November 13, 2011

Lingo:


Lingo (noun):
strange or incomprehensible language or  speech: as 
(a) a foreign language
(b) the special vocabulary of a particular field of interest
(c) language characteristic of an individual


Diabetes has its own language. I have assimilated it into my daily life, and, more often than not, I forget that D-lingo is foreign to most people. Some of it's technical (you know me, I love some good science), and some of it is just plain silly. Read some of it, read all of it, read none of it, re-visit it if you ever get confused-- Hopefully this entry will help you "normal" people to  understand more of what I write about.

Diabetes
Type 1 [Juvenile, Insulin-dependent, what I have :)]: an autoimmune disorder resulting from a combination of genetic and environmental factors. [As I understand it, there are multiple genes responsible for the predisposition to diabetes, and multiple environmental factors that can trigger onset.] Basically, at some point, for some reason, a T1's body thinks that the insulin-producing cells of the pancreas are bad and kills them off. The body's ability to produce insulin is completely lost, so artificial insulin must be taken [hence the "insulin-dependent"].

Type 2 [Adult-onset, Insulin-resistant]: a metabolic disorder. For some reason (genetics, weight, metabolism, etc.), the body has stopped responding as well to its own insulin. Diet, exercise, medication, and insulin are some of the many treatment options. When people think of "diabetes", they generally are thinking of type 2-- it gets significantly more media attention, and is much more common than T1.

Type 3: an honorary diabetic, has a normally functioning pancreas but understands the ins and outs of D because, in some way or another, they or someone in their life has been significantly impacted by it. (Primary examples: Mom and Dad) [Note: "Type 3" is also used to describe some more obscure types of diabetes that have not been qualified as either type 1 or type 2, but in the DOC (diabetes online community), type 3 is commonly used as I have defined here.]

Medications
Insulin: a hormone produced in the pancreas that regulates body metabolism by allowing cells to take up, use, and store sugar [from the food we eat]. Think of it this way: insulin is the key that unlocks your cells to let sugar in. That sugar then provides energy for your body to function the way it's supposed to. The amount of insulin required by any given person varies by persontime of day, activity level, stress.... Everyone is different and each unique insulin regimen reflects the amount of medication needed to keep that individual healthy, and healthy is what matters. Insulin can be delivered via insulin pump or injection. It comes in vials and pens (for injections).


Glucagon: a hormone produced in the pancreas that raises blood sugar levels (think about it as the opposite of insulin). I have an emergency glucagon kit that can be injected if I seize and/or pass out from low blood sugar [which hasn't happened to me ever].

Victoza: a medicine I take once a day via injection. It helps to stabilize my blood sugars by decreasing my body's natural random release of glucagon and slowing gastric emptying. It's designed for people with Type 2, but I am taking it off-label (i.e. not as directed). Unlike insulin and glucagon, Victoza isn't replacing something my body already makes, it's completely artificial, designed to help people like me take better control of their diabetes. :)

Gadgets, etc.
Pump [Insulin Pump]: affectionately nick-named Minnie. This sweet little gadget gives me a constant drip of insulin, and extra boluses when I tell it to, for food or to correct blood sugars. It has nifty calculators to remember how much insulin I need for what, but it doesn't do everything-- I still need to test 6+ times a day and do a set change once every 3 days. It's still way better than 4+ shots a day!
*On a silly note, whenever I try to type "insulin pump", I almost inevitably type "insulin pimp" by accident. It makes me giggle. Also, having a pump is like having an inside joke with myself. Any time anyone uses the word pump in a sentence, I laugh out loud. Sometimes I probably seem crazy :)*
Pumping has its very own lingo...
  • Infusion Set: My pump connects to me via an infusion set (I use the silhouette, the picture to the left). It is injected into fat tissue (stomach or hips usually) using a needle, which is pulled out to leave just the cannula (a little tube) behind. The needle/cannula is 13mm long and lasts for 3 days if there aren't any issues. A set change takes about 3 minutes and consists of me inserting a new set and refilling the pump's insulin reservoir. [It sounds like a lot, but it's an awesome alternative to lots of shots daily!] 
  • Basal: the automatic, constant drip of insulin that my pump delivers 24/7/365. The basal rate changes slightly throughout the day. I can also set temporary rates to accommodate for stress, sickness, or exercise-- I refer to that as "turning up" or "turning down".
  • Bolus: the extra doses of insulin I give throughout the day to adjust  blood sugars and account for the carbs I eat. The pump calculates my bolus based on insulin:carb ratios and sensitivity factors I pre-set into its "BolusWizard". 
Test Kit: a consolidated collection of testing supplies; a little black case with my [blood glucose] meter, test strips (what the blood actually goes on), and lancets (what I prick my finger with).
  • Test: to check blood sugar. This involves pricking my finger with a lancet, followed by squeezing the dickens out of my finger tip and positing the blood on a test strip in the meter.
  • Blood Sugar: a measure, in mg/dL, of the amount of glucose in the blood stream. For a non-diabetic, 70-120 is normal. I aim for between 90 and 180.
  • Low [low blood sugar, hypoglycemia]: a blood sugar below 80, treated immediately with fast-acting (pure) sugar- My go-to treatments are orange candy and Juicy Juice :) When I am low, I feel shaky, weak, fatigued, dizzy among other things-- I would say it is easily one of the most miserable parts of diabetes.
  • High [high blood sugar, hyperglycemia]: a blood sugar over 250 is high. High blood sugar is responsible for most of the long-term complications of diabetes. They are treated immediately with insulin. High blood sugar resulting from too little insulin can lead to Ketones: toxic byproducts from the body using fat and muscle for energy instead of sugar in the absence of insulin. Ketones are dangerous! When I am high I feel lethargic, nauseous, and thirsty. 
  • Dexcom: a continuous glucose monitor. It doesn't replace testing, but it gives a 24-hour picture of blood sugar trends by taking glucose reading in the interstitial fluid about every 5 minutes. 
A1c [HbA1c]: Hemoglobin A1c- a measure of glycated hemoglobin. [Oh, you're still waiting for that in English?] It's a measure of average blood sugar over a period of a couple months. It's measured in %, not mg/dL like blood sugar is. For me, a 7% would probably be ideal, but for now, it's just another number to work on, not stress about.


This isn't a comprehensive list of D lingo, but it sure is a good start. I will add and edit as time goes on and as I write more.

I hope this is somewhat insightful :) Let me know if I missed anything or need to explain anything better...

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