What Andrew wrote in 2009 and what I have some common threads in the thinking process. Let me tell you about it.

I was diagnosed with Dup 3 years ago. Started as a lump around the upper joint of my pinky finger on my right hand. The lump has since reduced in size but it managed to bend my finger about 45 degrees at the first knuckle and another 45 degrees at the second knuckle. No pain, no thrub, no nothing ... just a bent finger.

I first attributed to working out with weights with unprotected hands, to the rubbing of holding a golf club for years, to the 25 odd years of playing tennis. But the doc diagnosed in 2010 Dupuytren disease, didn't recommend Xintrax injection because the area is so small and the risk of the enzymes eating into the flexors, but he offered to operate right away. I didn't like his attitude so I didn't do anything and went on with my life.

Recently I read about NA and what it is and it seems like it is the least invasive intervention if I want to have my finger straightenned out. The bent pinky doesn't bother me much, except when you accidentally hit something because you have this hook sticking out, or makes me conscious during a hand shake. But other than that I guess I could live with it if it won't go any further. Doesn't interfere with weights or tennis or golf. I also have a nod on my left hand and the ring finger bent about 3 degrees forward ... nothing much.

All this finger business since 3 years ago and it has stayed that way, no progress other than my thinking that I need to do something about it. I am going to see a doctor that uses NA (to me, cuts to weaken the extra growth and be able to extend the finger by its own muscular strength). I plan to learn some more before I decide what I need done, if anything. It just seems like a lot of hassle for nothing much in my case. I am thin, active, hit the elliptical and work with weights 3 times a week, starting to play tennis again, watch what I eat, been taking my vitamins (3 gr of C, resveratrol, omega, for joint supplements) daily for the last 12 years. I think I'm in good shape, and since my last physical all is normal good blood pressure and all that. I used to run 4-5 miles every other day but now just do elliptical to save my knees that used to heat up from the pounding of steady running. I am going to be 68 this year and the idea of days or weeks of discomfort just turn me off. I think Andrew may have a point in that there could many origins/reasons why these nods in the hands come to make life more difficult, not just the genetic heritage thing. I remember I had bump on the inside of my left wrist ages ago and it eventually went totally away. C'est la vie.

I am a little puzzled as to how it could be possible that a larger than average number of diabetics have DD without its also being true that a larger number than average of DD patients have diabetes. I have A level Maths; but I am willing to be convinced if I see the arguments.

However, you may be right, Stephen, when you hint that there may be two kinds of DD, a mild kind that is connected to diabetes and a more aggressive kind that is not connected. This remains to be discovered.

Meanwhile it seems to me that there is nothing wrong with anecdotal evidence to begin with. For example, the observation that lung cancer was more frequently observed in smokers led to studies that proved that this was true. In the case of DD, if not just one but several DD patients using this forum were to adjust their diet and see a slowing down or reversal of the disease, it would provide a good reason for requesting funds for a controlled study. Nor is the presumption that excess sugar in the blood may cause Dupuytren's totally without foundation. If 30% of diabetics have DD, it would seem to follow that (at least in the case of these patients) either high blood sugar causes DD or there is some other factor, such as insufficient insulin, that causes both illnesses. Of these two possibilities, in view of the fact that high blood sugar is known to cause other kinds of damage in the body, e.g. blindness, poor circulation in the feet, etc., the high blood sugar hypothesis seems not implausible. Well, it's worth giving it a trial at any rate.

It's not a question of cause and effect, but simply a mathematical fact; if, for example, taking the group of British people called 'Patel', we find a disproportionately large number of them living in London, it follows automatically that if we take a random Londoner, the chances of him being called 'Patel' are larger than would be the case for people elsewhere in Britain. It doesn't mean that being a Londoner causes people to have the name 'Patel', or vice versa. As far as I can see (but let me be corrected by a mathematician if I'm wrong), if a larger proportion of diabetics have DD than the average population (which was proved by the Reykjavik study), then it follows automatically that a larger proportion of DD sufferers will be diabetic than the average population. But it doesn't necessarily mean that diabetes causes DD or that DD causes diabetes.

I agree completely. The real question is which links are relevant and in which direction.

There seems to be a statistical link between alcoholism and DD but I think we can dismiss the proposition that DD causes alcoholism. It seems likely that alcoholism can cause DD which raises the question as to whether abstinence from alcohol will prevent the onset of DD or reduce the severity.

I think we can agree that a statistical correlation does not prove causation in either direction and this may well be the case with diabetes and DD. Of course it could be that the correlation is simply telling us that the physiological makeup that makes us susceptible to diabetes also makes us susceptible to DD and frozen shoulder etc without there being any causal connections between these various conditions.

The word "dependent" could be misleading although exact.
In reality, it only indicates a relationsip between two factors, but will never suggest that one is the cause and the other one the effect. I guess this is for the doctors to sort which is the effect and which is the cause. In the meantime, you cannot really discard that DD might cause alcoholism! (joke!)