Diabetes Pharmacology Ontology
type: Ontology
creator: Sabbir M. Rashid
contributor: Deborah L. McGuinness
contributor: Jamie McCusker
contributor: Oshani Seneviratne
contributor: Daniel Gruen
created: 2022-06-08T18:00:00
modified: 2022-12-18T18:00:00
description: The Diabetes Pharmacology Ontology contains the classes needed to describe antihyperglycemic therapies.
license: LICENSE-2.0
version IRI: http://purl.org/twc/dpo/ont/1.0

Therapy Planning Component
type: Class

Pharmacotherapy Factor
type: Class
subclass of: Therapy Planning Component
equivalent class: Treatment Factor
comment: A circumstance influencing the treatment of a disease through the use or recommendation of one or more drugs.
definition: Therapy-related factors identified include: route of administration, treatment complexity, duration of treatment period, medication side effects, degree of behavioral change required, taste of medication and requirement for drug storage. [Definition Source: url:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503662/ ]

Diagnostic Factor
type: Class
subclass of: Therapy Planning Component
equivalent class: Diagnostic Factor
comment: A circumstance influencing the dianosis of a disease.
definition: A biological, physiological, behavioral, or molecular indicator of the presence or predisposition towards development of a specific disease. [Definition Source: NCI]

Patient Characteristic
type: Class
subclass of: Diagnostic Factor
equivalent class: Characteristic
definition: The distinguishing qualities or prominent aspect of a person. [Definition Source: NCI]

Therapy
type: Class
subclass of: Therapy Planning Component
equivalent class: Therapeutic Procedure
definition: An action or administration of therapeutic agents to produce an effect that is intended to alter or stop a pathologic process. [Definition Source: NCI]

Test Finding
type: Class
subclass of: Diagnostic Factor
equivalent class: Measurement
comment: A finding or categorization surmised from recorded measurements.
definition: Annotation used to indicate the size or magnitude of something that was determined by comparison to a standard. [Definition Source: NCI]

Symptom
type: Class
subclass of: Patient Characteristic
equivalent class: symptom
definition: A symptom is a perceived change in function, sensation, loss, disturbance or appearance reported by a patient indicative of a disease. [ url:https://link.springer.com/chapter/10.1007/978-1-4615-4789-1_5 url:https://www.nature.com/subjects/signs-and-symptoms url:https://www.merriam-webster.com/dictionary/symptom ][Definition Source: SYMP:0000462]

has therapy preference
type: ObjectProperty
range: Therapy

has therapy aversion
type: ObjectProperty
range: Therapy

has diagnosis
type: ObjectProperty
sub property of: has attribute
range: Disease

has therapy
type: ObjectProperty
sub property of: has attribute
range: Therapy

Nutrition Metabolism and Development Symptom
type: Class
subclass of: Symptom
equivalent class: nutrition, metabolism, and development symptom
comment: A symptom involving the nutrition, metabolism, and/or development system.
definition: Symptoms concerning nutrition metabolism and development [include:] A disorder characterized by a loss of appetite; An abnormal loss of the appetite for food. Anorexia can be caused by cancer, aids, a mental disorder (i.e., anorexia nervosa), or other diseases; Clinical manifestation consisting of a physiopathological lack or loss of appetite accompanied by an aversion to food and the inability to eat; Loss of appetite; The lack or loss of appetite accompanied by an aversion to food and the inability to eat. It is the defining characteristic of the disorder anorexia nervosa. [Definition Source: url:http://www.icd9data.com/2013/Volume1/780-799/780-789/783/default.htm ]

Polydipsia
type: Class
subclass of: Nutrition Metabolism and Development Symptom
equivalent class: polydipsia
definition: Polydipsia is a nutrition, metabolism, and development symptom characterized by an excessive or abnormal thirst. [ url:http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=polydipsia ][Definition Source: SYMP:0000560]

Polyphagia
type: Class
subclass of: Nutrition Metabolism and Development Symptom
equivalent class: polyphagia
definition: Polyphagia is a nutrition, metabolism, and development symptom characterized by an excessive appetite or eating. [ url:http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=polyphagia ][Definition Source: SYMP:0000524]

Body Mass Index Finding
type: Class
subclass of: Test Finding
equivalent class: Body Mass Index Finding
definition: The result of a body mass index measurement. [Definition Source: NCI]

Blood Glucose Measurement
type: Class
subclass of: Test Finding
equivalent class: Blood Glucose Measurement
definition: A quantitative measurement for assessing the amount of glucose present in a blood sample. [Definition Source: NCI]

Cholesterol Measurement
type: Class
subclass of: Test Finding
equivalent class: Cholesterol Measurement
definition: The determination of the amount of total cholesterol present in a sample. [Definition Source: NCI]

Triglyceride Measurement
type: Class
subclass of: Test Finding
equivalent class: Triglyceride Measurement
definition: A quantitative measurement of the amount of triglyceride present in a sample. [Definition Source: NCI]

Underweight
type: Class
subclass of: Body Mass Index Finding
equivalent class: underweight body mass index status
intersection of: Body Mass Index Finding
intersection of: Restriction
  on property: hasValue
  all values from: Underweight BMI Range
comment: BMI<18.5
definition: The quantification of weight/height relationships below a certain threshold that classes an individual as underweight. This threshold may vary based on an individual's ethnicity but is commonly considered in European populations to correspond to a BMI < 18. [Definition Source: EFO:0005936]

Underweight BMI Range
type: DataRange
on data range: decimal
max inclusive: 18.5

Normal Weight
type: Class
subclass of: Body Mass Index Finding
intersection of: Body Mass Index Finding
intersection of: Restriction
  on property: hasValue
  all values from: Normal Weight BMI Range
comment: 18.5<BMI<24.9
definition: BMI greater than or equal to 18.5 to 24.9 kg/m^2 [Definition Source: url:https://www.ncbi.nlm.nih.gov/books/NBK541070/ ]

Normal Weight BMI Range
type: DataRange
on data range: decimal
min inclusive: 18.5
max inclusive: 24.9

Overweight
type: Class
subclass of: Body Mass Index Finding
equivalent class: overweight body mass index status
intersection of: Body Mass Index Finding
intersection of: Restriction
  on property: hasValue
  all values from: Overweight BMI Range
comment: 25<BMI<30
definition: The quantification of weight/height relationships above a certain threshold that classes an individual as overweight. This threshold may vary based on an individual's ethnicity but is commonly considered to correspond in European populations to a 25<BMI<30. [Definition Source: EFO:0005935]

Overweight BMI Range
type: DataRange
on data range: decimal
min inclusive: 25
max inclusive: 30

Obese
type: Class
subclass of: Body Mass Index Finding
intersection of: Body Mass Index Finding
intersection of: Restriction
  on property: hasValue
  all values from: Obese BMI Range
equivalent class: Obesity
equivalent class: obese body mass index status
comment: 30<BMI
definition: Having a high amount of body fat (body mass index [BMI] of 30 or more). [Definition Source: NCI]
definition: The quantification of weight/height relationships above a certain threshold that classes an individual as overweight. This threshold may vary based on an individual's ethnicity but is commonly considered to correspond in European populations to a BMI > 30. [Definition Source: EFO:0007041]

Obese BMI Range
type: DataRange
on data range: decimal
min inclusive: 30

Prediabetes Fasting Blood Glucose Level
type: Class
subclass of: Blood Glucose Measurement
intersection of: Fasting glucose [Mass/volume] in Serum or Plasma
intersection of: Restriction
  on property: hasValue
  all values from: Prediabetes Fasting Blood Glucose Range
comment: impaired fasting glucose
definition: FPG 100 mg/dL (5.6 mmol/L) to 125 mg/dL (6.9 mmol/L). [Definition Source: url:https://doi.org/10.2337/dc22-S002 ]

Prediabetes Fasting Blood Glucose Range
type: DataRange
on data range: decimal
min inclusive: 100
max inclusive: 125

Diabetes Fasting Blood Glucose Level
type: Class
subclass of: Blood Glucose Measurement
intersection of: Fasting glucose [Mass/volume] in Serum or Plasma
intersection of: Restriction
  on property: hasValue
  all values from: Diabetes Fasting Blood Glucose Range
definition: FPG ≥126 mg/dL (7.0 mmol/L). [Definition Source: url:https://doi.org/10.2337/dc22-S002 ]

