Terms and Defintions from the Guru

A

Active Rest: The Guru’s best example of an exercise oxymoron. Active Rest stands for movement during the rest periods between intervals (as opposed to the very scientific method of stopping and keeling over).

Aerobic Exercise: Aerobic literally means ‘with oxygen’ (don’t know where the word came from, but you can pretend the Guru invented it if you want). It stands for exercise performed at moderate levels of intensity for extended periods of time that maintains an increased heart rate.

Algorithm: Sounds like a word only those who attended ‘havad’ would use, but it’s actually a step by step plan for determining how much insulin to take for both the blood level of glucose and the intake of carbohydrate.

Anaerobic Exercise: Anaerobic literally means ‘without oxygen’ (again, feel free to give me the credit…) It is any activity that is brief, and where oxygen is not needed for energy purposes. These are ‘all out’ activities, like the 100 meter sprint.

Anaerobic Threshold: The specific point at which your body moves from aerobic exercise to anaerobic exercise. This signifies a change in the energy that your body uses for activity.

Apidra: A rapid acting insulin manufactured by Aventis®. Onset of action of Apidra is 10 to 15 minutes, peak action is 60 to 90 minutes, and the duration is less than 5 hours.

Arthroscleroses: A disease involving the narrowing of the arteries, which is caused partly by deposits of cholesterol in the arteries. (Picture the gutters of your house getting clogged with leaves duirng the fall.) These deposits can be caused by both genetics and by eating foods high in cholesterol.

Artificial pancreas: A ‘very large’ machine that can measure blood glucose and release appropriate insulin. (Large is the key word here…These machines are entirely too large to be carried around with us, unless you want to pull a wagon that weighs a few hundred pounds).

Aspart (Novolog®) insulin: A rapid acting insulin analog manufactured by NovoNordisk®. The action of aspart insulin is faster than Regular insulin. Onset of action is 10 to 15 minutes, peak action is 60 to 90 minutes, and duration is less then 5 hours.

B
Basal: The amount of insulin needed to meet your basic metabolic insulin requirements; this includes even the simple act of breathing (yes, breathing requires energy!)

Basal Rate: A ‘pumping’ term that stands for the amount of insulin that is continuously delivered by an insulin pump. It is measured in units per hour (U/hr).

Bicycle, dual action arm handles: Sounds quite ‘techy’, but this type of bike is simply one with handles for your arms which force you to use arms as well as legs.

Bicycle, recumbent: A type of stationary bicycle where you sit and pedals are in front of you. (kinda like you’re riding a Harley.) This type of machine is better for those with weak lower back muscles.

Bioelectical Impedance: Another fancy shmancy way to determine your amount of body fat. An electrical impulse travels through your body (no you won’t feel it) and is able to tell the amount of fat. The slower the signal, the more fat you’ve got.

Blood Glucose: The glucose carried through the body by the blood stream. Also known as BG

Blood Pressure: In a nutshell, this is a measurement of how ‘open’ your blood vessels are; the lower the number, the more ‘open’ your blood vessels (and more importantly, the easier it is on your heart to get blood to all parts of the body). Ideal blood pressure is 120/80 or below. The top number is your systolic blood pressure, a measure of pressure when your heart is ejecting blood. The bottom number is your diastolic blood pressure, a measure of the pressure when your heart is relaxing.

Body Composition: A breakdown of your weight that shows the proportion of your body weight that is fat as opposed to your lean body tissue (all of the other stuff). Aka Body fat percentage

Body Mass Index: A number that represents the body’s mass. It’s determined by dividing the weight in kilograms by the height in meters.

Bolus: A ‘pumping’ term used to denote the amount of insulin delivered at one time, usually before a meal or when blood glucose is high.

Bone Density: This test has nothing to do with how smart your bones are, it is a measurement of how thick (and there for how strong) your bones are.


C
Cadence: This number represents how many times you turn the pedal every minute. Also known as RPMs, revolutions per minute.

Cannula: A ‘pumping’ term, a small tube (or catheter) that is inserted into the body and lies just underneath the skin to infuse insulin.

