Reference Guide

Glossary of Terms

A comprehensive reference of diabetes and blood glucose monitoring terminology. Understand the key concepts behind test strips, meters, and glucose management.

A1C (HbA1c): A blood test that measures average blood glucose levels over the past 2-3 months by measuring the percentage of hemoglobin proteins coated with sugar. Also known as glycated hemoglobin or hemoglobin A1c.
Accuracy: How close a blood glucose reading is to the actual blood glucose level. Test strip accuracy is regulated by the FDA and must meet ISO 15197 standards.

Blood Glucose: The concentration of glucose (sugar) present in the blood, measured in milligrams per deciliter (mg/dL) in the US or millimoles per liter (mmol/L) in most other countries.
Basal Rate: The continuous, low-level delivery of insulin by an insulin pump to maintain stable blood glucose levels between meals and overnight. Rates can be programmed to vary throughout the day.
Bolus: A dose of insulin delivered by an insulin pump or injection to cover food intake or correct high blood glucose. Types include meal boluses, correction boluses, and extended boluses.

Calibration: The process of setting or checking a glucose meter's accuracy using a known glucose concentration. Some meters require manual calibration with each new box of test strips.
Capillary Blood: Blood obtained from small blood vessels (capillaries) near the skin surface, typically from a fingertip. This is the most common sample type for home glucose monitoring.
CGM (Continuous Glucose Monitor): A device that continuously measures glucose levels in interstitial fluid through a small sensor inserted under the skin, providing real-time readings and trends throughout the day and night.
Coding: The process of entering a code into a glucose meter to match the specific lot of test strips being used. Many modern meters feature 'no-coding' technology.
Control Solution: A liquid containing a known amount of glucose used to verify that the meter and test strips are working correctly. Regular control solution testing ensures accurate results.
Cannula: A small, flexible plastic tube inserted under the skin to deliver insulin from a pump or serve as a CGM sensor. Cannulas are typically made of Teflon or steel.
Closed-Loop System: An automated insulin delivery system that uses CGM data to automatically adjust insulin pump delivery. Also known as an 'artificial pancreas,' it reduces the need for manual insulin dosing decisions.
Carbohydrate Counting: A meal planning approach where carbohydrates are counted in grams to match insulin doses. Essential for insulin users to maintain blood glucose control.

DPP-4 Inhibitors: Oral medications that block the enzyme DPP-4, which breaks down incretin hormones. This increases insulin release and decreases glucagon. Examples include Januvia, Tradjenta, and Onglyza.
Dawn Phenomenon: A natural rise in blood glucose in the early morning hours (4-8 AM) caused by the body's release of hormones. May require insulin adjustment or medication timing changes.
DKA (Diabetic Ketoacidosis): A serious, potentially life-threatening complication occurring when the body produces high levels of ketones due to insufficient insulin. More common in Type 1 diabetes.

Electrode: The conductive element within a test strip that measures the electrical current generated by the glucose reaction, which is then converted to a glucose reading.
Electrochemistry: The method used by most modern test strips to measure glucose. An enzyme reaction with glucose produces an electrical current proportional to the glucose concentration.
Enzyme: A protein that catalyzes the chemical reaction in test strips. Common enzymes include glucose oxidase (GOD) and glucose dehydrogenase (GDH).

Fasting Blood Glucose: Blood glucose level measured after not eating for at least 8 hours. Normal fasting glucose is typically below 100 mg/dL.
FDA (Food and Drug Administration): The US regulatory agency responsible for approving and monitoring the safety and effectiveness of medical devices, including glucose meters and test strips.
Fingerstick: The process of pricking the finger with a lancet to obtain a small blood sample for glucose testing. Alternative sites include the palm, forearm, and thigh.
Flash Glucose Monitor: A type of continuous glucose monitoring system that requires the user to scan the sensor with a reader or smartphone to obtain glucose readings, rather than displaying them automatically.
Fiber: A type of carbohydrate that the body cannot digest. Fiber does not raise blood glucose and can help slow the absorption of other carbohydrates. Recommended intake is 25-30 grams daily.

Glucose Dehydrogenase (GDH): An enzyme used in some test strips that is not affected by oxygen levels, making it suitable for various testing conditions. Different co-factors (FAD, NAD, PQQ) affect specificity.
Glucose Oxidase (GOD): The most commonly used enzyme in test strips. It specifically reacts with glucose but can be affected by oxygen levels and certain medications.
Glycemic Control: The management of blood glucose levels within a target range to prevent diabetes complications. Good glycemic control is indicated by A1C levels below 7% for most adults with diabetes.
GLP-1 Receptor Agonists: Injectable medications that mimic the GLP-1 hormone to stimulate insulin release, suppress glucagon, slow digestion, and reduce appetite. Examples include Ozempic, Trulicity, and Wegovy.
Glucagon: A hormone produced by the pancreas that raises blood glucose by signaling the liver to release stored glucose. Injectable glucagon is used to treat severe hypoglycemia.
Glycemic Index (GI): A ranking of carbohydrates from 0-100 based on how quickly they raise blood glucose. Low GI foods (under 55) cause slower, smaller rises in blood sugar.
Glycemic Load (GL): A measure that considers both the glycemic index and the amount of carbohydrate in a serving. Provides a more accurate picture of a food's effect on blood glucose.
Gestational Diabetes: Diabetes that develops during pregnancy in women who did not previously have diabetes. Usually resolves after delivery but increases future risk of Type 2 diabetes.