Diabetes Fasting Blood Glucose Range
type: DataRange
on data range: decimal
min inclusive: 126

Prediabetes Two Hour Blood Glucose Level
type: Class
subclass of: Blood Glucose Measurement
intersection of: Glucose [Mass/volume] in Serum or Plasma --2 hours post 75 g glucose PO
intersection of: Restriction
  on property: hasValue
  all values from: Prediabetes Two Hour Blood Glucose Range
comment: impaired glucose tolerance
definition: 2-h PG during 75-g OGTT 140 mg/dL (7.8 mmol/L) to 199 mg/dL (11.0 mmol/L). [Definition Source: url:https://doi.org/10.2337/dc22-S002 ]

Prediabetes Two Hour Blood Glucose Range
type: DataRange
on data range: decimal
min inclusive: 140
max inclusive: 199

Diabetes Two Hour Blood Glucose Level
type: Class
subclass of: Blood Glucose Measurement
intersection of: Glucose [Mass/volume] in Serum or Plasma --2 hours post 75 g glucose PO
intersection of: Restriction
  on property: hasValue
  all values from: Diabetes Two Hour Blood Glucose Range
definition: 2-h PG ≥200 mg/dL (11.1 mmol/L) during OGTT. [Definition Source: url:https://doi.org/10.2337/dc22-S002 ]

Diabetes Two Hour Blood Glucose Range
type: DataRange
on data range: decimal
min inclusive: 200

Prediabetes HbA1C Level
type: Class
subclass of: Blood Glucose Measurement
intersection of: Hemoglobin A1c/Hemoglobin.total in Blood by IFCC protocol
intersection of: Restriction
  on property: hasValue
  all values from: Prediabetes HbA1C Range
definition: A1C 5.7–6.4% (39–47 mmol/mol). [Definition Source: url:https://doi.org/10.2337/dc22-S002 ]

Prediabetes HbA1C Range
type: DataRange
on data range: decimal
min inclusive: 117.58
max inclusive: 138.62

Diabetes HbA1C Level
type: Class
subclass of: Blood Glucose Measurement
intersection of: Hemoglobin A1c/Hemoglobin.total in Blood by IFCC protocol
intersection of: Restriction
  on property: hasValue
  all values from: Diabetes HbA1C Range
definition: A1C ≥6.5% (48 mmol/mol). [Definition Source: url:https://doi.org/10.2337/dc22-S002 ]

Diabetes HbA1C Range
type: DataRange
on data range: decimal
min inclusive: 141.25

Very High HbA1C Level
type: Class
subclass of: Blood Glucose Measurement
intersection of: Hemoglobin A1c/Hemoglobin.total in Blood by IFCC protocol
intersection of: Restriction
  on property: hasValue
  all values from: Very High HbA1C Range
definition: A1C ≥ 9%

Very High HbA1C Range
type: DataRange
on data range: decimal
min inclusive: 215

Optimal LDL Level
type: Class
subclass of: Cholesterol Measurement
intersection of: Cholesterol in LDL [Mass/volume] in Serum or Plasma
intersection of: Restriction
  on property: hasValue
  all values from: Optimal LDL Range

Optimal LDL Range
type: DataRange
on data range: decimal
max inclusive: 100

Near Optimal LDL Level
type: Class
subclass of: Cholesterol Measurement
intersection of: Cholesterol in LDL [Mass/volume] in Serum or Plasma
intersection of: Restriction
  on property: hasValue
  all values from: Near Optimal LDL Range

Near Optimal LDL Range
type: DataRange
on data range: decimal
min inclusive: 100
max inclusive: 129

Borderline High LDL Level
type: Class
subclass of: Cholesterol Measurement
intersection of: Cholesterol in LDL [Mass/volume] in Serum or Plasma
intersection of: Restriction
  on property: hasValue
  all values from: Borderline High LDL Range

Borderline High LDL Range
type: DataRange
on data range: decimal
min inclusive: 130
max inclusive: 159

High LDL Level
type: Class
subclass of: Cholesterol Measurement
intersection of: Cholesterol in LDL [Mass/volume] in Serum or Plasma
intersection of: Restriction
  on property: hasValue
  all values from: High LDL Range

High LDL Range
type: DataRange
on data range: decimal
min inclusive: 160
max inclusive: 189

Very High LDL Level
type: Class
subclass of: Cholesterol Measurement
intersection of: Cholesterol in LDL [Mass/volume] in Serum or Plasma
intersection of: Restriction
  on property: hasValue
  all values from: Very High LDL Range

Very High LDL Range
type: DataRange
on data range: decimal
min inclusive: 190

Normal Triglyceride Level
type: Class
subclass of: Triglyceride Measurement
intersection of: Triglyceride [Mass/volume] in Body fluid
intersection of: Restriction
  on property: hasValue
  all values from: Normal Triglyceride Range

Normal Triglyceride Range
type: DataRange
on data range: decimal
max inclusive: 149

Borderline High Triglyceride Level
type: Class
subclass of: Triglyceride Measurement
intersection of: Triglyceride [Mass/volume] in Body fluid
intersection of: Restriction
  on property: hasValue
  all values from: Borderline High Triglyceride Range

Borderline High Triglyceride Range
type: DataRange
on data range: decimal
min inclusive: 150
max inclusive: 199

High Triglyceride Level
type: Class
subclass of: Triglyceride Measurement
intersection of: Triglyceride [Mass/volume] in Body fluid
intersection of: Restriction
  on property: hasValue
  all values from: High Triglyceride Range

High Triglyceride Range
type: DataRange
on data range: decimal
min inclusive: 200
max inclusive: 499

Very High Triglyceride Level
type: Class
subclass of: Triglyceride Measurement
intersection of: Triglyceride [Mass/volume] in Body fluid
intersection of: Restriction
  on property: hasValue
  all values from: Very High Triglyceride Range

Very High Triglyceride Range
type: DataRange
on data range: decimal
min inclusive: 500

Urinary System Symptom
type: Class
subclass of: Symptom
equivalent class: urinary system symptom
comment: A symptom involving the urinary system.
definition: Symptoms of urinary disorders vary from person to person and based on the cause of the disorders. Common urinary symptoms include: Abdominal cramping; Abdominal, pelvic or back pain that can be severe; Bloody or pink-colored urine (hematuria); Cloudy urine; Fever and chills; Foul-smelling urine; Frequent urination; General ill feeling; Leaking of urine; Pain during sexual intercourse; Pain or burning with urination (dysuria); Unexplained weight loss; Urgent need to urinate. [Definition Source: url:https://www.healthgrades.com/right-care/kidneys-and-the-urinary-system/urinary-disorders ]

Polyuria
type: Class
subclass of: Urinary System Symptom
equivalent class: polyuria
definition: A urinary system symptom that is characterized by the excessive secretion of urine. [ url:http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=polyuria ][Definition Source: SYMP:0000565]

Dysuria
type: Class
subclass of: Urinary System Symptom
equivalent class: dysuria
definition: A urinary system symptom that is characterized by the difficult, or painful, discharge of urine. [ url:http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=dysuria ][Definition Source: SYMP:0000485]

Urinary Tract Infection (UTI)
type: Class
subclass of: Urinary System Symptom
equivalent class: Urinary Tract Infection
definition: A bacterial infectious process affecting any part of the urinary tract, most commonly the bladder and the urethra. Symptoms include urinary urgency and frequency, burning sensation during urination, lower abdominal discomfort, and cloudy urine. [Definition Source: NCI]

Frequent Urination
type: Class
subclass of: Urinary System Symptom
equivalent class: urinary frequency
equivalent class: Pollakisuria
definition: Increased frequency of urination. [Definition Source: HP:0100515]

Foul Urine
type: Class
subclass of: Urinary System Symptom
equivalent class: Abnormal urinary odor
definition: A deviation from the normal odor of the urine. [Definition Source: HP:0012088]

Vision Symptom
type: Class
subclass of: Symptom
equivalent class: vision symptom
comment: A symptom involving visual impairment.

