Trending Diabetes Terminology
Have you noticed lately that some of the good old fashioned terminology used to describe diabetes results or situations has been changing? The good thing is that many of these new terms have the same meaning. It stands to reason with the introduction of many new diabetes tools over the past few years, that new terminology would surface at some point. An non-diabetes example of this would be the the word "cloud". Before the internet we thought of the word "cloud" as being something white in the sky, beautiful to look at, but often associated with rain. Now we use the term "cloud" as any of the several parts of the Internet that allows us to process and store documents and data . This "cloud" can also help us to have electronic access to software and other resources. In fact, the pop-up screen on my computer has told me that I need to make space in my "cloud" if I want to continue to save and store information.
Today I want to review some of this new terminology with the same meaning as well as review some of the new terminology being used in monitoring our diabetes control. (Table 1&11)
As for the phones, iPhone versus telephone, yet both will convey the message we are trying to communicate.
You may ask why Diabetes Canada has adopted this new terminology. In 2020, Diabetes Canada circulated a consensus statement titled 'Language Matters". The background to the development of this statement was basically the fact that words and the language used in talking to patients can have a significant impact. Inappropriate language could contribute to stigma for people living with diabetes. The goal is to use language that instills confidence and promotes positive motivation for the patient living with diabetes. It is important that all providers of diabetes management do not communicate a hurtful or shaming message which could lead to worse outcomes for the patient. The full document can be found at this website if you desire more information. I really like some of the suggestions they have included in the document. One example is to avoid saying: poorly controlled, poor control, good control, well controlled . Rather use blood sugar levels that are : stable, within the target range. More examples are provided and I know I have heard many of them used inappropriately and their use has conveyed a negative impact along with anxiety and frustration.
Table 1 (1) Comparison of Old and New Terms with the same meaning
New term | Old term | Definition |
Capillary blood glucose (CBG) | Self-monitored blood glucose (SMBG) | Using finger pricks, it tells us what the glucose level is in our capillary blood |
Intermittently scanned continuous glucose monitoring (isCGM) | Flash glucose monitoring (FGM) | Interstitial fluid glucose is measured using a sensing device with intermittent scanning |
Real-time continuous glucose monitoring (rtCGM) | Continuous glucose monitoring | Interstitial fluid glucose is being continuously monitored by means of a sensing device that can be accessed anytime to see a real-time display of blood glucose level |
A1C | hemoglobin A1C or glycosylated hemoglobin | Measure a person's average blood glucose level over the past 2-3 months. While it is very useful, it does not tell you or your health provider the real-time variability of day to day fluctuations in blood glucose. |
Now that the use of real-time continuous glucose monitoring (rtCGM) is so frequent, new glucose metrics have resulted such as those found in Table 11 (1).
However before I move on to Table 11, let's take a look at some definitions of certain terms you may have heard when talking to your health-care provider(s).
Body mass index (BMI)- is a measure to evaluate body weight relative to a person's height. This measurement is often used to describe if a person is underweight, normal weight, overweight, or obese. Calculate your BMI by using this reference .
Capillary- the smallest of the body's blood vessels. Glucose and oxygen travel trough these capillary walls and enter the cells. When you do a finger puncture, it is the capillary blood you are testing.
C-Peptide level- is based on blood sugar level. C-Peptide is a sign that your body is producing insulin. A low or no C-Peptide level indicates that your pancreas is producing little or no insulin. Sometimes this test may be performed a couple of times since the result may vary depending on when you last ate.
Autoimmune disease- the body's own immune system mistakenly attacks and destroys body tissue that it believes to be unfamiliar (strange). Other autoimmune related diseases include:rheumatoid arthritis and celiac disease.
Neuropathy- refers to damage or impairment of one or more nerves that may result in numbness,, tingling, muscle weakness and pain in the affected area. As we know, diabetic induced neuropathy can result and often does when nerves become damaged from continuous high glucose levels.
Other commonly used terms and definitions can be found at this site. (2)
Table 11 Glucose metrics associated with continuous glucose monitoring (1,2)
Glucose metric | Definition |
Glucose Management Indicator (GMI) | This is an approximate A1C level that is based on the average glucose levels from rtCGM readings for the past 14 or more days. |
Glycemic Variability | Refers to the measurement of fluctuations in blood glucose levels or other parameters involved in maintaining glucose within its normal range over a given period of time. |
Time in Range (TIR) | Refers to the time you spend in the target glucose range. Percentage of values between 3.9-10.0 mol/L (70-180 mg/dL). |
Time below Range (TBR) | Refers to the total percentage of values less than 3.9 mol/L (70 mg/dL) and should be less than 4% for most individuals |
Time above range (TAR) | Refers to the total percentage of values greater than 10.1 mol/L (180mg/dL) and should be less than 25% for most individuals |
Diabetes changes are happening fast. There seems to be continuous news on new measuring tools, new medicines that control both the diabetes and heart issues, new insulin delivery systems and new and updated guidelines for patients and health-care practitioners. All of this is good however it is hard to stay abreast of everything. It is for this reason I write this blog and I hope you do find it useful. I am continuously reading and looking for new information to provide to my audience. There has been alot of information on "sleep"" lately so I may branch into that area in the near future. If there is a topic of interest for you, please don't hesitate to make a comment at the end of any of my blogs.
Once again, thank you for your time and support.
This blog is not intended to give medical advice, but for information purposes only. Always consult with your health-care provider for individualized care. References:
1)Diabetes Canada website-https://www.diabetes.ca/ accessed at various times in the month of September,2022. (please note that Table 1 & 11 have been adapted/modified for the purposes of this blog. More extensive coverage is found on the original sites)
2)American Diabetes Association- Common terms -https://diabetes.org/resources/students/common-terms -accessed the month of September at various dates and times
#old&newterminology. ##newdiabeteswords . .
###gonearethedays ####A1C
To all those affected by the recent storms, I am sorry for your loss and wish you all good things in the days ahead.
A final comment: This is my first attempt at making tables in this blog, so bear with me as I hope to perfect them eventually. Thanks for your patience.
MESSAGE ALERT: Don't forget to register for the Virtual Diabetes Type 1 Conference being held October 15th, 2022 . Registration is at this website. Registration is complimentary.
MESSAGE ALERT: Don't forget to register for the Virtual Diabetes Conference for Type 2 diabetes on October 22nd, 2022 by going to this website. Registration is complimentary.
The picture of the old rotary dial phone is from my friend's cottage in Caissie Cape, NB.
Fun photo, Karen! Terminology can be so important in influencing how people feel -- I remember when they used to talk about "diabetics" rather than "people living with diabetes"... putting so much more emphasis on the disease instead of the person who was dealing with it! Good that we keep trying to improve, even though change can be hard, or at least inconvenient.
great information....always have to keep up on new sayings and technical terms.
Thanks for this blog! With the new terminologies, I am finding it takes time to adjust. I still catch myself saying flash glucose monitoring because I feel this is still more understood by patients and some clinicians. That’s not to say I won’t adapt but it will have to take time. Love the old phone and new smart phone analogy. Thank you for sharing your wisdom.