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      Incidence and Determinants of Carpal Tunnel Decompression Surgery in Type 2 Diabetes: The Fremantle Diabetes Study

      Author(s): , , ,  
      Publication date Created:
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      Journal: Diabetes Care
      Publisher: American Diabetes Association

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          Abstract

          To examine the incidence and predictors of carpal tunnel decompression (CTD) in community-based patients with type 2 diabetes, we studied 1,284 type 2 diabetic participants (mean +/- SD age 64.1 +/- 6.1 years, 49.1% male) in the longitudinal observational Fremantle Diabetes Study who had no history of CTD. A total of 67 participants (5.8%) had a first CTD during 12,109 years (mean 9.4 +/- 3.7) of follow-up, an incidence of 5.5 per 1,000 patient-years. This was at least 4.2 times the incidence in the general population (P < 0.001). In Cox proportional hazards analysis, significant independent determinants of first-ever CTD were higher BMI, taking lipid-lowering medication, and being in a stable relationship (P <or= 0.021). The crude incidence of first CTD is increased in type 2 diabetes and is associated with obesity and sociodemographic/treatment factors that could indicate treatment-seeking behavior including CTD in symptomatic patients.

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          The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study.

          P J Dyck, K. M. Kratz, J L Karnes … (1993)
          The magnitude of the health problem from diabetic neuropathies remains inadequately estimated due to the lack of prospective population-based studies employing standardized and validated assessments of the type and stage of neuropathy as compared with background frequency. All Rochester, Minnesota, residents with diabetes mellitus on January 1, 1986, were invited to participate in a cross-sectional and longitudinal study of diabetic neuropathies (and also of other microvascular and macrovascular complications). Of 64,573 inhabitants on January 1, 1986 in Rochester, 870 (1.3%) had clinically recognized diabetes mellitus (National Diabetes Data Group criteria), of whom 380 were enrolled in the Rochester Diabetic Neuropathy Study. Of these, 102 (26.8%) had insulin-dependent diabetes mellitus (IDDM), and 278 (73.2%) had non-insulin-dependent diabetes mellitus (NIDDM). Approximately 10% of diabetic patients had neurologic deficits attributable to nondiabetic causes. Sixty-six percent of IDDM patients had some form of neuropathy; the frequencies of individual types were as follows: polyneuropathy, 54%; carpal tunnel syndrome, asymptomatic, 22%, and symptomatic, 11%; visceral autonomic neuropathy, 7%, and other varieties, 3%. Among NIDDM patients, 59% had various neuropathies; the individual percentages were 45%, 29%, 6%, 5%, and 3%. Symptomatic degrees of polyneuropathy occurred in only 15% of IDDM and 13% of NIDDM patients. The more severe stage of polyneuropathy, to the point that patients were unable to walk on their heels and also had distal sensory and autonomic deficits (stage 2b) occurred even less frequently--6% of IDDM and 1% of NIDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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            Population-based linkage of health records in Western Australia: development of a health services research linked database

            C Holman, A. Bass, Ian L Rouse … (1999)
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              Risk factors in carpal tunnel syndrome.

              Joshua Smith, Michael Clark, Stevan Hubbard … (2004)
              We have undertaken a large case-control study using the UK General Practice Research Database to quantify the relative contributions of the common risk factors for carpal tunnel syndrome (CTS) in the community. Cases were patients with a diagnosis of CTS and, for each, four controls were individually matched by age, sex and general practice. Our dataset included 3,391 cases, of which 2,444 (72%) were women, with a mean age at diagnosis of 46 (range 16-96) years. Multivariate analysis showed that the risk factors associated with CTS were previous wrist fracture (OR=2.29), rheumatoid arthritis (OR=2.23), osteoarthritis of the wrist and carpus (OR=1.89), obesity (OR=2.06), diabetes (OR=1.51), and the use of insulin (OR=1.52), sulphonylureas (OR=1.45), metformin (OR=1.20) and thyroxine (OR=1.36). Smoking, hormone replacement therapy, the combined oral contraceptive pill and oral corticosteroids were not associated with CTS. The results were similar when cases were restricted to those who had undergone carpal tunnel decompression.
              Article 0 comments Cited 68 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: Diabetes Care
                Abbreviated Title: Diabetes Care
                Publisher: American Diabetes Association
                ISSN (Print): 0149-5992
                ISSN (Electronic): 1935-5548
                Publication date Created: February 27 2008
                Publication date Created: March 01 2008
                Publication date (Electronic): December 10 2007
                Publication date (Print): March 01 2008
                Volume: 31
                Issue: 3
                Pages: 498-500
                Article
                DOI: 10.2337/dc07-2058
                PubMed ID: 18070996
                SO-VID: b425f81f-e973-4939-a2c5-2c70f6b34970
                Copyright © © 2008
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