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IDDM (Insulin-dependent diabetes mellitus)
See: Type 1 Diabetes Mellitus.

Of unknown origin.

See: Impaired glucose tolerance.

Immunosuppressive Drugs
Drugs that block the body's ability to fight infection or foreign substances that enter the body. A person receiving a kidney or pancreas transplant is given these drugs to stop the body from rejecting the new organ or tissue. Cyclosporin is a commonly used immunosuppressive drug.

Impaired Glucose Tolerance (IGT)
Blood glucose (sugar) levels higher than normal but not high enough to be called diabetes. People with IGT may or may not develop diabetes. Other names (no longer used) for IGT are "borderline," "subclinical," "chemical," or "latent" diabetes.
See Prediabetes

Implantable Insulin Pump
A small pump placed inside of the body that delivers insulin in response to commands from a hand-held device called a programmer.

The loss of a man's ability to have an erect penis and to emit semen. Some men may become impotent after having diabetes for a long time because the nerves or blood vessels have become damaged. Sometimes the problem has nothing to do with diabetes and may be treated with counseling.

How often a disease occurs; the number of new cases of a disease among a certain group of people for a certain period of time.

Taking food, water, or medicine into the body by mouth.

Putting liquid into the body with a needle and syringe. A person with diabetes injects insulin by putting the needle into the tissue under the skin (called subcutaneous). Other ways of giving medicine or nourishment by injection are to put the needle into a vein (intravenous) or into a muscle (intramuscular).

Injection Sites
Places on the body where people can inject insulin most easily. These are:

  • The outer area of the upper arm.
  • Just above and below the waist, except the area right around the navel (a 2-inch circle).
  • The upper area of the buttock, just behind the hip bone.
  • The front of the thigh, midway to the outer side, 4 inches below the top of the thigh to 4 inches above the knee.

These areas can vary with the size of the person.

Injection Site Rotation
Changing the places on the body where a person injects insulin. Changing the injection site keeps lumps or small dents from forming in the skin. These lumps or dents are called lipodystrophies. However, people should try to use the same body area for injections that are given at the same time each day-for example, always using the stomach for the morning injection or an arm for the evening injection. Using the same body area for these routine injections lessens the possibility of changes in the timing and action of insulin.

A hormone that helps the body use glucose (sugar) for energy. The beta cells of the pancreas (in areas called the islets of Langerhans) make the insulin. When the body cannot make enough insulin on its own, a person with diabetes must inject insulin made from other sources, i.e., beef, pork, human insulin (recombinant DNA origin), or human insulin (pork-derived, semisynthetic).

See also: What is Insulin? and Diabetes Team Questions about Insulin

Insulin Allergy
When a person's body has an allergic or bad reaction to taking insulin made from pork or beef or from bacteria, or because the insulin is not exactly the same as human insulin or because it has impurities.

The allergy can be of two forms. Sometimes an area of skin becomes red and itchy around the place where the insulin is injected. This is called a local allergy.

In another form, a person's whole body can have a bad reaction This is called a systemic allergy. The person can have hives or red patches all over the body or may feel changes in the heart rate and in the rate of breathing. A doctor may treat this allergy by prescribing purified insulins or by desensitization. See also: Desensitization.

Insulin Analog
A synthetic modification of insulin where specific amino acids have been substituted for the natural ones at one or more places on the insulin molecule.

Insulin Antagonist
Something that opposes or fights the action of insulin. Insulin lowers the level of glucose (sugar) in the blood, whereas glucagon raises it; therefore, glucagon is an antagonist of insulin.

Insulin Binding
When insulin attaches itself to something else. This can occur in two ways. First, when a cell needs energy, insulin can bind with the outer part of the cell. The cell then can bring glucose (sugar) inside and use it for energy. With the help of insulin, the cell can do its work very well and very quickly. But sometimes the body acts against itself. In this second case, the insulin binds with the proteins that are supposed to protect the body from outside substances (antibodies). If the insulin is an injected form of insulin and not made by the body, the body sees the insulin as an outside or "foreign" substance. When the injected insulin binds with the antibodies, it does not work as well as when it binds directly to the cell.

Insulin-Dependent Diabetes Mellitus (IDDM)
See: Type 1 Diabetes Mellitus.

Insulin-Induced Atrophy
Small dents that form on the skin when a person keeps injecting a needle in the same spot. They are harmless.

See also: Lipoatrophy; injection site rotation.

Insulin-Induced Hypertrophy
Small lumps that form under the skin when a person keeps injecting a needle in the same spot.

See also: Lipodystrophy; injection site rotation.

Insulin Lispro
See Lispro Insulin

Insulin Pen
An insulin injection device the size of a pen that includes a needle and holds a vial of insulin. It can be used instead of syringes for giving insulin injections.