Hematocrit: The percentage of red blood cells in blood. Abnormal hematocrit levels can affect the accuracy of some glucose meter readings.
Hyperglycemia: High blood glucose, typically defined as above 180 mg/dL after meals or above 130 mg/dL when fasting. Symptoms include increased thirst, frequent urination, and fatigue.
Hypoglycemia: Low blood glucose, typically defined as below 70 mg/dL. Symptoms include shakiness, sweating, confusion, and in severe cases, loss of consciousness.
Hybrid Closed-Loop: An automated insulin delivery system that adjusts basal insulin automatically but still requires user input for meal boluses. Examples include Medtronic 780G and Tandem Control-IQ.
Hyperosmolar Hyperglycemic State (HHS): A serious condition in Type 2 diabetes characterized by extremely high blood glucose (often over 600 mg/dL), severe dehydration, and altered consciousness without significant ketones.

Interference: Substances or conditions that can affect the accuracy of glucose readings, including certain medications (like acetaminophen), vitamin C, uric acid, and extreme temperatures.
Interstitial Fluid: The fluid between cells in body tissue. CGM sensors measure glucose in interstitial fluid, which lags behind blood glucose by approximately 5-15 minutes.
ISO 15197: The international standard that specifies accuracy requirements for blood glucose monitoring systems. Meters must produce results within ±15% of lab values for readings above 100 mg/dL.
Insulin Pump: A small, computerized device that delivers rapid-acting insulin continuously through a thin tube (cannula) inserted under the skin. Pumps can be programmed to deliver basal and bolus insulin.
Infusion Set: The disposable component of an insulin pump system that includes tubing and a cannula or needle for subcutaneous insulin delivery. Infusion sets are typically changed every 2-3 days.
Insulin: A hormone produced by the pancreas that allows cells to absorb glucose from the blood. People with diabetes may need injectable or inhaled insulin to manage blood glucose levels.
Intermediate-Acting Insulin: Insulin that starts working in 2-4 hours, peaks in 4-12 hours, and lasts 12-18 hours. NPH (Neutral Protamine Hagedorn) is the most common example.
Incretin: Hormones released by the gut after eating that stimulate insulin secretion and suppress glucagon. GLP-1 and GIP are the main incretins. Incretin-based therapies mimic or enhance their effects.
Insulin Resistance: A condition where cells in the body don't respond effectively to insulin, requiring the pancreas to produce more insulin. A hallmark of Type 2 diabetes and prediabetes.
Insulin Sensitivity Factor: Also called correction factor, this indicates how much one unit of rapid-acting insulin will lower blood glucose. Used to calculate correction boluses for high blood sugar.
Insulin-to-Carb Ratio (ICR): The number of grams of carbohydrate covered by one unit of rapid-acting insulin. For example, a 1:10 ratio means 1 unit of insulin covers 10 grams of carbs.
Injection Site Rotation: The practice of changing insulin injection locations to prevent lipohypertrophy and ensure consistent absorption. Recommended sites include abdomen, thighs, buttocks, and upper arms.

Ketones: Chemicals produced when the body burns fat for energy instead of glucose. High ketone levels can indicate diabetic ketoacidosis (DKA), a dangerous condition requiring immediate treatment.

Lancet: A small, sharp needle used to puncture the skin to obtain a blood sample for glucose testing. Lancets come in various gauges (sizes) and should be used only once.
Lancing Device: A spring-loaded device that holds a lancet and controls the depth of skin puncture. Adjustable depth settings accommodate different skin types.
Long-Acting Insulin: Insulin that provides steady, background coverage for 20-24+ hours with minimal peak. Examples include Lantus (glargine), Levemir (detemir), and Tresiba (degludec).
Lipohypertrophy: Lumpy or thickened areas under the skin caused by repeated insulin injections in the same location. Can affect insulin absorption and should be avoided by rotating injection sites.

