August 22, 2006
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Carpal tunnel syndrome commonly diagnosed in patients that later develop diabetes

Hyperglycemia and associated metabolic disorders may contribute to development of both carpal tunnel syndrome and Bell's palsy.

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Patients with type 2 diabetes have an increased incidence of carpal tunnel syndrome and Bell's palsy up to 10 years before being diagnosed as diabetic, a new study found.

"The present study makes the novel observation that the incidence of CTS (carpal tunnel syndrome) is increased from before the time of clinical diagnosis of diabetes when exposure to hyperglycemia will generally have been less prolonged and less severe," the authors said in the study.

"Hyperglycemia and associated metabolic abnormalities may contribute to causing these important focal peripheral disorders before the diagnosis of diabetes," they said.

Martin C. Gulliford, FRCP, and colleagues at King's College, London, conducted the cohort study, which analyzed data for 644,495 patients treated at 114 family practices in England and Wales. All data had been included in THIN, a medical records database, according to the study, published in the journal Diabetes Care.

After applying exclusion criteria, the final data analysis included 2,647 prediabetic patients — patients later diagnosed with diabetes — and 5,294 age-, sex-, and practice-matched control patients. Both groups had a mean age of 62.4 ± 13.1 years; women comprised 49% of the study population.

Follow-up averaged 8.9 ± 1.7 years for prediabetic patients and 8.8 ± 1.7 years for control patients, according to the study.

The researchers found that prediabetic patients had a CTS incidence of 425.1 cases per 100,000 person-years compared to an incidence of 260 cases per 100,000 person-years among control patients. This yielded a significantly higher relative risk (RR) of 1.63 for prediabetic patients (P<.001), and a RR of 1.36 after adjusting for known risk factors (P=.039).

Prediabetic patients also had nearly twice the incidence of Bell's palsy compared to control patients. However, "This increased risk ... was not independent of elevated [body mass index], which is itself a cause of pre-diabetes," the study authors said.

For more information:

  • Gulliford MC, Latinovic R, Charlton J, Hughs RAC. Increased incidence of carpal tunnel syndrome up to 10 tears before diagnosis of diabetes. Diabetes Care. 2006;29:1929-1930.