Carbohydrates: One of the three major classes of foods and numero uno when it comes to effects on raising blood glucose.. Carbohydrates are found in grain, fruits, and vegetables. Carbohydrates have 4 calories per gram and a healthy diet should account for 50% of your calories. slang term – carbs

Carbohydrate Counting: Estimating (I prefer to use the scientific term ‘guestimating’) the amount of carbohydrates in food(s) in order to determine insulin needs by way of an insulin to carbohydrate ratio.
Cartridge: The container that holds insulin for use in a pump or an insulin pump. Cartridges are not interchangeable. A cartridge for an insulin pen will not fit into a pump.

Certified Diabetes Educator: A healthcare professional qualified by the American Association of Diabetes Educators to teach people with diabetes how to manage their condition Also known as CDE

Cholesterol: A form of fat that is needed for the body’s production of some hormones, examples include butter and egg yolks. It has no calories but will raise the amount of cholesterol in your blood, and excessive levels of cholesterol can lead to atherosclerosis.

Collars: Clips that attach to the end of a weight lifting bar to prevent weights from sliding off the end of the bar and making a scene in the gym.

Conventional Diabetes Treatment: A system of diabetes management practiced by most people with diabetes involving only one or two shots of insulin daily, self-monitoring of blood glucose and a standard program of nutrition and exercise.

Continuous Subcutaneous Insulin Infusion: A method of insulin delivery where insulin is delivered under the skin by an insulin pump to mimic the way the body provides insulin. Also known as CSII

Cool down: The process of an easy, full-body exercise that will allow the body to transition from an exercise mode to a non-exercise mode. Depending on the intensity of the exercise, one may need to take a slow jog or walk, or one may simply stretch.

D
Dawn phenomenon: When I first heard of this I thought it meant if I ever happened to wake up before the dogs, but it’s actually, the tendency for your blood glucose to rise early in the morning due to secretion of hormones (like growth hormone, cortisol and adrenalin) that counteract insulin.

Delayed Onset Muscle Soreness: Soreness of the muscles that can occur up to 48 hours after your workout. Also known as DOMS

Diabetes: A disease where the body cannot maintain healthy blood glucose levels because either the body no longer produces insulin (type 1), or the body cannot appropriately use insulin (type 2) Type I has also been known as insulin dependent diabetes mellitus, IDDM, and juvenile diabetes. Type II has been referred to non-insulin dependent diabetes mellitus, NIDDM, or adult onset diabetes.

Diabetic Ketoacidosis: A serious condition resulting from a high level of ketones in the body because of a deficiency of insulin. Also known as DKA

Diabetes Control and Complications Trial: The decisive 10 year study (1983-1993) of type I diabetes that showed the intensive control of blood glucose would prevent and delay complications of diabetes. Also known as DCCT

Dietitian: A specialist in nutrition who educates others on the role of food and nutrition as part of their healthcare plan. A registered dietitian (R.D.) has special qualifications.

E
Endocrinologist: A physician who specializes in diseases of the endocrine system, and a specialist in diabetes. slang term – endo

Epinephrine: One of the hormones secreted by the body that helps the liver release glucose and limit the release of insulin. ‘Epi’ as it is also known, can make the heart beat faster and raise blood pressure. Also known as adrenalin.

Exchange plan: A dietary plan where foods similar in type are grouped together so that one can substitute foods for another within that group. Groups can include: starches and breads, meats, fruits mild vegetables, and fats. (Think of the weight watchers diets…)

Extended bolus: a ‘pumping’ term that allows a bolus to be delivered over an extended time (30 minutes -12 hrs) rather then all at once. Extended boluses are often used for meals that digest slowly such as meals high in protein or fat.

F
Fartlek: A Swedish word for interval training that has no specific measure or distance. Also known as Speed play.

Fat: One of the three main classes of food and a source of energy in the body. Fats help the body use some vitamins and keep the skin healthy. They also serve as energy stores for the body. See also saturated and unsaturated fats.

Fat, Saturated: Found primarily in meats and dairy products, these solid fats (at room temperature) raise your total cholesterol. Because of this, it is recommended to be kept under 10% of total daily calories. Some examples include butter, lard, meat fat, solid shortening, palm oil and coconut oil.
Fat, Unsaturated: Found in plant oils such as olive, peanut, corn, cottonseed, sunflower, safflower and soybean, these liquids tend to lower the level of cholesterol in the blood.