Insulin Pump
A device that delivers a continuous supply of short-acting insulin into the body. The insulin flows from the pump through a plastic tube (called a catheter) that is connected to a needle inserted into the skin and taped in place.

Insulin is delivered at different rates, which can be either manually set or preprogrammed: a low, steady rate (called the basal rate) for continuous day-long coverage, and extra boosts of insulin (called bolus doses) to cover meals or when extra insulin is needed. Both the basal and bolus rates are adjustable by the user, in response to blood sugar tests done with standard methods; no available pump can measure the sugar level and calculate what changes to make in the insulin doses.

The pump runs on batteries and can be worn clipped to a belt or carried in a pocket. It is usually used by people with insulin-dependent diabetes, although it is occasionally recommended for people with other forms of diabetes.

See also: Insulin Pumps, Diabetes Team Questions about Insulin Pumps

Insulin Reaction
Too low a level of glucose (sugar) in the blood; also called hypoglycemia. This occurs when a person with diabetes has injected too much insulin, eaten too little food, or exercised without extra food. The person may feel hungry, nauseated, weak, nervous, shaky, confused, and sweaty. Taking small amounts of sugar, sweet juice, or food with sugar will usually help the person feel better within 10-15 minutes.

See also: Hypoglycemia; insulin shock.

Insulin Receptors
Areas on the outer part of a cell that allow the cell to join or bind with insulin that is in the blood. When the cell and insulin bind together, the cell can take glucose (sugar) from the blood and use it for energy.

Insulin Resistance
A state in which a given level of serum insulin produces a less than expected biological effect. Patients may vary from normoglycemic to severely diabetic despite large doses of insulin. 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 does not respond well to insulin. Also, as people age, their body cells lose some of the ability to respond to insulin. Insulin resistance is also linked to high blood pressure and high levels of fat in the blood (see Syndrome X).

Another kind of insulin resistance may rarely happen in people who take insulin injections. They may have to take very high doses of insulin every day (e.g., 200 units or more (in adults)) to bring their blood glucose down to the normal range. This has also been called "insulin insensitivity."

Insulin Sensitizer
Any of several diabetes medications that reduce insulin resistance. Examples include metformin (Glucophage) and the thiazolidinediones (or "glitazones") rosiglitazone (Avandia) and pioglitazone (Actos).

Insulin Shock
A term no longer used. See Hypoglycemia; insulin reaction.

A tumor of the beta cells in areas of the pancreas called the islets of Langerhans. Although not usually cancerous, such tumors may cause the body to make extra insulin and may lead to a blood glucose (sugar) level that is too low.

Intermittent Claudication
Pain in the muscles of the leg that occurs off and on, usually while walking or exercising, and results in lameness (claudication). The pain results from a narrowing of the blood vessels feeding the muscle. Drugs are available to treat this condition.

Intensive Management
A form of treatment for insulin-dependent 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; adjustment of insulin, food intake, and activity levels based on blood glucose test results; dietary counseling; and management by a diabetes team.

See also: Diabetes Control and Complications Trial; team management.

Intramuscular Injection
Putting a fluid into a muscle with a needle and syringe.

Intravenous Injection
Putting a fluid into a vein with a needle and syringe.

Islet Cell Antibodies (ICA's)
Specialized proteins, called antibodies, that are found in the blood of many people with Type 1 diabetes at the time of diagnosis. Most people with Type 1 diabetes have antibodies to a variety of islet cell proteins that are apparently released as a consequence of damage to the beta cells of the pancreas. The presence of these antibodies therefore is a useful indicator that the autoimmune process has begun.

The antibodies that are presently routinely assayed include:

  • IAA antiinsulin
  • GAD65 anti glutamic acid decarboxylase
  • ICA512 a specific islet cell antibody
  • EMA antiendomyseal antibodies (a test for celiac synmdrome, another autoimmune disorder occurring in 5% of new-onset Type 1 diabetes)
  • Anti 21-hydroxylase (a test for Addison's disease, also an autoimmune condition found in 2% of new onset Type 1 diabetes)

Islet Cell Transplantation
Moving the beta (islet) cells from a donor pancreas and putting them into a person whose pancreas has stopped producing insulin. The beta cells make the insulin that the body needs to use glucose (sugar) for energy. Although transplanting islet cells may one day help people with diabetes, the procedure is still in the research stage. Transplantation of the pancreas itself is surgically feasible, and is sometimes advised for some patients.

See also: Pancreas Transplant.

Islet Cells (Islets/Islands of Langerhans)
(Pronouciation: EYE-let cells). The clumps of cells within the pancreas that include those cells that make insulin and other hormones. The cells include several subvarieties, including:

and PP cells and D1 cells, about which little is known.

The islet cells appear under low-power magnification to be islands (islets) within the pancreas. First described by Dr. Paul Langerhans in 1869, whose name is now associated with these islands.


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