Glossary of Diabetes - D

D

Dawn phenomenon

A sudden rise in blood glucose levels in the early morning hours. This condition sometimes occurs in people with type 1 (formerly known as insulin-dependent) diabetes and (rarely) in people with type 2 (formerly known as noninsulin-dependent) diabetes. Unlike the Somogyi effect, it is not a result of an insulin reaction. People who have high levels of blood glucose in the mornings before eating may need to monitor their blood glucose during the night. If blood glucose levels are rising, adjustments in evening snacks or insulin dosages may be recommended. See also: Somogyi effect.

Debridement

The removal of infected, hurt, or dead tissue. it is necessary to deprive bacteria of a growth medium and to provide intact tissues a 'clean' surface on which they can begin to repair damage.

Dehydration

loss of fluid in the body (usually water) resulting in abnormal concentrations of substances in the blood and fluids. Too high concentrations interfere with many body processes. Insufficient fluid intake, or excessive urine output or both, are the usual causes.

Delta cell

A type of cell in the pancreas clumped with other cells (in the islets of Langerhans). Delta cells make somatostatin, a hormone that is believed to control how the beta cells make and release insulin and how the alpha cells make and release glucagon.

Desensitization

A method to reduce or stop an allergic reaction to something. Success is variable for reasons unknown.

Dextrose (see #Glucose)

a variety of glucose. Glucose, like many biochemicals comes in different isomers. In biological tissues throughout the earth, only the dexter form is produced and used.

DESMOND

A NHS training course for newly diagnosed diabetics freely available in the UK.

Diabetes control and complications trial (DCCT)

A 10-year study (1983–1993) funded by the National Institute of Diabetes and Digestive and Kidney Diseases to assess the effects of intensive therapy on the long-term complications of diabetes. The study very clearly showed that intensive management (i.e., close control) of insulin-dependent diabetes prevents or slows the development of the long-term complications of diabetes (eye, kidney, and nerve damage caused by diabetes), essentially to the 'normal' level.

Diabetes insipidus

a type of diabetes (excess urination) unrelated to diabetes mellitus.

Diabetes mellitus

A disease that occurs when the body is not able to use dietary carbohydrates (e.g., sugar, starch, ...) as it should. Caused by lack of insulin, inability to respond to insulin, or both.

Diabetic amyotrophy

A disease of the nerves leading to the muscles. This condition affects only one side of the body and occurs most often in older men with mild diabetes. See also: Neuropathy.

Diabetic angiopathy

See: Angiopathy.

Diabetic coma

see coma

Diabetic ketoacidosis (DKA)

see acidosis

Diabetic myelopathy

Spinal cord damage found in some people with diabetes.

Diabetic nephropathy

See: Nephropathy

Diabetic neuropathy

See: Neuropathy

Diabetic osteopathy

Loss of foot bone as viewed by x-ray; often temporary. Also called "disappearing bone disease."

Diabetic retinopathy

damage to the retina caused by growth of very small blood vessels. The proliferative variety is dangerous and often leads to blindness. It has been the leading non0traumatic cause of blindness in adults in the developed world for much of the 20th century.

Diabetogenic

Causing diabetes; some drugs cause blood glucose (sugar) to rise temporarily. Other cause it to rise permanently; if so they have caused diabetes. A chemical used as rat poison is an example.

Diabetologist

A doctor who sees and treats people with diabetes mellitus.

Diagnosis

A decision as to the cause of some symptoms or problem. A goal of most physicians is to eliminate as many possible causes as possible (the 'diagnostic differential tree') and so work toward making an affirmative diagnosis. Reaching this point suggests a course of treatment. Mistaken diagnoses are sometimes very serious problems as physicians concentrate on treatment after a diagnosis is reached, not retracing the diagnostic analysis. Ideally, diagnoses are always correct, but disease variations are such that they are sometimes in error. In the case of diabetes, the tests are very clear. If you do not have high blood glucose at times (e.g., when fasting), you shouldn't be diagnosed as diabetic, though perhaps as "prediabetic". Every one has higher glucose levels for one or two hours after eating food which contains some types of carbohydrates.

Dialysis

providing kidney function artificially. This requires an artificial kidney (a dialysis machine) and relatively long periods hooked up to the machine every few days. It is not equivalent to a working kidney, but is sufficient to maintain life, sometimes for extended periods.

Diastolic blood pressure

See: Blood pressure.

Diet plan

See: Meal plan.

Dietitian

An expert in nutrition who helps people with special health needs plan the kinds and amounts of foods to eat. In the US, a registered dietitian (R.D.) has special training and experience. The health care team for diabetes should ideally include a dietitian, preferably an R.D.

Dilated pupil examination

A necessary part of an examination for diabetic eye disease. Special drops are used to enlarge the pupils, enabling the doctor to view the retina at the back of the eye for damage. See funduscopy.

Distal sensory neuropathy

See: Peripheral neuropathy.

Diuretic

a drug or substance which has the effect of increasing the amount of urine the kidneys excrete. Swollen feet and ankles are sometimes treated with diuretics. There are several classes, which act at different points in the water resorption portion of the kidney tubule.

Deoxyribonucleic acid

a stable molecule which can be replicated with few errors, and which is used to store information about protein structures. It also contains mechanisms to block or unblock the transcription of that information of selected proteins at appropriate times. It was the sequence of information in a single human's DNA (that of Dr Craig Venter) which was the primary initial object of the Human Genome Project. That, and continuing work is expected to increase understanding of body functions and most likely to more effective treatments for many diseases. Its amino acid code (DNA triplet --> amino acid incorporation) is identical across all Terrestrial life except for a very few bacteria. DNA is the chief genetic information storage structure of nearly all life on Earth. In humans and other multi-cellular organisms, the exceptions all use RNA, which is a very closely related molecule. DNA is stored chiefly in the cell nucleus of plant and animal (including human) cells. Small amounts of DNA are also kept in the mitochondria, where fuel (chiefly glucose) is processed aerobically to produce high energy chemicals (ATP) which are used throughout the cell to power energy consuming reactions.

Dupuytren's contracture

A condition that causes the fingers to curve inward and may also affect the palm. The condition is more common in people with diabetes and may precede diabetes. The mechanism is unclear. Treatment is limited to surgery (typically only in severe cases) and is usually of limited value.

Dysglycemia (or Dysglycaemia)

Abnormal blood sugar levels from any cause which results in disease. A condition resulting from a disorder of blood sugar metabolism. Usually the more specific terms hyperglycemia, hypoglycemia, or others are used instead, and dysglycemia is used only when a firm diagnosis has not yet been made.