Fiber: A plant based substance that can not be digested; it provides ‘0’ energy but is low in fat and may help prevent heart disease and colon cancer. Fiber helps in the digestive process and is thought to lower cholesterol and help control blood glucose. See also soluble and insoluble fiber.

Fiber, Soluble: A type of fiber found in beans, fruits, and oat products; thought to help lower blood fats and blood glucose.

Fiber, Insoluble: A type of fiber found in found in whole-grain products and vegetables; passes directly through the digestive system, helping to rid the body of waste products.

Fitness Evaluation: Measurements of your current resting heart rate, body fat, strength and flexibility.

Flexibility: Plastic Man’s super power - how far and how easily you can move your joints. See also sit & reach test

Flexibility, Sit & Reach Test: A test of the flexibility of the lower back and rear thigh muscles.

Fructose: The sugar found in fruits, vegetables and honey. It is absorbed slower in the body then glucose (but personally my favorite).

G
Galactose: A type of sugar found in milk products and sugar beets. It is also made by the body. It is considered a nutritive sweetener because it contains calories.

Glargine (Lantus®) insulin: A long acting insulin analog manufactured by Aventis® Pharmaceuticals. The action of glargine is slow and constant, usually lasting 24 hours, which allows for once a day injections. Glargine is used as a basal insulin for injection therapy.

Glucagon: A hormone made in the alpha cell of the pancreas that raises glucose and can be injected in sever hypoglycemia.
Glucose: The major source of energy for the body and comes from the digestion of food (protein, carbohydrate and fat). Carbohydrate provides the most consistent source of glucose.

Glycemic Index: The effect of different foods on blood glucose (sugar) levels over a period of time. Researchers have discovered that some types of food may raise blood glucose levels more quickly than other foods containing the same amount of carbohydrates.

Glycogen: A substance made up of sugars. It is stored in the liver and muscles and releases glucose into the blood when needed by cells. Glycogen is the chief source of stored fuel in the body.

Glycogenesis: The process by which glycogen is formed from glucose. Also known as glucogenesis.

Goals: Objectives that you set as benchmarks for your exercise plan. See also back up, long term, short term.

Goals, back up: These are goals that are often referred to as Plan B. They are secondary goals that are made should something unforeseen prevent you from attaining your primary goals. (Example – a sprained ankle may prevent you from competing in your first marathon, but may not deter you from your overall goal of becoming more active.)

Goals, long term: Goals set to be achieved 3-6 months from now.

Goals, short term: Goals set to be achieved anywhere from one week to a month.

Goniometer: A device that a measure of flexibility for your hamstrings, looks like a giant protractor.

Gram: A unit of weight in the metric system. There are 28 grams in 1 ounce. In some meal plans for people with diabetes, the suggested amounts of food are given in grams.

H
Heart Rate: The number of times your heart will beat in one minute. Also known as pulse. See also max, recovery, and target heart rates.

Heart Rate, Max: The maximum amount of beats your heart can beat per minute. An easy method (220 – your age = max heart rate) uses your age to calculate your max heart rate, because your max heart rate should decline as we age.

Heart Rate, Recovery: Checking heart rate one minute after exercise is stopped. This amount measures your recovery - the larger your drop the ‘fitter’ you are. (Is ‘fitter’ a word?)

Heart Rate, Target: A set of numbers that represents the recommended range of your heart rate when exercising. This amount is typically 50-85% of max heart rate.

Hemobglobin A1c: A measurement of blood glucose control reflecting the average blood glucose for the last 60 to 90 days. Also known as.Glycosylated hemoglobin.

High Density Lipoproteins: A particle in blood that carries cholesterol and helps reduce arteriosclerosis. Also known as HDL

Hill repeats: A workout that involves running intervals uphill (because it’s harder then running downhill).

HDL / LDL ratio

HDL: cleaners removing LDLs and sending to liver

Honeymoon Phase: A period of variable duration, after diagnosis of type I diabetes when the need for injections of insulin is reduced and / or eliminated. This is because there are still beta cells in the body producing insulin.

