Q: What is a diabetic foot ulcer?
Jessica Acop, RN, Program Director, Maui Memorial Medical Center Wound Care and Hyperbaric Therapy: A diabetic foot ulcer is an open sore found below the ankle, usually located on the bottom of the foot. It usually starts with a foot injury, such as a cut or blister, and can linger for weeks without improvement. According to the American Podiatric Medical Association, diabetic ulcers affect approximately 15-25 percent of people with diabetes.
Without treatment, ulcers can be life-threatening, because infectious bacteria can damage your skin and kill your tissues. It can also infect your bloodstream or cause a bone infection, both of which can lead to sepsis.
If you have diabetes, or help care for someone with diabetes, it’s important to understand what a diabetic foot ulcer is and how to care for a foot injury to avoid an ulcer.
If you are diabetic, make sure to control your blood sugar levels and monitor your feet daily for any change or injury. Seek treatment as soon as possible. Longer wait times drastically reduce your chances to heal, so the sooner you can see a physician about your need, the better.
Some behaviors also make foot ulcers more likely to develop. Alcohol consumption, poorly trimmed toenails, tobacco use, poor hygiene and wearing poorly fitted shoes (ones without enough cushioning or room for your toes) can promote ulcer formation.
If you have developed a foot ulcer, wound care is essential. Maui Memorial Medical Center Wound Care and Hyperbaric Therapy provides comprehensive wound care treatments including two hyperbaric oxygen (HBO) chambers — the only chambers available in state outside of Oahu. For more information about our wound care team or to schedule an appointment, call (808) 986-4500 or visit mauihealth.org/woundcare.
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Q: My relative has celiac disease. Should I be tested even if I have no symptoms?
Dr. Michael Shea, Intensivist and Chief Medical Director, Maui Health: Celiac disease is hereditary, and people who have a close relative with celiac are at higher risk. At the same time, many people with celiac disease have unexpected symptoms or no symptoms at all. So if someone in your family was diagnosed with celiac disease, you should be tested too.
Celiac disease is an autoimmune disease triggered by gluten, a protein found in wheat, barley and rye. When someone has celiac disease, eating gluten causes their immune system to attack their small intestine. This damages tissues that help the body absorb nutrients.
Classical celiac disease has very dramatic symptoms that can’t be ignored, like diarrhea; stools that are pale, fatty and foul-smelling; and weight loss or slow growth in children.
But many people have less obvious symptoms. For example, gastrointestinal symptoms could be mild, like gas or bloating. Other symptoms might seem unrelated, like fatigue, migraine, tingling in the hands or feet, infertility, rash and certain vitamin deficiencies. Still other people with celiac disease may have no apparent symptoms at all.
Even if you don’t have clear symptoms, screening is important if you think you might be at risk for celiac disease. That’s because living with untreated celiac can cause long-term health problems. It’s been linked to other autoimmune disorders including diabetes and multiple sclerosis.
Celiac disease can be diagnosed with a blood test. It can be easily treated by removing all foods with gluten from your diet.
Around one in 100 people has celiac disease, and some studies estimate as many as 80 percent of people with celiac aren’t diagnosed. Having a relative with celiac disease increases your risk. Talk with your doctor if you think you should be tested.
* Physicians, providers and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in Healthwise Maui, which appears on Thursdays. Maui Health 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 mauihealth.org/healthwise.
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