Blurred Vision
type: Class
subclass of: Vision Symptom
equivalent class: blurred vision
definition: A vision symptom that is characterized by a decreased clarity or sharpness in vision, which can be caused by eye conditions myopia or hyperopia. [Definition Source: SYMP:0000012]

Neurological and Physiological Symptom
type: Class
subclass of: Symptom
equivalent class: neurological and physiological symptom

Fatigue
type: Class
subclass of: Neurological and Physiological Symptom
equivalent class: fatigue
definition: Fatigue is a neurological and physiological symptom characterized by a weariness or exhaustion from labor, exertion, or stress. [ url:http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=fatigue ][Definition Source: SYMP:0019177]

Musculoskeletal System Symptom
type: Class
subclass of: Symptom
equivalent class: musculoskeletal system symptom
comment: A symptom involving the musculoskeletal system.
definition: Musculoskeletal symptoms are defined as pain in the muscles, tendons, and nerves arising from repetitive, continuous, and unnatural movements. These symptoms can be expressed in various areas of the body and affect the quality of life by causing difficulties in performing occupational tasks and activities of daily living (ADL). [Definition Source: url:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3567324/ ]

Arthritis
type: Class
subclass of: Musculoskeletal System Symptom
equivalent class: arthritis
definition: Arthritis is a musculoskeletal system symptom characterized as an inflammation of joints due to infectious, metabolic, or constitutional causes. [ url:http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=arthritis ][Definition Source: SYMP:0019169]

Peripheral Neuropathy
type: Class
subclass of: Musculoskeletal System Symptom
equivalent class: peripheral muscle weakness
definition: Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, the vast communication network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body. [Definition Source: url:https://www.ninds.nih.gov/peripheral-neuropathy-fact-sheet ]

Condition
type: Class
subclass of: Patient Characteristic
equivalent class: Condition
definition: A state of being, such as a state of health. [Definition Source: NCI]

Hyperlipidemia
type: Class
subclass of: Condition
equivalent class: Abnormal Blood Chemistry and Hematology Test Result
definition: Elevated levels of lipids in the blood. [Definition Source: NCI]

Hypertension
type: Class
subclass of: Condition
equivalent class: Hypertension
definition: Blood pressure that is abnormally high. [Definition Source: NCI]

History
type: Class
subclass of: Patient Characteristic
equivalent class: History
definition: The aggregate of past events; the continuum of events occurring in succession leading from the past to the present; a record or narrative description of past events. [Definition Source: NCI]

Family History
type: Class
subclass of: History
equivalent class: Family Medical History
definition: A record of a patient's background regarding health and disease events of blood relatives. A patient's family medical history may be important in diagnosing existing conditions. [Definition Source: NCI]

Personal History
type: Class
subclass of: History
equivalent class: Personal Medical History
definition: A record of a patient's background regarding health and the occurrence of disease events of the individual. In addition, personal medical history may be a variable in epidemiologic studies. [Definition Source: NCI]

Family History of Coronary Artery Disease
type: Class
subclass of: Family History
equivalent class: Family History of Coronary Artery Disease
definition: History of a first-degree relative (less than 55 years for male relatives or less than 65 years for female relatives) having had any of the following: coronary artery disease, myocardial infarction, coronary artery bypass graft surgery, percutaneous coronary intervention, or sudden cardiac death without obvious cause. [Definition Source: NCI]

Family History of Diabetes
type: Class
subclass of: Family History
definition: Having at least one-first-degree relative with diabetes. [Definition Source: url:https://doi.org/10.1111/jdi.12033 ]

Personal History of Gestational Diabetes
type: Class
subclass of: Personal History
definition: Gestational diabetes mellitus (GDM), defined as glucose intolerance that is first recognized during pregnancy, is associated with maternal obesity and confers a 4‐ to 7‐fold greater risk of incident type 2 diabetes (DM), and increased risk of developing the metabolic syndrome (MetS) in midlife. In addition, a history of GDM among nondiabetic women is characterized by elevations in fasting glucose and insulin concentrations, as well as dyslipidemia and greater inflammation in the absence of the MetS. [Definition Source: url:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187501/ ]

Personal History of Febrile States
type: Class
subclass of: Personal History
definition: Febrile seizures are defined as events in infancy or childhood that usually occur between three months and five years of age and are associated with a fever, but without evidence of intracranial infection or a defined cause for the seizure. [Definition Source: url:https://www.aafp.org/pubs/afp/issues/2008/1115/p1199.html ]

Bilateral Lower Extremity Burning Sensation
type: Class
subclass of: Nervous System Symptom
comment: Occasional Burning Sensation in Bilateral Lower Extremities

Disease
type: Class
subclass of: Patient Characteristic
equivalent class: Disease or Disorder
definition: Any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. The term is often used broadly to include injuries, disabilities, syndromes, symptoms, deviant behaviors, and atypical variations of structure and function. [Definition Source: NCI]

Coronary Artery Disease
type: Class
subclass of: Disease
equivalent class: Coronary Artery Disease
definition: Narrowing of the coronary arteries due to fatty deposits inside the arterial walls. The diagnostic criteria may include documented history of any of the following: documented coronary artery stenosis greater than or equal to 50% (by cardiac catheterization or other modality of direct imaging of the coronary arteries); previous coronary artery bypass surgery (CABG); previous percutaneous coronary intervention (PCI); previous myocardial infarction. (ACC) [Definition Source: NCI]

Diabetes Mellitus
type: Class
subclass of: Disease
equivalent class: Diabetes Mellitus
definition: A metabolic disorder characterized by abnormally high blood sugar levels due to diminished production of insulin or insulin resistance/desensitization. [Definition Source: NCI]

Renal Disease
type: Class
subclass of: Disease
equivalent class: Kidney Disorder
comment: Disease associated with kidneys, typically chronic kidney disease.
definition: A neoplastic or non-neoplastic condition affecting the kidney. Representative examples of non-neoplastic conditions include glomerulonephritis and nephrotic syndrome. Representative examples of neoplastic conditions include benign processes (e.g., renal lipoma and renal fibroma) and malignant processes (e.g., renal cell carcinoma and renal lymphoma). [Definition Source: NCI]

Cardiovascular Disease
type: Class
subclass of: Disease
equivalent class: Cardiovascular Disorder
definition: A non-neoplastic or neoplastic disorder affecting the heart or the vessels (arteries, veins and lymph vessels). Representative examples of non-neoplastic cardiovascular disorders are endocarditis and hypertension. Representative examples of neoplastic cardiovascular disorders are endocardial myxoma and angiosarcoma. [Definition Source: NCI]

Nervous System Symptom
type: Class
subclass of: Symptom
equivalent class: nervous system symptom

Cerebral Vascular Accident
type: Class
subclass of: Nervous System Symptom
equivalent class: stroke
equivalent class: Stroke
comment: A stroke.
definition: A sudden loss of neurological function secondary to hemorrhage or ischemia in the brain parenchyma due to a vascular event. [Definition Source: NCI]
definition: Stroke is a nervous system symptom characterized by a sudden diminution or loss of consciousness, sensation, and voluntary motion caused by rupture or obstruction (as by a clot) of a blood vessel of the brain. [ url:http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=stroke ][Definition Source: SYMP:0000734]

Pain
type: Class
subclass of: Nervous System Symptom
equivalent class: pain
definition: A sensation perception where there is an unpleasant sensation that usually indicates the body is threatened or damaged. The sensation may be sharp or dull, short-lived or chronic, intermittent or continual, confined to one area or spread over the entire body. [ url:http://www.nationalpainfoundation.org/MyTreatment/articles/Cancer_PainDefinitions.asp ][Definition Source: SYMP:0000576]

Chest Pain
type: Class
subclass of: Pain
equivalent class: chest pain
equivalent class: Chest pain
equivalent class: Chest Pain
definition: An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) localized to the chest. [Definition Source: HP:0100749]

Behavior
type: Class
subclass of: Patient Characteristic
equivalent class: Behavior
definition: The actions or reactions of an object or organism, usually in relation to the environment or surrounding world of stimuli. [Definition Source: NCI]

Sedentary Lifestyle
type: Class
subclass of: Behavior
equivalent class: Sedentary Lifestyle
definition: A type of lifestyle that lacks physical exercise, characterized by sitting, reading, watching television or using a computer for much of the day without vigorous physical exertion. [Definition Source: NCI]

Insufficient Exercise
type: Class
subclass of: Sedentary Lifestyle

High Sugar Diet
type: Class
subclass of: Sedentary Lifestyle

Alcohol Use
type: Class
subclass of: Behavior
equivalent class: Alcohol Use History
definition: A description of an individual's current and past experience with alcoholic beverage consumption. [Definition Source: NCI]