Hyperlipedemia: Elevated levels of fat in the blood

Hypoglycemia: Levels of blood glucose lower than normal, usually less then 70 mg/dl. This will occur when there is too much insulin, too little food, or has exercised more than usual. Symptoms include dizziness, shakiness, rapid heartbeat, sudden hunger, cold or clammy skin, fuzzy vision, confusion, mood changes, and tingling or numbness in the hands, arms, tongue or lips and, if left untreated, can lead to unconsciousness. Also known as, Insulin reaction, low blood glucose, insulin shock.

Hydrogenation: a process used to turn liquid vegetable oils in to solids. process

Hypertensive: A fancy word for high blood pressure.

Hemoglobin A1C: A blood test that measures the amount of glucose (sugar) attached to hemogloblin. Hemoglobin is the part of the red blood cell that carries oxygen to the cells. The HbA1C test shows what the person's average blood glucose (sugar) level was for the 2- to 3-month period before the test. Also known as HbA1C.
Homeostasis: When the body is working as it should because all of its systems are in balance.

Hormone: Released by special cells, hormones are chemicals that tell other cells what to do. For instance, insulin is a hormone made by the beta cells in the pancreas. When released, insulin tells other cells to use glucose (sugar) for energy.

Hyperglycemia: It occurs when blood glucose levels rise above 180 mg/dl, and the body does not have enough insulin or cannot use insulin correctly to move glucose (sugar) into the cell for energy. Symptoms of hyperglycemia include nausea, vomiting, muscle and joint aches, blurred vision, excessive thirst, and frequent urination. Over time, weight loss can result. Hyperglycemia can occur even while using an insulin pump. Hyperglycemia can lead to diabetic ketoacidosis (DKA) if untreated. Also known as high blood glucose (sugar).

I
Intensity

Insulin: the key hormone that emits glucose to enter the cells

Insulin pump: Device that slowly pushes insulin through a cathetar under the skin but can also be used to give a large does before meals. Personally, the best invention since sliced bread, and without it I can’t eat sliced bread….

Insulin reaction: the result of too much insulin in the body without glucose to compensate for it. AKA Hypoglycemia, low blood glucose, or my favorite ‘the lows’

Insulin resistance: A condition where the body cells resist or do not respond to insulin being secreted by the body. An early stage of those with type II diabetes.

Intensive diabetes treatment: A classification of diabetes management using three or four insulin injections based upon measurement of blood glucose along wth very careful diet and exercise t approximate the normal range of glucose

Intervals: A workout involving alternating short intense periods of exercise with periods of relatively easy exercise. For example an interval workout may consist of 8 intervals of one minute hard, one minute easy..

Infusion set: a ‘pumping’ term, for a length of thin plastic tubing (24" or 43" long) with a Luer™-lock connector at one end, and a small cannula at the other end. The cannula is placed under the skin. It is connected to the insulin pump and used to deliver insulin to the body.

Infusion site: a ‘pumping’ term for the place on the body where the infusion set needle is inserted under the skin. The most frequently used areas include the upper, outer arm; stomach (just above and below the waist, avoiding a 2 inch circle around the naval). and the front and outside portion of the thigh. These areas can vary with the size of the person. Discuss appropriate site selection with your healthcare professional.

Injection sites: Places on the body where people can inject insulin. The most frequently used areas include the upper, outer arm; stomach (just above and below the waist, avoiding a 2 inch circle around the naval); c

Injection site rotation - Changing the places on the body where a person injects insulin. Changing the injection site keeps lumps or small dents (called lipodystrophies) from forming in the skin. Discuss appropriate injection site rotation with your healthcare professional.

Insulin - A hormone produced by the beta cells in the pancreas. Insulin is needed by the body to regulate use of glucose.

Insulin pen: An insulin injection device the size of a pen that includes a needle and prefilled cartridge (vial) of insulin. It can be used instead of syringes for giving insulin injections.

Insulin pump: A small, battery-powered device that mechanically pumps measured amounts of insulin through an infusion set into the body. The pump is not automatic. You program and control it, and you must check your blood sugar four to six times a day to ensure delivery of appropriate amounts of insulin by the pump.