Mediator: A chemical compound in electrochemical test strips that transfers electrons from the enzyme reaction to the electrode. Common mediators include ferricyanide and osmium complexes.
mg/dL: Milligrams per deciliter - the unit of measurement for blood glucose used in the United States. To convert to mmol/L, divide by 18.
mmol/L: Millimoles per liter - the unit of measurement for blood glucose used in most countries outside the US. To convert to mg/dL, multiply by 18.
Metformin: The most commonly prescribed oral medication for Type 2 diabetes. It works by reducing liver glucose production and improving insulin sensitivity. Usually the first-line treatment.
Medical Nutrition Therapy (MNT): Evidence-based nutrition counseling provided by a registered dietitian to help manage diabetes. Covers meal planning, carb counting, and lifestyle modifications.

Net Carbs: Total carbohydrates minus fiber and sugar alcohols. Some people with diabetes count net carbs instead of total carbs, though this approach is debated.

Occlusion: A blockage in the insulin pump tubing or cannula that prevents insulin delivery. Pumps have alarms to detect occlusions, which require immediate attention to prevent hyperglycemia.

Photometry: An older technology for measuring glucose that uses color change reactions. The intensity of color produced is proportional to the glucose concentration.
Postprandial Glucose: Blood glucose level measured after eating, typically 1-2 hours after the start of a meal. Target is usually below 180 mg/dL for most people with diabetes.
Precision: The consistency of glucose readings when the same sample is tested multiple times. High precision means readings are reproducible, though not necessarily accurate.
Premixed Insulin: A combination of rapid or short-acting insulin with intermediate-acting insulin in a single injection. Common ratios include 70/30 and 75/25.
Plate Method: A simple meal planning approach where half the plate is non-starchy vegetables, a quarter is protein, and a quarter is carbohydrates. Helps control portions without counting.
Prediabetes: A condition where blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. A1C between 5.7-6.4% or fasting glucose of 100-125 mg/dL.

Quality Control: Procedures to ensure glucose meters and test strips are functioning correctly, including control solution testing and proper storage of supplies.

Reagent: Chemical substances on a test strip that react with glucose in the blood sample. Reagents must be protected from moisture, heat, and light to maintain accuracy.
Reservoir: The cartridge or container within an insulin pump that holds the insulin supply. Reservoirs typically hold 180-300 units of insulin and are refilled every 2-3 days.
Rapid-Acting Insulin: Insulin that begins working within 15 minutes, peaks in 1-2 hours, and lasts 2-4 hours. Examples include Humalog (lispro), NovoLog (aspart), and Apidra (glulisine).

Sample Size: The volume of blood required for a glucose test, measured in microliters (µL). Modern test strips typically require 0.3-1.0 µL of blood.
SMBG (Self-Monitoring of Blood Glucose): The practice of regularly testing blood glucose levels at home using a glucose meter and test strips. SMBG is essential for diabetes management.
Suspend Before Low: A pump feature that automatically stops insulin delivery when the CGM predicts glucose will drop below a set threshold, helping to prevent hypoglycemia.
Sulfonylureas: A class of oral diabetes medications that stimulate the pancreas to release more insulin. Examples include glipizide, glyburide, and glimepiride. Risk of hypoglycemia is a side effect.
SGLT2 Inhibitors: Oral medications that work by blocking glucose reabsorption in the kidneys, causing excess glucose to be excreted in urine. Examples include Jardiance, Farxiga, and Invokana.
Sugar Alcohols: Reduced-calorie sweeteners found in sugar-free products (sorbitol, xylitol, erythritol). They have less impact on blood glucose than regular sugar but may cause digestive issues.
Somogyi Effect: Rebound high blood glucose in the morning caused by the body's response to overnight hypoglycemia. Distinguished from dawn phenomenon by checking blood glucose around 3 AM.
Subcutaneous: The layer of tissue just below the skin where insulin injections and pump cannulas are placed. Insulin absorbs from this tissue into the bloodstream.

Test Strip: A disposable strip containing chemicals that react with glucose in a blood sample. The strip is inserted into a glucose meter which displays the glucose reading.
Time in Range (TIR): The percentage of time glucose levels stay within a target range, typically 70-180 mg/dL. A TIR of 70% or higher is a common goal for diabetes management.
Type 1 Diabetes: An autoimmune condition where the pancreas produces little or no insulin. People with Type 1 diabetes require insulin therapy and frequent glucose monitoring.
Type 2 Diabetes: A metabolic condition characterized by insulin resistance and relative insulin deficiency. It is the most common form of diabetes, often managed with lifestyle changes and medications.
Tubeless Pump: An insulin pump design where the pump and reservoir are integrated into a small pod worn directly on the body, eliminating the need for tubing. The Omnipod is a popular example.
Thiazolidinediones (TZDs): Oral medications that improve insulin sensitivity in muscle and fat tissue. Examples include pioglitazone (Actos) and rosiglitazone (Avandia). May cause fluid retention.

Ultra-Rapid Insulin: The fastest-acting insulin formulations that begin working in as little as 2-5 minutes. Examples include Fiasp and Lyumjev, designed to better match mealtime glucose spikes.

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