Drug Use
type: Class
subclass of: Behavior
equivalent class: Drug Use History
definition: A description of an individual's current and past use and/or abuse of drugs and chemicals. This includes prescription medication, illicit drugs and recreational substances. [Definition Source: NCI]

Occupation
type: Class
subclass of: Patient Characteristic
equivalent class: Occupation
definition: The principal activity that a person does to earn money. [Definition Source: NCI]

Sedentary Occupation
type: Class
subclass of: Occupation
definition: A physical demand level described as the exertion of up to 10 pounds of force occasionally, negligible amount of work frequently, and a negligible amount of force constantly to move objects. [Definition Source: url:https://medical-dictionary.thefreedictionary.com/sedentary+work ]

Antihyperglycemic Treatment
subclass of: Therapy
equivalent class: hypoglycemic agent
comment: Treatment designed to lower blood sugar levels.
definition: A drug which lowers the blood glucose level. [Definition Source: CHEBI]

Efficacy
subclass of: Pharmacotherapy Factor
equivalent class: Treatment Efficacy
definition: The probability of benefit to individuals in a defined population from a medical technology applied for a given medical problem under ideal conditions of use. Efficacy is a measure of effect of therapy among appropriate patients in whom treatment is tolerated and effectively administered, under the condition of sufficient patients' compliance, usually determined in randomized trials. [Definition Source: NCI]

High Efficacy
subclass of: Efficacy
comment: A high capacity to bring about a desired effect.

Intermediate Efficacy
subclass of: Efficacy
comment: An intermediate capacity to bring about a desired effect.

Low Efficacy
subclass of: Efficacy
equivalent class: Lack of Efficacy
comment: A low capacity to bring about a desired effect.
definition: The lack of expected or desired effect related to a therapy. [Definition Source: NCI]

Weight Change Potential
subclass of: Pharmacotherapy Factor
equivalent class: Weight Change
comment: The capacity for an increase or decrease in the weight of an individual.

Weight Loss Potential
subclass of: Weight Change Potential
comment: The capacity for a decrease in the weight of an individual.

Weight Gain Potential
subclass of: Weight Change Potential
comment: The capacity for an increase in the weight of an individual.

Neutral Weight Change
subclass of: Weight Change Potential
comment: The lack of an effect on the capacity for an increase or decrease in the weight of an individual.

Hypoglycemia Risk
subclass of: Pharmacotherapy Factor
comment: The possiblility of lowering blood sugar below the normal range.
definition: The most important risk factor for the occurrence of hypoglycemia is the aggressiveness of therapy applied to achieve glycemic control. [Definition Source: url:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784865/ ]

No Known Hypoglycemia Risk
subclass of: Hypoglycemia Risk
comment: No known association with the lowering of blood sugar below the normal range.

Known Hypoglycemia Risk
subclass of: Hypoglycemia Risk
comment: A known association with the lowering of blood sugar below the normal range.

Cardiovascular Effect
subclass of: Pharmacotherapy Factor
comment: A pharmacotherapy factor related to the heart or blood vessels.
definition: Cardiovascular effects are defined as any uncomfortable physical effect that relates to the heart and blood vessels. [Definition Source: url:https://effectindex.com/categories/cardiovascular-effects ]

Atherosclerotic Cardiovascular Disease Risk
subclass of: Cardiovascular Effect
comment: Risk of cardiovascular disease resulting from atherosclerosis.

Potential ASCVD Benefit
subclass of: Atherosclerotic Cardiovascular Disease Risk
comment: Potential to reduce the risk of cardiovascular disease resulting from atherosclerosis.

Increased ASCVD Risk
subclass of: Atherosclerotic Cardiovascular Disease Risk
comment: Potential to increase the risk of cardiovascular disease resulting from atherosclerosis.

Neutral ASCVD Risk
subclass of: Atherosclerotic Cardiovascular Disease Risk
comment: Minimal effect on reducing or increasing the risk of cardiovascular disease resulting from atherosclerosis.

Heart Failure Risk
subclass of: Cardiovascular Effect
comment: Risk of heart failure.

Potential Heart Failure Benefit
subclass of: Heart Failure Risk
comment: Potential to decrease the risk of heart failure.

Increased Heart Failure Risk
subclass of: Heart Failure Risk
comment: Potential to increase the risk of heart failure.

Neutral Heart Failure Risk
subclass of: Heart Failure Risk
comment: Minimal effect on reducing or increasing the risk of heart failure.

Cost
subclass of: Pharmacotherapy Factor
equivalent class: Cost
comment: The expense associated with a therapy.
definition: The amount paid, charged, or engaged to be paid, for purchasing goods, services and financial instruments. [Definition Source: NCI]

Low Cost
subclass of: Cost
comment: Relatively inexpensive.

High Cost
subclass of: Cost
comment: Relatively expensive.

Renal Effect
subclass of: Pharmacotherapy Factor
comment: A pharmacotherapy factor related to the kidneys.

Diabetic Kidney Disease Progression
subclass of: Renal Effect
comment: The progression of diabetic kidney disease.
definition: Defined by the presence of diabetes and reduced estimated glomerular filtration rate (eGFR) to <60/ mL/min/1.73 m2, increased albuminuria (>300 mg/24 hours) or both, diabetic kidney disease (DKD) is a progressive disease that affects one in seven individuals worldwide eventuating renal replacement therapy (RRT) and premature death secondary to cardiovascular causes. [Definition Source: url:https://www.ncbi.nlm.nih.gov/books/NBK571719/ ]

Renal Dosing Consideration
subclass of: Renal Effect
comment: Drug dosage considerations related to the effect on the kidneys.

Potential Diabetic Kidney Disease Benefit
subclass of: Diabetic Kidney Disease Progression
comment: Potential to decrease the risk or progression of diabetic kidney disease.

Increased Diabetic Kidney Disease Risk
subclass of: Diabetic Kidney Disease Progression
comment: Potential to increase the risk or progression of diabetic kidney disease.

Neutral Diabetic Kidney Disease Risk
subclass of: Diabetic Kidney Disease Progression
comment: Minimal effect on reducing or increasing the risk or progression of diabetic kidney disease.

Biguanide
subclass of: Antihyperglycemic Treatment
equivalent class: biguanide
equivalent class: Biguanide Antidiabetic Agent
definition: Any antidiabetic agent with the biguanide base structure or phenformin derivatives with antihyperglycemic activity. Biguanide antidiabetic agents activate AMP-activated protein kinase (AMPK) resulting in decreased glucose production in the liver, increased peripheral glucose uptake and improved utilization of glucose. Biguanide-based antidiabetic agents do not cause hypoglycemia. In addition, biguanide antidiabetics decrease absorption of glucose from the gastrointestinal tract. [Definition Source: NCI]

Metformin
subclass of: Biguanide
equivalent class: metformin
equivalent class: metFORMIN [Moles/volume] in Serum or Plasma
equivalent class: Metformin
definition: An agent belonging to the biguanide class of antidiabetics with antihyperglycemic activity. Metformin is associated with a very low incidence of lactic acidosis. This agent helps reduce LDL cholesterol and triglyceride levels, and is not associated with weight gain, and prevents the cardiovascular complications of diabetes. Metformin is not metabolized and is excreted unchanged by the kidneys. [Definition Source: NCI]
subclass of: Restriction
  on property: has attribute
  has value: HighEfficacy
    type: High Efficacy
subclass of: Restriction
  on property: has attribute
  has value: NeutralWeightChange
    type: Neutral Weight Change
subclass of: Restriction
  on property: has attribute
  has value: NoKnownHypoglycemiaRisk
    type: No Known Hypoglycemia Risk
subclass of: Restriction
  on property: has attribute
  has value: PotentialASCVDBenefit
    type: Potential ASCVD Benefit
subclass of: Restriction
  on property: has attribute
  has value: NeutralHeartFailureRisk
    type: Neutral Heart Failure Risk
subclass of: Restriction
  on property: has attribute
  has value: LowCost
    type: Low Cost
subclass of: Restriction
  on property: has attribute
  has value: NeutralDKDRisk
    type: Neutral Diabetic Kidney Disease Risk