Insulin resistance: Many people with Type 2 diabetes produce enough insulin, but their bodies do not respond to the action of insulin. This may happen because the person is overweight and has too many fat cells, which do not respond well to insulin. Insulin resistance is also linked to high blood pressure and high levels of fat in the blood (also called Metabolic Syndrome). If a person with insulin resistance uses insulin injections, they may require very high doses of insulin (over 100 units a day) to bring blood glucose (sugar) levels into normal range.

Intensive management: A form of treatment for Type 1 or Type 2 diabetes in which the main objective is to keep blood glucose (sugar) levels as close to the normal range as possible. The treatment consists of three or more insulin injections a day or use of an insulin pump; four or more blood glucose tests a day; and adjustment of insulin, based on food intake, activity levels and blood glucose test results. See also: Diabetes Control and Complications Trial.

J
Juvenile diabetes mellitus: The previous term for type I diabetes. It wad given it’s name because those who were diagnosed with type I were usually diagnosed during adolescence.

K
Ketones - are substances produced when the body burns muscle or fat for energy. Ketones develop when there is not enough insulin available to help glucose enter the cells for energy. The body, in turn, burns muscle and fat for energy. A waste product of fat burning is ketones. In uncontrolled diabetes, the process becomes unbalanced and ketones can accumulate in the blood, pass through the urine and ultimately result in diabetic. AKA ketone bodies

Ketoacidosis (DKA). Also see diabetic ketoacidosis.

L
LDL stick to the walls of your areteries and can obstruct blood flow

Lancet: A sharp needle to prick the skin used to prick the skin for a blood glucose test (aka ‘the sharpies’)

Lente Insulin: An intermediate-acting insulin that works in 4-6 hours and is gone by 12 hours.

Lipoatrophy: Indented areas where insulin is constantly injected

Low Density Lipoprotein A particle in the blood contining cholesterol and thought to be responsible for atherosclerois aka LDL

Lispro insulin - lispro insulin- A rapid acting insulin analog manufactured by Eli Lilly®. Also called Humalog® insulin. The action of lispro insulin is faster than Regular insulin. Onset of action is 10 to 15 minutes, peak action is 60 to 90 minutes, and duration is less than 5 hours.

Luer™-lock: A ‘pumping term’, the Luer™-lock is a special threaded fitting used to connect the infusion set to the pump's insulin cartridge.

Lean body tissue: everything else.

M
Maximal Test: evaluate your heart rate while you’re going all out.

Meal plan: A guide for controlling the amount of calories, carbohydrates, proteins and fats a person eats. People with diabetes can use plans such as carbohydrate counting, the Exchange Lists or the Point System to help them balance their meal and insulin requirements so that they can keep their diabetes under control. See also: Exchange lists; point system.

Metabolism: The term for the way cells chemically change food so that it can be used to keep the body alive. It is a two-part process. One part is called catabolism-when the body uses food for energy. The other is called anabolism-when the body uses food to build or mend cells. Insulin is necessary for the metabolism of food.

Mg/dL: The unit used to measure blood glucose levels. It is the abbreviation for milligrams of glucose per deciliter of blood.

N
Nutrition: The process by which the body draws nutrients from food and uses them to make or mend its cells. YOU ARE WHAT YOU EAT!!!

NPH: An intermediate-acting insulin, which starts to work in 4-6 hours and ends in 12 hours; a choice for those on multiple daily injections.


O
Occlusion: a ‘pumping term’ for a "blockage’ in the infusion set. This can occur if the tubing is squeezed, ort if the cannula is bent. Insulin pumps may or may not have alarms built in to warn you of a possible occlusion.

Ophthamologist: A doctor who specializes in diseases of the eyes

Osteoporosis: A disease of severe bone loss that occurs with aging, affecting women more then men. Weight bearing activity and lifting weights will help to decrease the amount of bone loss.

Overtraining: Pushing your workouts too hard and too fast; symptoms of overtraining include an elevated heart rate, chronically sore or weak, chronic colds, and not sleeping well.

P
Pancreas: The organ behind the stomach that contains the Islets of Langerhans

Podiatrist: A person who specializes in treating the feet

Protein: One of the three major classes of food. Proteins are made of amino acids, which are called the building blocks of the cells, responsible for allowing cells to grow and to mend themselves. Protein is found in foods from animals but also plants. Proteins have 4 calories per gram and should account for 15-20% of your daily intake of calories.

