, metabolic products, enzymes and hormones. Blood serum cannot coagulate because it lacks a coagulation protein.

SGLT-2 inhibitors

SGLT-2 inhibitors are oral antidiabetics, primarily used to treat type 2 diabetes. SGLT-2 inhibitors reduce blood sugar levels by blocking the sodium-glucose transporter 2 (SGLT-2) in the kidneys. This inhibiting action enables more sugar to be excreted in the urine via the kidneys. The blood sugar level drops. Additionally, this mode of action leads to a fall in body weight and blood pressure levels.

Simple sugars

These are sugars (carbohydrates) that are made up of only one building block. The most well-known simple sugar is glucose (dextrose). When several sugars are linked together, they are known as a double sugars or polysaccharides.


Somogyi effect, also known as rebound hyperglycemia

The Somogyi effect, also known as rebound hyperglycemia is characterized by an early morning increase in blood sugar levels following low blood sugar levels during the night. The blood sugar level initially drops as a result of administering too high an insulin dosage in the evening. This causes the body to launch counter regulation measures. The various mechanisms, especially the release of the stress hormone adrenaline, cause an increase in blood sugar levels in the morning.


Stents are meshed vascular devices made from metal or plastic. They are often used in blood vessels, e.g., in the treatment of the coronary arteries, to keep the arteries open and ensure that occlusions do not reoccur.


Stratification means “layering” or “formation of layers”. In research, for example, participants in a population study, based presence of specific characteristics, are divided into smaller groups known as strata. Commonly used characteristics for stratification include age or gender. This system helps researchers obtain more accurate results for certain subgroups while avoiding calculation errors.

Stress hormone

As the name suggests, the body releases stress hormones, such as adrenaline, cortisone, or growth hormone, when in stressful situations.

Subcutaneous (abbreviation: s.c.)

Subcutaneous means “under the skin”. For example, insulin is injected under the skin. Fatty tissue is located below the skin. This is known as subcutaneous fat.


Sugars are carbohydrates and are a crucial source of energy for the body. Depending on their size, they are categorized as simple sugars, double sugars and multiple sugars.

Sugar substitutes

In contrast to sweeteners, sugar substitutes do provide energy, but less than household sugar (sucrose). They are metabolized independently of insulin and, as a result, influence blood sugar levels to a lesser extent than sugar. They also do not cause caries. Fructose, maltitol, mannitol, and xylitol are examples of sugar substitutes.


Sulfonylureas are oral antidiabetics used in the treatment of type 2 diabetes. They trigger the release of insulin by the pancreas into the bloodstream. However, their effectiveness decreases over time, meaning that they are only partially suitable as a long-term therapy for diabetes. They are often used for patients who cannot be treated using metformin. In contrast to metformin, therapy with sulfonylureas carries the risk of low blood sugar levels.


This is a term used to describe sugar substitutes. They have a far greater sweetening effect than household sugar (sucrose) and a negligible nutritional value. They contain almost no calories. Examples of sweeteners include aspartame, cyclamate, or saccharine.



TENS stands for Transcutaneous electrical nerve stimulation and is a healing method from naturopathy. This technique uses electricity to combat pain. The device generates an electrical impulse that is transmitted to the nervous system via the skin. The electrical impulse stimulates the nerves and reduces or completely eliminates pain.

Time in range

Time in range is a new benchmark for diabetes management and metabolic control. Measurement is only possible using what is known as a CGM or iscCGM system. These systems measure blood sugar levels continuously throughout the day. This allows the determination of how many hours a day the blood sugar value was within a specific target range.

Tissue Doppler echocardiography

The tissue Doppler echocardiography can help identify disorders of the heart muscles (myocardium). It is a special type of echocardiography – a type of diagnostic imaging. Using ultrasound waves, it is able to assess the structure and function of the heart.

Titration phase

The titration phase refers to the starting period when the dosage is tested and adjusted to determine the individual effective dosage.

Trace elements

Trace elements are minerals of which the body requires only tiny amounts. Iodine, zinc, selenium, or iron are examples of trace elements. If the body does not receive a sufficient amount of these elements over a longer period of time, the symptoms of deficiency can develop.

Transcription factor

Transcription factors are specific types of proteins required to read the information stored in the genes.


Triglycerides are also known as neutral fats. They consist of a glycerin molecule, known as sugar alcohol, linked to 3 fatty acids.




Veins are blood vessels that transport low-oxygen blood to the heart.

Vitamin D

Vitamin D can be found in small amounts in eggs and dairy products. The largest source of vitamin D comes via the skin. The skin is able to use sunlight to produce its own vitamin D. Vitamin D plays a crucial role in bone growth.


Wagner’s classification

The severity of diabetic foot syndrome can be classified using the Wagner scale. The scale grades using wound depth. The classification can be expanded by adding Armstrong’s criteria describing the presence of infection or ischaemia (circulatory disorder).

Waist-to-hip ratio

Waist-to-hip ratio indicates the ratio between the circumference of the waist and hips. A measurement tape is placed around the hips to determine the circumference. The tape is placed around the lowest rib to measure the waist. If the ratio between waist and hip circumference is greater than 0.85 for women and 1.0 for men, then this deemed an unfavorable ratio. These findings also correlate to an increased risk of cardiovascular diseases and diabetes.