SGLT2 Inhibitor
subclass of: Antihyperglycemic Treatment
equivalent class: sodium-glucose transport protein subtype 2 inhibitor
equivalent class: SGLT2 Inhibitor
definition: Any inhibitor of the sodium-glucose co-transporter subtype 2 (SGLT2) with antihyperglycemic activity. By binding to and blocking SGLT2, these inhibitors suppress reabsorption of glucose in the proximal tubule within the kidneys and thereby enhancing urinary excretion of glucose. This eventually normalizes blood glucose levels. SGLT2, a transport system exclusively expressed in the proximal renal tubules, mediates about 90% of renal glucose reabsorption from tubular fluid. [Definition Source: NCI]
subclass of: Restriction
  on property: has attribute
  has value: IntermediateEfficacy
    type: Intermediate Efficacy
subclass of: Restriction
  on property: has attribute
  has value: WeightLossPotential
    type: Weight Loss Potential
subclass of: Restriction
  on property: has attribute
  has value: NoKnownHypoglycemiaRisk
    type: No Known Hypoglycemia Risk
subclass of: Restriction
  on property: has attribute
  has value: HighCost
    type: High Cost

Empagliflozin
subclass of: SGLT2 Inhibitor
equivalent class: empagliflozin
equivalent class: Empagliflozin
definition: An orally available competitive inhibitor of sodium-glucose co-transporter 2 (SGLT2; SLC5A2) with antihyperglycemic activity. Upon oral administration, empagliflozin selectively and potently inhibits SGLT2 in the kidneys, thereby suppressing the reabsorption of glucose in the proximal tubule. Inhibition of SGLT2 increases urinary glucose excretion by the kidneys, resulting in a reduction of plasma glucose levels in an insulin-independent manner. Inhibition of SGLT2 in the kidneys also suppresses the renal reabsorption of 1,5-anhydroglucitol (1,5AG). This lowers serum 1,5AG and neutrophil 1,5-anhydroglucitol-6-phosphate (1,5AG6P) levels, which may improve neutropenia and neutrophil dysfunction in patients with glycogen storage disease type Ib (GSD Ib). SGLT2, a transport protein exclusively expressed in the proximal renal tubules, mediates approximately 90% of renal glucose reabsorption from tubular fluid. [Definition Source: NCI]
subclass of: Restriction
  on property: has attribute
  has value: PotentialASCVDBenefit
    type: Potential ASCVD Benefit
subclass of: Restriction
  on property: has attribute
  has value: PotentialHeartFailureBenefit
    type: Potential Heart Failure Benefit
subclass of: Restriction
  on property: has attribute
  has value: PotentialDKDBenefit
    type: Potential Diabetic Kidney Disease Benefit

Canagliflozin
subclass of: SGLT2 Inhibitor
equivalent class: canagliflozin
equivalent class: Canagliflozin
definition: A C-glucoside with a thiophene ring that is an orally available inhibitor of sodium-glucose transporter 2 (SGLT2) with antihyperglycemic activity. Canagliflozin is also able to reduce body weight and has a low risk for hypoglycemia. [Definition Source: NCI]
subclass of: Restriction
  on property: has attribute
  has value: PotentialASCVDBenefit
    type: Potential ASCVD Benefit
subclass of: Restriction
  on property: has attribute
  has value: PotentialHeartFailureBenefit
    type: Potential Heart Failure Benefit
subclass of: Restriction
  on property: has attribute
  has value: PotentialDKDBenefit
    type: Potential Diabetic Kidney Disease Benefit

Dapagliflozin
subclass of: SGLT2 Inhibitor
equivalent class: dapagliflozin
equivalent class: Dapagliflozin
definition: A selective sodium-glucose co-transporter subtype 2 (SGLT2) inhibitor with antihyperglycemic activity. Dapagliflozin selectively and potently inhibits SGLT2 compared to SGLT1, which is the cotransporter of glucose in the gut. [Definition Source: NCI]
subclass of: Restriction
  on property: has attribute
  has value: PotentialHeartFailureBenefit
    type: Potential Heart Failure Benefit
subclass of: Restriction
  on property: has attribute
  has value: PotentialDKDBenefit
    type: Potential Diabetic Kidney Disease Benefit

Ertugliflozin
subclass of: SGLT2 Inhibitor
equivalent class: Ertugliflozin
definition: Ertugliflozin is in a class of medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors. It lowers blood sugar by causing the kidneys to get rid of more glucose in the urine. Ertugliflozin is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may develop if high blood sugar is not treated). [Definition Source: https://medlineplus.gov/druginfo/meds/a618011.html]
subclass of: Restriction
  on property: has attribute
  has value: PotentialHeartFailureBenefit
    type: Potential Heart Failure Benefit

GLP-1 RA
subclass of: Antihyperglycemic Treatment
equivalent class: glucagon-like peptide-1 receptor agonist
equivalent class: GLP-1 Mimetics
definition: Any of the analogues of the endogenous gastrointestinal hormone glucagon-like peptide-1 (GLP-1) with antihyperglycemic activity. GLP-1 mimetics mimic the activity of GLP-1 and thereby stimulate glucose-dependent secretion of insulin from pancreatic beta cells, suppress glucagon secretion from alpha cells, increase insulin sensitivity and inhibit gastric emptying thereby slowing absorption of nutrients and creating a satiating effect. Altogether, this lowers blood glucose levels. GLP-1 is rapidly inactivated by the enzyme dipeptidyl peptidase-4 (DPP-4). [Definition Source: NCI]
definition: An agonist that binds to and activates glucagon-like peptide-1 (GLP-1) receptors. [Definition Source: CHEBI]
subclass of: Restriction
  on property: has attribute
  has value: HighEfficacy
    type: High Efficacy
subclass of: Restriction
  on property: has attribute
  has value: WeightLossPotential
    type: Weight Loss Potential
subclass of: Restriction
  on property: has attribute
  has value: NoKnownHypoglycemiaRisk
    type: No Known Hypoglycemia Risk
subclass of: Restriction
  on property: has attribute
  has value: NeutralHeartFailureRisk
    type: Neutral Heart Failure Risk
subclass of: Restriction
  on property: has attribute
  has value: HighCost
    type: High Cost

Dulaglutide
subclass of: GLP-1 RA
equivalent class: Dulaglutide
definition: A glucagon-like peptide-1 (GLP-1) receptor agonist that is 90% homologous to native human GLP-1 (7-37) and is composed of a dipeptidyl peptidase-IV-protected GLP-1 analog covalently linked to a human immunoglobulin G4 (IgG4)-Fc heavy chain, with antihyperglycemic activity. Upon administration, dulaglutide binds to and activates GLP-1 receptors, thereby increasing intracellular cyclic AMP (cAMP) in pancreatic beta cells. This increases glucose-dependent insulin release. Dulaglutide also reduces the elevated glucagon secretion by inhibiting alpha cells of the pancreas and slows gastric emptying. Altogether this lowers the postprandial glucose level. GLP-1 is normally secreted by L cells of the gastrointestinal (GI) mucosa in response to a meal to normalize blood glucose levels. [Definition Source: NCI]
subclass of: Restriction
  on property: has attribute
  has value: PotentialASCVDBenefit
    type: Potential ASCVD Benefit
subclass of: Restriction
  on property: has attribute
  has value: PotentialDKDBenefit
    type: Potential Diabetic Kidney Disease Benefit

Liraglutide
subclass of: GLP-1 RA
equivalent class: liraglutide
equivalent class: Liraglutide
definition: A long-acting, fatty acylated glucagon-like peptide-1 (GLP-1) analog administered subcutaneously, with antihyperglycemic activity. Liraglutide's prolonged action and half-life of 11-15 hours are attributed to the attachment of the fatty acid palmitic acid to GLP-1 that reversibly binds to albumin. Albumin binding protects liraglutide from immediate degradation and elimination and causes GLP-1 to be released from abumin in a slow and consistent manner. This agent may cause thyroid C-cell tumors and increases the risk of acute pancreatitis. [Definition Source: NCI]
subclass of: Restriction
  on property: has attribute
  has value: PotentialASCVDBenefit
    type: Potential ASCVD Benefit
subclass of: Restriction
  on property: has attribute
  has value: PotentialDKDBenefit
    type: Potential Diabetic Kidney Disease Benefit

Semaglutide
subclass of: GLP-1 RA
equivalent class: semaglutide
equivalent class: Semaglutide
definition: A polypeptide that contains a linear sequence of 31 amino acids joined together by peptide linkages. It is an agonist of glucagon-like peptide-1 receptors (GLP-1 AR) and used for the treatment of type 2 diabetes. [Definition Source: CHEBI]
subclass of: Restriction
  on property: has attribute
  has value: PotentialASCVDBenefit
    type: Potential ASCVD Benefit
subclass of: Restriction
  on property: has attribute
  has value: PotentialDKDBenefit
    type: Potential Diabetic Kidney Disease Benefit