Pancreas: The organ that hosts the Greek Fraternity of the body, producing both alpha cells, which produce glucagon, and beta cells, which produce insulin.

Peak action: The time period when the effect of the insulin is having the most effect on lowering the blood glucose.

Postprandial Blood Glucose: Blood glucose taken 1-2 hours after eating to measure the amount of glucose (sugar) in the blood. This is used to determine if the meal dose of insulin was enough. Also known as PPBG

R
Radial Artery: An artery that runs on the inside of your forearm. This is one of the easiest places to take your pulse. Find it by placing your middle and index fingertips of one hand just below the base of your thumb on the opposite wrist.

Range of Motion: How far you are able to move a particular joint.

Ratings of Perceived Exertion: A method of gauging intensity of your workouts. Using the numerals 0 to 10, 0 will represent ‘easy as pie’ exercise, while 10 represents ‘please end this pain’ exercise. Also known as RPE.

Regular Insulin: A fast acting insulin active in 1-2 hours and gone by 4-6 hours. This type of insulin is used in insulin pumps.

Rebound: A swing to a high level of glucose in the blood after having a low level. This often occurs from over treating for a low blood glucose.

Repetition: One complete motion of an exercise, from start to finish.

S
Set: A group of consecutive repetitions.

Submaximal Test: A test that will evaluate your heart rate when you’re working at less then your maximal effort.

Stress Hormones: Hormones released by the body in times of intense physical or emotional stress. These hormones cause glucose stored in the liver and muscle to be released for energy, which can result in high blood glucose. Also known as counter-regulatory hormones

Subcutaneous: Beneath the skin, but just above the muscle. The infusion set used in insulin pump therapy is placed subcutaneously, and so are injections.

Skinfold Calipers: A devise that looks like salad tongs, used to determine the measurement of your body fat. The literal translation for the phrase, ‘pinch an inch’. Accuracy is dependent on the person completing the measurements.

T
Tempo workouts: Workouts that cause (as my mom used to say) ‘a good sweat’. It’s faster then challenging but not brutal, lasting between 4-10 minutes.

Trans Fatty Acids: Unsaturated fats that are chemically altered through, ‘the miracle of modern science’, with hydrogenation. Unfortunately this process causes these fats to act like saturated fats. Also known as TFA’s

Talk Test: A non-scientific term for determining your intensity during exercise. The idea behind the talk test is that when you are exercising you should not be gasping for air, but you should also not be able to sing along to your favorite song (Brittany Spears) blasting through your i-pod.

Temporary basal rate: a ‘pumping’ term describing an option on some pumps to increase or decrease the amount of basal insulin. This is incredibly useful for periods where an increase or decrease in your basal rate is needed (home sick with the flu, mowing the lawn, etc.)

Tendons: Tissues which connect muscle to bone. These were unfortunately left out of the song ‘elbow connected to the arm bone, arm bone connected to the shoulder bone.’ But still very important.

U
Ultralente Insulin: A long acting insulin that lasts 24 to 36 hours; a choice for those on multiple daily injections.

Underwater Weighing: A method of body composition testing. Body composition is determined by placing you (in your skivvies, or you birthday suit if your that bold) on what looks like a large scale that is placed into a tub of water. By exhaling every last ounce of air in your lungs (yes, every last ounce) you begin to sink; the amount you sink helps to determine your body composition. This method is very accurate but not always easily accessible.

V
Visceral fat: The fat that collects around the waist. This is what all of those exercise gimmicks focus on by emphasizing the idea of ’spot reduction’ (they don’t work).

Very Low Density Lipoproteins: A portion of your total cholesterol. This is the main particle in the blood that carries triglycerides. High levels are assocaited with a number of diseases and metabolic states. When thinking about your VLDL number try to remember ‘Very Low Densiity Lipoproteins need to be as Low as possible.’ Also known as VLDL

W
Warm up: Think of this as the ‘pre-game’ to the main event, the main event being your exercise session. This is performed before participating in exercise, generally consisting of a gradual increase in intensity in physical activity.

Z
I got nuthin for ya here…

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