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Diabetics in risk group for Dupuytren's

Since I began writing this column I've become fascinated with little-known syndromes and diseases. I guess it started with the fact that I have Charcot neuroarthropathy, which isn't a household term.

It's a disease that causes deformity in the bones of my right foot due to poor blood flow in the leg, because I have diabetic neuropathy.

I got an email from a reader who has it in both feet. She shared some of her struggles, and she has it much worse than I do. But, like me, she copes and does the best she can. It's not easy, but we're alive and still kicking, even with messed up feet.

A few days ago I saw a post on Facebook about something a friend struggles with -- Dupuytren's disease, pronounced du-pwe-TRANZ. It's named after Baron Guillaume Dupuytren, who brought the disease to the forefront in a lecture in 1831.

I tooled around the internet and found information on it from Baylor University Medical Center on the U.S. National Library of Medicine website (nlm.nih.gov), the Mayo Clinic (mayoclinic.org) and the Dupuytren Foundation (dupuytrens.org).

According to the foundation, the disease is "the most common crippling hand condition that people have never heard of." It affects at least 10 million Americans by making their fingers permanently bent, sometimes severely.

It can affect the hands and knuckle pads, and the feet, where it's called Ledderhose disease. People with Dupuytren's have a greater risk of cardiovascular disease, several types of cancer and early death -- for reasons unknown.

Dr. Adrian E. Flatt, of Baylor University, wrote that the disease origins are unknown. It is said to have originated with the Vikings, who spread it through Europe and beyond as they traveled and intermarried. Hence, the disease is often referred to as Viking disease.

Flatt notes that in a 1963 book by Australian hand surgeon John Heuston, the author wrote that "Dupuytren's contracture is virtually confined to people of European descent." It seems to abound in countries whose populations are basically English stock. That includes everywhere from Iceland and Australia to Canada and the United States.

Information on the Mayo Clinic website describes the disease as a deformity that usually develops over years and affects a layer of tissue that lies under the skin of the palm. Knots of tissue form under the skin, eventually creating a thick cord that can pull one or more fingers into a bent position. As it progresses, the skin on the palm could appear puckered or dimpled.

The affected fingers can't be straightened completely, which complicates everyday activities like placing your hands in your pockets, putting on gloves or shaking hands. It mainly affects the ring and pinky fingers, but the middle finger can be involved.

There are a number of factors that are believed to increase the risk of getting Dupuytren's disease:

Age. It occurs most commonly after 50.

Sex. Men are more likely to develop the disease.

Family history. It tends to run in families.

Tobacco and alcohol use. Smoking is associated with greater risk, possibly because of microscopic changes within blood vessels caused by smoking. But alcohol intake can also be a factor.

Diabetes. Ah, there it is. People with diabetes are reported to have an increased risk for getting Dupuytren's disease.

In most cases, they say, doctors can diagnose the disease by the look and feel of the hands. Other tests are rarely necessary.

Treatment involves removing or breaking apart the cords that are pulling your fingers toward your palm. There are several options that can be discussed with your doctor, with surgery often required in advanced cases.

Email me at:

rboggs@arkansasonline.com

ActiveStyle on 12/04/2017

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