Lixisenatide
subclass of: GLP-1 RA
equivalent class: lixisenatide
equivalent class: Lixisenatide
definition: A forty-four membered polypeptide consisting of L-His, Gly, L-Glu, Gly, L-Thr, L-Phe, L-Thr, L-Ser, L-Asp, L-Leu, L-Ser, L-Lys, L-Gln, L-Met, L-Glu, L-Glu, L-Glu, L-Ala, L-Val, L-Arg, L-Leu, L-Phe, L-Ile, L-Glu, L-Trp, L-Leu, L-Lys, L-Asn, Gly, Gly, LPro, L-Ser, L-Ser, Gly, L-Ala, L-Pro, L-Pro, L-Ser, L-Lys, L-Lys, L-Lys, L-Lys, L-Lys, and L-Lys-NH2 residues joined in sequence. Used as an adjunct to diet and exercise for the treatment of adults with type II diabetes. [Definition Source: CHEBI]
subclass of: Restriction
  on property: has attribute
  has value: NeutralASCVDRisk
    type: Neutral ASCVD Risk

Exenatide
subclass of: GLP-1 RA
equivalent class: exendin-4
equivalent class: Exenatide
definition: A 39 amino acid peptide and synthetic version of exendin-4, a hormone found in the saliva of the venomous lizard Gila monster, with insulin secretagogue and antihyperglycemic activity. Exenatide is administered subcutaneously and mimics human glucagon-like peptide-1 (GLP-1). Compared to GLP-1, exenatide has a longer half-life of 2.4 hours. [Definition Source: NCI]
definition: A bioactive polypeptide of 39 amino acid residues isolated from the saliva of the Gila monster (Heloderma suspectum). High-affinity glucagon-like peptide 1 (GLP-1) receptor agonist (Kd = 136 pM); potently induces cAMP formation without stimulating amylase release in pancreatic acini; potentiates glucose-induced insulin secretion in isolated rat islets; protects against glutamate-induced neurotoxicity. A synthetic version is called exenatide. [Definition Source: CHEBI]
subclass of: Restriction
  on property: has attribute
  has value: NeutralASCVDRisk
    type: Neutral ASCVD Risk

DPP-4 Inhibitor
subclass of: Antihyperglycemic Treatment
equivalent class: EC 3.4.14.5 (dipeptidyl-peptidase IV) inhibitor
equivalent class: Dipeptidyl Peptidase-4 Inhibitor
definition: Any inhibitor of the proline-specific serine protease dipeptidyl peptidase 4 (DPP-4), with hypoglycemic activity. DPP-4 inhibitors bind to DPP-4 and inhibit the breakdown of the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). This prolongs incretin activity, increases postprandial insulin release, decreases glucagon release, delays gastric emptying and lowers blood glucose levels. The risk for hypoglycemia is negligible with the use of DPP-4 inhibitors. [Definition Source: NCI]
definition: An EC 3.4.14.* (dipeptidyl- and tripeptidyl-peptidases) inhibitor that specifically inhibits dipeptidyl peptidase-4 (EC 3.4.14.5). [Definition Source: CHEBI]
subclass of: Restriction
  on property: has attribute
  has value: IntermediateEfficacy
    type: Intermediate Efficacy
subclass of: Restriction
  on property: has attribute
  has value: NeutralWeightChange
    type: Neutral Weight Change
subclass of: Restriction
  on property: has attribute
  has value: NoKnownHypoglycemiaRisk
    type: No Known Hypoglycemia Risk
subclass of: Restriction
  on property: has attribute
  has value: NeutralASCVDRisk
    type: Neutral ASCVD Risk
subclass of: Restriction
  on property: has attribute
  has value: HighCost
    type: High Cost
subclass of: Restriction
  on property: has attribute
  has value: NeutralDKDRisk
    type: Neutral Diabetic Kidney Disease Risk

Sitagliptin
subclass of: DPP-4 Inhibitor
equivalent class: sitagliptin
equivalent class: Sitagliptin
definition: An orally available, competitive, beta-amino acid-derived inhibitor of dipeptidyl peptidase 4 (DDP-4) with hypoglycemic activity. Sitagliptin may cause an increased risk in the development of pancreatitis. [Definition Source: NCI]

Saxagliptin
subclass of: DPP-4 Inhibitor
equivalent class: saxagliptin
equivalent class: Saxagliptin
definition: A potent, selective and competitive, cyanopyrrolidine-based, orally bioavailable inhibitor of dipeptidyl peptidase 4 (DPP-4), with hypoglycemic activity. Saxagliptin is metabolized into an, although less potent, active mono-hydroxy metabolite. [Definition Source: NCI]
definition: A monocarboxylic acid amide obtained by formal condensation of the carboxy group of (2S)-amino(3-hydroxyadamantan-1-yl)acetic acid with the amino group of (1S,3S,5S)-2-azabicyclo[3.1.0]hexane-3-carbonitrile. Used in its monohydrate form for the treatment of Type II diabetes. [Definition Source: CHEBI]
subclass of: Restriction
  on property: has attribute
  has value: IncreasedHeartFailureRisk
    type: Increased Heart Failure Risk

Alogliptin
subclass of: DPP-4 Inhibitor
equivalent class: alogliptin
equivalent class: Alogliptin
definition: A selective, orally bioavailable, pyrimidinedione-based inhibitor of dipeptidyl peptidase 4 (DPP-4), with hypoglycemic activity. In addition to its effect on glucose levels, alogliptin may inhibit inflammatory responses by preventing the toll-like receptor 4 (TLR-4)-mediated formation of proinflammatory cytokines. [Definition Source: NCI]
definition: A piperidine that is 3-methyl-2,4-dioxo-3,4-dihydropyrimidine carrying additional 2-cyanobenzyl and 3-aminopiperidin-1-yl groups at positions 1 and 2 respectively (the R-enantiomer). Used in the form of its benzoate salt for treatment of type 2 diabetes. [Definition Source: CHEBI]

Linagliptin
subclass of: DPP-4 Inhibitor
equivalent class: linagliptin
equivalent class: Linagliptin
definition: A potent, orally bioavailable dihydropurinedione-based inhibitor of dipeptidyl peptidase 4 (DPP-4), with hypoglycemic activity. The inhibition of DPP-4 by linagliptin appears to be longer lasting than that by some other DPP-4 inhibitors tested. [Definition Source: NCI]
definition: A xanthine that is 7H-xanthine bearing (4-methylquinazolin-2-yl)methyl, methyl, but-2-yn-1-yl and 3-aminopiperidin-1-yl substituents at positions 1, 3, 7 and 8 respectively (the R-enantiomer). Used for treatment of type II diabetes. [Definition Source: CHEBI]

Thiazolidinedione
subclass of: Antihyperglycemic Treatment
equivalent class: thiazolidinediones
equivalent class: Thiazolidinedione Antidiabetic Agent
definition: Any antidiabetic agent with the glitazone (thiazolidinedione) base structure with antihyperglycemic activity. Glitazone antidiabetic agents selectively bind to and stimulate the nuclear receptor peroxisome proliferator-activated receptor (PPAR) gamma. This results in the selective transcription of a number of insulin-sensitive genes involved in glucose metabolism. This eventually enhances insulin sensitivity, reduces insulin resistance and decreases hepatic gluconeogenesis. PPARs function as transcription factors that regulate expressions of genes involved in cellular differentiation, development, and metabolism (carbohydrate, lipid, protein), as well as tumorigenesis; PPARgamma is expressed at high levels in adipose tissue. [Definition Source: NCI]
subclass of: Restriction
  on property: has attribute
  has value: HighEfficacy
    type: High Efficacy
subclass of: Restriction
  on property: has attribute
  has value: WeightGainPotential
    type: Weight Gain Potential
subclass of: Restriction
  on property: has attribute
  has value: NoKnownHypoglycemiaRisk
    type: No Known Hypoglycemia Risk
subclass of: Restriction
  on property: has attribute
  has value: IncreasedHeartFailureRisk
    type: Increased Heart Failure Risk
subclass of: Restriction
  on property: has attribute
  has value: LowCost
    type: Low Cost
subclass of: Restriction
  on property: has attribute
  has value: NeutralDKDRisk
    type: Neutral Diabetic Kidney Disease Risk

