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Dupuytren's reversed
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05/01/2013 14:13
Andrew 
05/01/2013 14:13
Andrew 
Re: Dupuytren's reversed

Well, that is very interesting, Stephen. So if your statistics are correct (I see you now say that 20% of diabetics have DD, whereas in an earlier post you said 30%), we can say:

(a) If a person has diabetes, the chances of their also having DD are 20%, that is nearly 3 times the usual incidence of 7%.

(b) If a person has DD, the chances of their also having diabetes are 14%, that is nearly 3 times the usual incidence of 5%.

So the correlation seems to work both ways and equally. Possibly, then, if the two diseases are connected in this way, the same things which are helpful in lessening the symptoms of type 2 diabetes (namely a less sugary diet) may also help in cases of DD. This is only a hypothesis of course, but it seemed to work in my case. That is, eight years after changing my diet the DD has not got any worse but in fact has improved and almost disappeared.

What you say about the progression of the disease being different in diabetics is also interesting. Do you have a source for this? In what way is it different? Do you mean that it is milder and not so aggressive?

05/02/2013 22:07
stephenp 
05/02/2013 22:07
stephenp 
Re: Dupuytren's reversed

Hi Andrew

Your numbers are correct as far as I can tell. The prevalence of DD in diabetics has been reported at between 3% and 32% depending on the study. Hart and Hooper reviewed this association and also stated that DD in diabetics is a "different condition from the condition in non-diabetics. There is a lower incidence of contractures and fewer cases require surgery." In people with diabetes the gender ratio is the same whereas in non-diabetics the disease is more prevalent in males. In people with type 1 diabetes, DD occurs earlier, again suggesting a relationship to altered blood glucose control. The references to this (which I have not read) are cited in Clinical Associations of Dupuytren's disease, Postgrad Med J, 2005, v81, 425-428 (which I have read).

I suspect that DD is a manifestation that has multiple causes of which altered sugar metabolism is one. The prevalence of DD in diabetics could conceivably depend on the control of diabetes, eg if blood glucose is better controlled and levels of glycosylated proteins are lower, DD may be milder or more stable (or even reversed!).

There are other associations that I expect are one way eg epilepsy, alcoholism, smoking and HIV.

I do not know if there is any information on changes in collagen and myofibroblasts in diabetics compared with non-diabetics with DD. Changes in myofibroblast proliferation, collagen types and collagenase gene expression are possibly more difficult to reverse by changes in diet. One exception might be free radical scavengers although I drink lots of green tea and the disease marches on.

Cheers

Stephen

PS if you want the papers, I can email them to you

05/03/2013 05:43
Andrew 
05/03/2013 05:43
Andrew 
Re: Dupuytren's reversed

Dear Stephen,

Yes, that is very interesting; thank you for the information. I would be very interested to read the papers you mention if you were to email them to andrewgoodson1 at gmail.com

I guess I am lucky (if there are several types of DD) to have the type which is associated with diabetes - not that I have diabetes, but the increase in my waist measurement at the time when I developed DD indicated, I believe, a tendency to pre-diabetes. What kind of DD do you have?

Andrew

05/13/2013 03:05
stephenp 
05/13/2013 03:05
stephenp 
Re: Dupuytren's reversed

Hi Andrew

I just emailed the paper to you.

I am a bit of an ectomorph and as my father and two brothers all have DD, I suspect it is not the type associated with diabetes.

Cheers

Stephen

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