Effects of diabetes mellitus on the rate of carpal tunnel release in patients with carpal tunnel syndrome

Shin, Jaeyong; Kim, Yong Wook; Lee, Sang Chul; Yang, Seung Nam; Chang, Jee Suk; Yoon, Seo Yeon

doi:10.1038/s41598-021-95316-9

Cited by 8 publications

(9 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Historically, among some physicians, there has been a cautious approach to carpal tunnel release in CTS in individuals with diabetes, based on the notion that they may not benefit from surgery to the same extent as individuals without diabetes [ 78 , 79 ]. As a result of this, current research indicates that persons with long-term diabetes and CTS might still be undertreated [ 80 ].…”

Section: Treatment Optionsmentioning

confidence: 99%

Carpal Tunnel Syndrome and Diabetes—A Comprehensive Review

Zimmerman

Gottsäter

Dahlin

2022

JCM

View full text Add to dashboard Cite

Carpal tunnel syndrome (CTS) is the most common compression neuropathy in the general population and is frequently encountered among individuals with type 1 and 2 diabetes. The reason(s) why a peripheral nerve trunk in individuals with diabetes is more susceptible to nerve compression is still not completely clarified, but both biochemical and structural changes in the peripheral nerve are probably implicated. In particular, individuals with neuropathy, irrespective of aetiology, have a higher risk of peripheral nerve compression disorders, as reflected among individuals with diabetic neuropathy. Diagnosis of CTS in individuals with diabetes should be carefully evaluated; detailed case history, thorough clinical examination, and electrophysiological examination is recommended. Individuals with diabetes and CTS benefit from surgery to the same extent as otherwise healthy individuals with CTS. In the present review, we describe pathophysiological aspects of the nerve compression disorder CTS in relation to diabetes, current data contributing to the explanation of the increased risk for CTS in individuals with diabetes, as well as diagnostic methods, treatment options, and prognosis of CTS in diabetes.

show abstract

Section: Treatment Optionsmentioning

confidence: 99%

Carpal Tunnel Syndrome and Diabetes—A Comprehensive Review

Zimmerman

Gottsäter

Dahlin

2022

JCM

View full text Add to dashboard Cite

show abstract

“…1 The overall prevalence of CTS in the general population of CTS is approximately 3% and risk factors for developing this disease include female gender, age, obesity, occupation, as well as medical conditions including pregnancy, cardiac or renal disease, and diabetes mellitus. [2][3][4] In particular, patients with diabetes mellitus are found to have a higher rate of developing CTS, with a prevalence of 14% in all patients with diabetes and 30% in patients with diabetic neuropathy. 3,4 CTS causes significant morbidity and interference with daily activities, resulting in nearly a half million carpal tunnel releases and direct costs of over 2 billion dollars in expenditure each year.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4] In particular, patients with diabetes mellitus are found to have a higher rate of developing CTS, with a prevalence of 14% in all patients with diabetes and 30% in patients with diabetic neuropathy. 3,4 CTS causes significant morbidity and interference with daily activities, resulting in nearly a half million carpal tunnel releases and direct costs of over 2 billion dollars in expenditure each year. 5 Prompt and accurate diagnosis of CTS is essential for appropriate and timely care.…”

Section: Introductionmentioning

confidence: 99%

Diabetes Increases Median Nerve Cross-Sectional Area but Not Disease Severity in Patients with Carpal Tunnel Syndrome