Pioglitazone
subclass of: Thiazolidinedione
equivalent class: pioglitazone
equivalent class: Pioglitazone
definition: An orally-active thiazolidinedione with antidiabetic properties and potential antineoplastic activity. Pioglitazone activates peroxisome proliferator-activated receptor gamma (PPAR-gamma), a ligand-activated transcription factor, thereby inducing cell differentiation and inhibiting cell growth and angiogenesis. This agent also modulates the transcription of insulin-responsive genes, inhibits macrophage and monocyte activation, and stimulates adipocyte differentiation. [Definition Source: NCI]
definition: A member of the class of thiazolidenediones that is 1,3-thiazolidine-2,4-dione substituted by a benzyl group at position 5 which in turn is substituted by a 2-(5-ethylpyridin-2-yl)ethoxy group at position 4 of the phenyl ring. It exhibits hypoglycemic activity. [Definition Source: CHEBI]
subclass of: Restriction
  on property: has attribute
  has value: PotentialASCVDBenefit
    type: Potential ASCVD Benefit

Rosiglitazone
subclass of: Thiazolidinedione
equivalent class: rosiglitazone
equivalent class: Rosiglitazone
definition: An agent belonging to the glitazone class of antidiabetic agents with antihyperglycemic and anti-inflammatory activities. In addition to its selective affinity for peroxisome proliferator-activated receptor (PPAR) gamma and its ability to lower blood glucose levels, rosiglitazone also exerts anti-inflammatory activity through its ability to inhibit nuclear factor-kappaB (NF-KB) activity and increase I-kappaB levels. In addition, rosiglitazone may cause fluid retention and may worsen congestive heart failure. This agent is also associated with an increased risk of heart attacks. [Definition Source: NCI]

Sulfonylurea
subclass of: Antihyperglycemic Treatment
equivalent class: N-sulfonylurea
equivalent class: Sulfonylurea Antidiabetic Agent
definition: Sulfonamide urea derivatives with antihyperglycemic activity. Sulphonylurea antidiabetic agents bind to sulfonylurea receptor type 1 (SUR1), the subunit of ATP-sensitive inwardly-rectifier potassium (IKATP) channels on the membranes of pancreatic beta cells, thereby blocking the inward current flow (influx) of positively charged K+ ions into the cell. This results in tonic membrane depolarization, and induces a calcium ion influx through voltage-sensitive calcium channels; increased intracellular calcium ion levels trigger exocytosis of insulin-containing granules. This eventually induces secretion of insulin. The IKATP channels found in pancreatic islets are complexes of four IKATP 6.2 and four SUR1 subunits. In addition, some sulfonylureas of larger molecular size may increase the sensitivity of peripheral tissues to insulin mediated through peroxisome proliferator-activated receptor gamma (PPARgamma). [Definition Source: NCI]
subclass of: Restriction
  on property: has attribute
  has value: HighEfficacy
    type: High Efficacy
subclass of: Restriction
  on property: has attribute
  has value: WeightGainPotential
    type: Weight Gain Potential
subclass of: Restriction
  on property: has attribute
  has value: KnownHypoglycemiaRisk
    type: Known Hypoglycemia Risk
subclass of: Restriction
  on property: has attribute
  has value: NeutralASCVDRisk
    type: Neutral ASCVD Risk
subclass of: Restriction
  on property: has attribute
  has value: NeutralHeartFailureRisk
    type: Neutral Heart Failure Risk
subclass of: Restriction
  on property: has attribute
  has value: LowCost
    type: Low Cost
subclass of: Restriction
  on property: has attribute
  has value: NeutralDKDRisk
    type: Neutral Diabetic Kidney Disease Risk

Glyburide
subclass of: Sulfonylurea
equivalent class: glyburide
equivalent class: Glyburide
definition: A sulfonamide urea derivative with antihyperglycemic activity that can potentially be used to decrease cerebral edema. Upon administration, glyburide binds to and blocks the sulfonylurea receptor type 1 (SUR1) subunit of the ATP-sensitive inwardly-rectifying potassium (K(ATP)) channels on the membranes of pancreatic beta cells. This prevents the inward current flow of positively charged potassium (K+) ions into the cell, and induces a calcium ion (Ca2+) influx through voltage-sensitive calcium channels, which triggers exocytosis of insulin-containing granules. In addition, glyburide also inhibits the SUR1-regulated nonselective cation (NC) Ca-ATP channel, melastatin 4 (transient receptor potential cation channel subfamily M member 4; (TRPM4)), thereby preventing capillary failure and brain swelling. SUR1-TRPM4 channels are formed by co-assembly of SUR1 with TRPM4 in neurons, astrocytes, and capillary endothelium during cerebral ischemia. Upon ischemia-induced ATP depletion, channels open which results in sodium influx, cytotoxic edema formation, capillary fragmentation and necrotic cell death. SUR1-TRPM4 is not expressed in normal, uninjured tissues. [Definition Source: NCI]
definition: An N-sulfonylurea that is acetohexamide in which the acetyl group is replaced by a 2-(5-chloro-2-methoxybenzamido)ethyl group. [Definition Source: CHEBI]

Glipizide
subclass of: Sulfonylurea
equivalent class: glipizide
equivalent class: Glipizide
definition: A short-acting, second-generation sulfonylurea with hypoglycemic activity. Glipizide is rapidly absorbed, has a very quick onset of action and a short half-life. This agent is extensively metabolized in the liver and the metabolites as well as the unchanged form are excreted in the urine. [Definition Source: NCI]
definition: An N-sulfonylurea that is glyburide in which the (5-chloro-2-methoxybenzoyl group is replaced by a (5-methylpyrazin-2-yl)carbonyl group. An oral hypoglycemic agent, it is used in the treatment of type 2 diabetes mellitus. [Definition Source: CHEBI]

Glimepiride
subclass of: Sulfonylurea
equivalent class: glimepiride
equivalent class: Glimepiride
definition: A long-acting, third-generation sulfonylurea with hypoglycemic activity. Compared to other generations of sulfonylurea compounds, glimepiride is very potent and has a longer duration of action. This agent is metabolized by CYP2C9 and shows peroxisome proliferator-activated receptor gamma (PPARgamma) agonistic activity. [Definition Source: NCI]

External Class
type: Class

symptom
type: Class
subclass of: External Class

nutrition, metabolism, and development symptom
type: Class
subclass of: symptom

neurological and physiological symptom
type: Class
subclass of: symptom

musculoskeletal system symptom
type: Class
subclass of: symptom

urinary system symptom
type: Class
subclass of: symptom

nervous system symptom
type: Class
subclass of: symptom

polyuria
type: Class
subclass of: urinary system symptom

dysuria
type: Class
subclass of: urinary system symptom

urinary frequency
type: Class
subclass of: urinary system symptom

polydipsia
type: Class
subclass of: nutrition, metabolism, and development symptom

polyphagia
type: Class
subclass of: nutrition, metabolism, and development symptom

eye symptom
type: Class
subclass of: symptom

vision symptom
type: Class
subclass of: eye symptom

blurred vision
type: Class
subclass of: eye symptom

fatigue
type: Class
subclass of: neurological and physiological symptom

arthritis
type: Class
subclass of: musculoskeletal system symptom

muscle weakness
type: Class
subclass of: musculoskeletal system symptom

peripheral muscle weakness
type: Class
subclass of: muscle weakness

stroke
type: Class
subclass of: nervous system symptom

pain
type: Class
subclass of: nervous system symptom

chest pain
type: Class
subclass of: pain

body mass index
type: Class
subclass of: External Class

underweight body mass index status
type: Class
subclass of: body mass index

overweight body mass index status
type: Class
subclass of: body mass index

obese body mass index status
type: Class
subclass of: body mass index

Constitutional symptom
type: Class
subclass of: External Class

Chest pain
type: Class
subclass of: Constitutional symptom

Functional abnormality of the bladder
type: Class
subclass of: External Class

Pollakisuria
type: Class
subclass of: Functional abnormality of the bladder

Abnormal macroscopic urine appearance
type: Class
subclass of: External Class

Abnormal urinary odor
type: Class
subclass of: Abnormal macroscopic urine appearance

