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Monday, 13 February 2012

Dupuytren’s disease and diabetes.

Dupuytren’s is another complication that can effect us diabetics. Dr. Richard Bernstein has stated elevated blood glucose can effect every tissue in the body, so obviously the hands are not immune. In his excellent book Diabetes Solution, he says on page 64, glycation of tendons occurs in such common diabetic complications as Dupuytren’s Contractures of the fingers, frozen shoulders, trigger fingers, carpel tunnel syndrome, and iliotibial band /tensor faceplate syndrome of hips and upper legs. All of these conditions are easily treated if caught early and blood sugars are controlled. As I have had Dupuytren’s for many years before type two diagnosis, and have held non diabetic BG numbers for three and a half years, I do not consider diabetes to be a major factor in my condition. What other factors could be involved. Could it be 50 years of playing golf, in later years often every day of the week, sometimes two rounds per day. Hitting 100’s of balls down practise ranges. Could it be 50 years of playing drums, often for 2 and 3 hours per day. A huge genetic factor is also involved. I think it is impossible I will ever know. As I said in a comment on the grip and rip post. Surgery is best left until the problem becomes advanced. As up to 50% of the time the condition returns.

In some cases, the chance of Dupuytren’s contracture reoccurring after surgery is as high as 50%. However, more extensive surgery is possible if the condition returns. Further treatments are currently being researched. Dupuytren’s disease (DD) is an ancient affliction of unknown origin. It is defined by Dorland as shortening, thickening, and fibrosis of the palmar fascia producing a flexion deformity of a finger. Tradition has it that the disease originated with the Vikings, who spread it throughout Northern Europe and beyond as they travelled and intermarried.

In his 1963 book, the Australian hand surgeon John Hueston wrote, “Dupuytren’s contracture is virtually confined to people of European descent” Its highest incidence is recorded in Iceland. As expected, the incidence is also high in Scandinavia: In a Norwegian study of 15,950 citizens, DD was present in 10.5% of men and in 3.2% of women. In a large 1962 review of published figures, P. F. Early arrayed the countries of European stock in order of incidence of DD: Denmark, Australia, New Zealand, Canada, United Kingdom, Germany, and the United States. He also commented that the incidence in Australia, Canada, England, and Wales was similar since their populations are of basically English stock, which may itself represent a diluted strain of Danish (Viking) stock.

In 1985, Robert McFarlane of Canada published a preliminary report of the activities of the committee on DD of the International Federation of Societies for Surgery of the Hand. In 812 patients, the family origin was Northern European in 68%, Southern European in 3%, black African and American Indian in 0.2%, Chinese in 2%, and Japanese in 16%. Northern European ancestry can hardly apply to Japan, where DD appears to be a different condition, in that 95% of cases occur in men and only 6% of cases occur in families with a history of DD—compared with 26% in other countries. I understand that an update of this massive study will be published shortly.

Drummer's Health - Dupuytren’s Contracture

There’s been a certain amount of talk on the forum about carpal tunnel syndrome but I’m afraid there is another affliction sent to make life difficult for us drummers: Dupuytren’s Contracture. It’s named after Baron Guillaume Dupuytren’s the surgeon who first suggested an operation to correct the affliction.

Dupuytren's Contracture and Climbing

This is not the first time a link between high-level rock climbing and Dupuytren’s has been suggested. In 2005 the British Journal of Sports Medicine published the results of a questionnaire-based study carried out amongst members of the Climbers Club, asking individuals to report on potential symptoms of the condition, as well as any possible contributory factors, such as age, alcohol consumption, etc. Whilst not exactly scientific, the report concluded that climbers were several times more likely to develop Dupuytren's than members of the general public.



Anonymous said...

Came across this accidentaly, whilst searching for Dupuytrens which my father suffers from. We do not believe he is diabetic but perhaps he should be checked. It has given me and the family something to think about.

Lowcarb team member said...

It may be worth getting your father checked for diabetes, but the condition can be caused by a variety of other factors unrelated to diabetes.


Lowcarb team member said...

I have carpal tunnel syndrome as result of using of heavy duty impact wrenches for over 30 years. Many of my workmates also suffered the same condition, a few elected to have surgery with varying outcomes for some it worked while others had the problem return. I decided against surgery because the company was closing and I'd found a lighter job and had a start date.

Over the years it's not been to much of a problem, that is until a short time after my diabetes diagnosis when it became very painful, I was referred to a consultant and had a EMG test which just confirmed the original diagnosis. I had a cortisone injection and was given a splint, the consultant said if it did not improve he would consider surgery. I didn't improve it got steadily worse and started affecting my arm to the extent I could not raise it above my shoulder.

On my next hospital visit the consultant decided I may have anther condition called Wartenberg syndrome, further EMG tests were done on my arm which ruled this out, I was given yet another follow up appointment when I ended up being discharged,as all the symptoms apart from the CPL had gone. The reason for this was between the appointments I had ditched the Statins, so it was just another of the many side effects I suffered.

I reported all this on a thread on DCUK for the benefit of other Statin users, the thread has been deleted by the mad axe man.

This WAS the thread!


Anonymous said...

Cugila was a destructive and vicious oaf. If only he had buried himself in his own hole.