Healthwise Maui

Q: Is it true that smoking can cause a stroke?

Mariah Mossman, registered nurse, Stroke Program manager, Maui Health System: Yes. Smoking not only causes heart disease and lung cancer but can also cause stroke. In fact, smoking is one of the top five causes of stroke. According to the National Stroke Association, smoking reduces the amount of oxygen in the blood, which causes the heart to work harder. This also allows blood clots to form more easily. Smoking also increases the amount of buildup in your arteries, which may block the flow of blood to the brain and cause a stroke. When you stop smoking, you greatly reduce your chances of having a stroke.

Maui Health System is hosting a free stroke awareness event today, from 4 to 6:30 p.m., at Maui Memorial Medical Center. Stroke education and interactive learning stations will be available in the courtyard from 4 to 5 p.m. Special guest speakers from Maui’s medical community will discuss topics relating to the event theme “Stroke: Preventable, Treatable, Beatable” from 5 to 6:30 p.m. in the auditorium. The event also includes food, entertainment, prizes and complimentary valet parking. For more information, visit

Q: What should I know about exercising with diabetes?

Dr. Robert Connaughton, vascular surgeon, Maui Health System: Health classes on diabetes often focus on the importance of diet. But actually, exercise can be really helpful in controlling this condition and keeping your body healthy. That’s because, while insulin is important for keeping your blood sugar under control, it can also cause problems with circulation.

When insulin levels are higher than normal, it can cause your blood vessels to thicken and become calcified. This can especially affect the capillaries, which is why parts of your body that are served by these small blood vessels — like the kidneys, brain, the muscle of the heart, and extremities like your feet and toes — can develop problems as a result.

Exercise helps, because strenuous exercise — not leisurely walking, but the kind that really gets your heart pumping — causes your muscles to absorb sugars directly out of your blood. This helps you keep your blood sugar levels under control with less insulin.

At the same time, exercise allows new collateral blood vessels to form in your body’s tissues, improving circulation and getting the blood flowing to these areas more effectively.

Q: I am diabetic and my doctor is recommending that I use diabetic shoes. Is this really necessary?

Dr. Robert Connaughton, vascular surgeon, Maui Health System: Diabetes can cause neuropathy — nerve damage that leads to numbness in your feet and toes. People with this condition often don’t know when they get an injury on their foot because they can’t feel it. Diabetics are also much more vulnerable to infection, because of poor circulation to the legs and feet, and because their white blood cells aren’t able to migrate properly into tissues to fight off bacteria.

Unfortunately, this is why it’s not uncommon for someone with diabetes to start out with a small sore on their toe and end up losing the foot or their entire leg.

Diabetic shoes are designed to cushion pressure points and protect feet from scratches. They really can make a difference in preventing these potentially serious blisters and sores from developing.

Above all, anyone with diabetes should avoid wearing slippers, as they offer no protection or cushioning for your feet at all.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at