Anti-diabetic Agent
type: Class
subclass of: External Class

Biguanide Antidiabetic Agent
type: Class
subclass of: Anti-diabetic Agent

Metformin
type: Class
subclass of: Biguanide Antidiabetic Agent

SGLT2 Inhibitor
type: Class
subclass of: Anti-diabetic Agent

Empagliflozin
type: Class
subclass of: SGLT2 Inhibitor

Canagliflozin
type: Class
subclass of: SGLT2 Inhibitor

Dapagliflozin
type: Class
subclass of: SGLT2 Inhibitor

Ertugliflozin
type: Class
subclass of: SGLT2 Inhibitor

GLP-1 Mimetics
type: Class
subclass of: Anti-diabetic Agent

Dulaglutide
type: Class
subclass of: GLP-1 Mimetics

Liraglutide
type: Class
subclass of: GLP-1 Mimetics

Semaglutide
type: Class
subclass of: GLP-1 Mimetics

Lixisenatide
type: Class
subclass of: GLP-1 Mimetics

Exenatide
type: Class
subclass of: GLP-1 Mimetics

Dipeptidyl Peptidase-4 Inhibitor
type: Class
subclass of: Anti-diabetic Agent

Sitagliptin
type: Class
subclass of: Dipeptidyl Peptidase-4 Inhibitor

Saxagliptin
type: Class
subclass of: Dipeptidyl Peptidase-4 Inhibitor

Alogliptin
type: Class
subclass of: Dipeptidyl Peptidase-4 Inhibitor

Linagliptin
type: Class
subclass of: Dipeptidyl Peptidase-4 Inhibitor

Thiazolidinedione Antidiabetic Agent
type: Class
subclass of: Anti-diabetic Agent

Pioglitazone
type: Class
subclass of: Thiazolidinedione Antidiabetic Agent

Rosiglitazone
type: Class
subclass of: Thiazolidinedione Antidiabetic Agent

Sulfonylurea Antidiabetic Agent
type: Class
subclass of: Anti-diabetic Agent

Glyburide
type: Class
subclass of: Sulfonylurea Antidiabetic Agent

Glipizide
type: Class
subclass of: Sulfonylurea Antidiabetic Agent

Glimepiride
type: Class
subclass of: Sulfonylurea Antidiabetic Agent

Conceptual Entity
type: Class
subclass of: External Class

Occupation or Discipline
type: Class
subclass of: Conceptual Entity

Occupation
type: Class
subclass of: Occupation or Discipline

Cost
type: Class
subclass of: Conceptual Entity

Property or Attribute
type: Class
subclass of: External Class

Measurement
type: Class
subclass of: Property or Attribute

Efficacy
type: Class
subclass of: Property or Attribute

Treatment Efficacy
type: Class
subclass of: Efficacy

Lack of Efficacy
type: Class
subclass of: Treatment Efficacy

Intervention or Procedure
type: Class
subclass of: External Class

Lipid Measurement
type: Class
subclass of: Intervention or Procedure

Cholesterol Measurement
type: Class
subclass of: Lipid Measurement

Triglyceride Measurement
type: Class
subclass of: Lipid Measurement

Glucose Measurement
type: Class
subclass of: Intervention or Procedure

Blood Glucose Measurement
type: Class
subclass of: Glucose Measurement

Therapeutic Procedure
type: Class
subclass of: Intervention or Procedure

General Qualifier
type: Class
subclass of: Property or Attribute

Condition
type: Class
subclass of: General Qualifier

Activity
type: Class
subclass of: External Class

Behavior
type: Class
subclass of: Activity

Lifestyle
type: Class
subclass of: Behavior

Sedentary Lifestyle
type: Class
subclass of: Lifestyle

Disease, Disorder or Finding
type: Class
subclass of: External Class

Sign
type: Class
subclass of: Disease, Disorder or Finding

Weight Change
type: Class
subclass of: Sign

Pain
type: Class
subclass of: Disease, Disorder or Finding

Chest Pain
type: Class
subclass of: Pain

Physical Examination Finding
type: Class
subclass of: Disease, Disorder or Finding

Body Mass Index Finding
type: Class
subclass of: Physical Examination Finding

Abnormal Blood Chemistry and Hematology Test Result
type: Class
subclass of: Disease, Disorder or Finding
label: Hyperlipidemia

Blood Pressure Finding
type: Class
subclass of: Disease, Disorder or Finding

Hypertension
type: Class
subclass of: Blood Pressure Finding
subclass of: CTRP Clinical Finding

CTRP Clinical Finding
type: Class
subclass of: Disease, Disorder or Finding

Obesity
type: Class
subclass of: CTRP Clinical Finding
subclass of: Sign

Disease or Disorder
type: Class
subclass of: Disease, Disorder or Finding

Genitourinary System Infection
type: Class
subclass of: Disease or Disorder

Urinary Tract Infection
type: Class
subclass of: Genitourinary System Infection

Disorder by Site
type: Class
subclass of: Disease or Disorder

Cerebrovascular Disorder
type: Class
subclass of: Disorder by Site

Stroke
type: Class
subclass of: Cerebrovascular Disorder

Non-Neoplastic Endocrine Pancreas Disorder
type: Class
subclass of: Disorder by Site

Diabetes Mellitus
type: Class
subclass of: Non-Neoplastic Endocrine Pancreas Disorder

Non-Neoplastic Heart Disorder
type: Class
subclass of: Disorder by Site

Coronary Artery Disease
type: Class
subclass of: Non-Neoplastic Heart Disorder

Urinary System Disorder
type: Class
subclass of: Disorder by Site

Kidney Disorder
type: Class
subclass of: Urinary System Disorder

Cardiovascular Disorder
type: Class
subclass of: Disorder by Site

History
type: Class
subclass of: Conceptual Entity

Personal Medical History
type: Class
subclass of: History

Family Medical History
type: Class
subclass of: Personal Medical History

Alcohol Use History
type: Class
subclass of: Personal Medical History

Drug Use History
type: Class
subclass of: Personal Medical History

Family History of Coronary Artery Disease
type: Class
subclass of: Family Medical History

Diagnostic or Prognostic Factor
type: Class
subclass of: Conceptual Entity

Treatment Factor
type: Class
subclass of: External Class

Diagnostic Factor
type: Class
subclass of: External Class

Characteristic
type: Class
subclass of: Property or Attribute

glimepiride
type: Class
subclass of: External Class

glipizide
type: Class
subclass of: External Class

glyburide
type: Class
subclass of: External Class

N-sulfonylurea
type: Class
subclass of: External Class

rosiglitazone
type: Class
subclass of: External Class

pioglitazone
type: Class
subclass of: External Class

thiazolidinediones
type: Class
subclass of: External Class

linagliptin
type: Class
subclass of: External Class

alogliptin
type: Class
subclass of: External Class

saxagliptin
type: Class
subclass of: External Class

sodium-glucose transport protein subtype 2 inhibitor
type: Class
subclass of: External Class

empagliflozin
type: Class
subclass of: External Class

canagliflozin
type: Class
subclass of: External Class

dapagliflozin
type: Class
subclass of: External Class

Ertugliflozin
type: Class
subclass of: External Class

glucagon-like peptide-1 receptor agonist
type: Class
subclass of: External Class

liraglutide
type: Class
subclass of: External Class

semaglutide
type: Class
subclass of: External Class

lixisenatide
type: Class
subclass of: External Class

exendin-4
type: Class
subclass of: External Class

EC 3.4.14.5 (dipeptidyl-peptidase IV) inhibitor
type: Class
subclass of: External Class

sitagliptin
type: Class
subclass of: External Class

biguanide
type: Class
subclass of: External Class

metformin
type: Class
subclass of: External Class

hypoglycemic agent
type: Class
subclass of: External Class

metFORMIN [Moles/volume] in Serum or Plasma
type: Class
subclass of: External Class

Fasting glucose [Mass/volume] in Serum or Plasma
type: Class
subclass of: External Class

Glucose [Mass/volume] in Serum or Plasma --2 hours post 75 g glucose PO
type: Class
subclass of: External Class

Hemoglobin A1c/Hemoglobin.total in Blood by IFCC protocol
type: Class
subclass of: External Class

Cholesterol in LDL [Mass/volume] in Serum or Plasma
type: Class
subclass of: External Class

Triglyceride [Mass/volume] in Body fluid
type: Class
subclass of: External Class

has attribute
type: ObjectProperty