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Healthwise Maui

Q: What is coronary artery disease?

Dr. Shalin Patel, interventional cardiologist, Pacific Permanente Group: Coronary artery disease develops when the blood vessels to your heart become damaged or clogged. Usually this occurs because fatty deposits called plaque build up in the arteries, causing them to get narrower, and making it harder for blood to get through. When the heart doesn’t get enough blood, it can cause chest pain or angina. Eventually, coronary artery disease can cause a heart attack.

There are several things you can do to help protect yourself from coronary artery disease. If you quit smoking, maintain a healthy weight, get regular exercise, and eat a healthy diet, you can reduce your risk. Other health conditions like high cholesterol, high blood pressure and uncontrolled diabetes can contribute to coronary artery disease, so working with your doctor to manage these conditions can also help.

You may also need medications to reduce your risk of heart attack or surgery to help restore blood flow to the heart.

Q: What’s the difference between Type 1 and Type 2 diabetes?

Jolly Anne L. Uclaray, Master of Science Nursing, registered nurse and certified diabetes educator, diabetes coordinator, Maui Memorial Medical Center: Diabetes is a condition that occurs when the body is having trouble producing or using insulin. Insulin is a hormone that helps (or move sugar into our cell and use as energy) our cells pull sugar from the bloodstream and use it as energy. When there’s a problem with insulin, those sugars accumulate in our blood. Over time, that can cause serious problems with blood circulation, which can lead to organs and tissues to stop working properly if not managed correctly.

There are two main types of diabetes. With Type 1 diabetes, the pancreas produces little or no insulin. This condition is often diagnosed early in life, which is why it used to be called “juvenile diabetes.” It’s not known what causes it, but it’s not common. Only about 5 to 10 percent of people with diabetes have Type 1 diabetes.

The vast majority of diabetics have what’s called Type 2 diabetes. With this condition, the pancreas doesn’t make enough insulin or doesn’t use it well. Type 2 diabetes used to be known as adult-onset diabetes but is now affecting more and more children probably due to the rise in childhood obesity. Type 2 diabetes is also more linked to a person’s lifestyle.  Being overweight or not getting enough exercise can increase your risk.

Whether you have Type 1 or Type 2 diabetes, you may need to take insulin or other medications to manage the condition. Following a diabetes meal plan and exercising safely can help you stay healthy.

* 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 mauihealthsystem.org/contact.

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