Increased Incidence of Carpal Tunnel Syndrome up to 10 Years Before Diagnosis of Diabetes
- Martin C. Gulliford, FRCP1,
- Radoslav Latinovic, BSC1,
- Judith Charlton, MSC1 and
- Richard A.C. Hughes, FRCP2
- 1Division of Health and Social Care Research, King’s College, London, U.K.
- 2Division of Clinical Neuroscience, King’s College, London, U.K.
- Address correspondence and reprint requests to Martin Gulliford, Public Health Sciences, Capital House, 42 Weston St., London SE1 3QD, U.K. E-mail: martin.gulliford{at}kcl.ac.uk
The frequency of carpal tunnel syndrome (CTS) is increased in patients with peripheral neuropathy from a variety of causes (1). Abnormal glucose metabolism may be implicated in the etiology of “idiopathic” polyneuropathy in subjects who do not have diabetes (2). We investigated whether the incidence of CTS, Bell’s palsy, and other peripheral nerve disorders is increased before the diagnosis of diabetes.
RESEARCH DESIGN AND METHODS
A cohort study was implemented (3) using THIN, a database containing medical records from family practices in England and Wales (4). The study was approved by the South East Research Ethics Committee. Data were analyzed for 114 family practices with 644,495 registered patients aged ≤100 years. Diabetes cases were selected if their diagnosis date was between 1 November 2003 and 31 October 2004 and if they were aged between 30 and 89 years at diagnosis and had never been prescribed insulin or diagnosed with type 1 diabetes. These criteria produced 2,655 cases. Two control groups were randomly selected, matching for age, sex, and practice, from subjects who were never diagnosed with diabetes or prescribed oral hypoglycemic drugs or insulin. Eight cases, for whom two respective control subjects could not be identified, were omitted.
Each patient’s medical record was searched for first occurrences of CTS, including carpal tunnel release and carpal tunnel injection (5). We also identified new occurrences of Bell’s facial palsy. …