Beckwitt

Schulz

Carrozzi

et al. 2024

Journal of Hand and Microsurgery

View full text Add to dashboard Cite

Background Ultrasonography (US) is a useful diagnostic modality for diagnosis of carpal tunnel syndrome (CTS). Diabetes mellitus is increasingly prevalent and is a risk factor for CTS. Given the increasing use of US in the diagnosis of CTS, our goal was to evaluate the influence of diabetes on CTS severity and the cross-sectional area (CSA) of the median nerve in patients with CTS. Methods Patients with clinically diagnosed CTS were seen in the outpatient setting from October 2014 to February 2021. Median nerve CSA and patient reported severity measures were obtained: Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and CTS-6. For patients with diabetes, additional parameters were collected including most recent A1c, insulin pharmacotherapy, and polypharmacy. Results Ninety-nine patients (122 nerves) without diabetes and 55 patients (82 nerves) with diabetes were recruited for the study. Patients in the diabetes group were more obese and older and had a significantly increased median nerve CSA compared with patients without diabetes. Obesity was associated with higher median nerve CSA in all patients but not in patients with diabetes. There was no difference in disease severity in patients with and without diabetes as reported by BCTSQ or CTS-6 scores. In patients with diabetes, there was significantly decreased median nerve CSA with A1c of 6.5 or higher and a trend to decreased CSA with polypharmacy. There was no influence of insulin therapy on median nerve CSA. Conclusion Diabetes is associated with higher median nerve CSA in patients with CTS of similar disease severity. The increased median nerve CSA in patients with diabetes may be reflective of diabetes-related microvascular changes. Interestingly, the trend to decreased median nerve CSA in patients with suboptimal diabetic control (A1c ≥ 6.5) may suggest eventual degenerative changes to the median nerve. In summary, clinicians should be cautious with interpreting a larger median nerve CSA as more severe CTS in patients with diabetes. Level of Evidence Level 3 Diagnostic.

show abstract

“…However, more studies confirm that patients with diabetes experience the same benefit from surgery as the general population [ 11 – 13 ]. One earlier study, with a different design and population, implied that the patients with diabetes had a lower chance of getting surgery [ 14 ]. Thus, our aim was to investigate whether individuals with diabetes and CTS are operated on to the same extent as individuals without diabetes and with CTS in a representative (i.e., the general population in the region of Skåne, Sweden) population, adjusting for age, sex and diabetes severity.…”

Section: Introductionmentioning

confidence: 99%

Surgery for carpal tunnel syndrome in patients with and without diabetes–Is there a difference in the frequency of surgical procedures?

Svensson,

Dahlin,

Rydberg

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Carpal tunnel syndrome (CTS) occurs more often among individuals with diabetes. The aim of this retrospective observational registry study was to examine whether individuals with diabetes and CTS are treated surgically to the same extent as individuals with CTS but without diabetes. Data on CTS diagnosis and surgery were collected from the Skåne Healthcare Register (SHR). A total of 35,105 individuals (age ≥ 18 years) diagnosed with CTS from 2004–2019 were included. Data were matched to the Swedish National Diabetes Register (NDR. Cox regression models were used to calculate the risk of the use of surgical treatment. Of the 35,105 included individuals with a CTS diagnosis, 17,662 (50%) were treated surgically, and 4,966 (14%) had diabetes. A higher number of individuals with diabetes were treated surgically (2,935/4,966, 59%) than individuals without diabetes (14,727/30,139, 49%). In the Cox regression model, diabetes remained a significant risk factor for surgical treatment (PR 1.14 (95% CI 1.11–1.17)). Individuals with type 1 diabetes were more frequently treated surgically (490/757, 65%) than individuals with type 2 diabetes (2,445/4,209, 58%). There was no difference between the sexes and their treatment. The duration of diabetes was also a risk factor for surgical treatment in diabetes type 2, but high HbA1c levels were not. Individuals with diabetes are more likely to be treated surgically for CTS than individuals without diabetes. Individuals with type 1 diabetes are more likely to be treated surgically for CTS than individuals with type 2 diabetes.

show abstract

Effects of diabetes mellitus on the rate of carpal tunnel release in patients with carpal tunnel syndrome

Cited by 8 publications

References 37 publications

Carpal Tunnel Syndrome and Diabetes—A Comprehensive Review

Carpal Tunnel Syndrome and Diabetes—A Comprehensive Review

Diabetes Increases Median Nerve Cross-Sectional Area but Not Disease Severity in Patients with Carpal Tunnel Syndrome

Surgery for carpal tunnel syndrome in patients with and without diabetes–Is there a difference in the frequency of surgical procedures?

Contact Info

Product

Resources

About