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

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 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. Diabetes Care 31:498–500, 2008 C arpal tunnel syndrome (CTS) is themost common entrapment neurop-athy complicating diabetes (1), with an incidence several-fold that in the gen-eral population (1–3). Based on clinical/ electrophysiological assessment (4), one-third of type 2 diabetic patients have CTS, and one-sixth of these report symptoms. Conventional treatments comprise splint-ing, diuretics and corticosteroid injec-tions, and carpal tunnel decompression (CTD) if conservative measures fail (2). Open and endoscopic CTD have equiva-lent outcomes (5)with 75%of cases cured or minimally symptomatic (6) regardless of diabetes status (7). There are, however, few epidemiologic data relating to CTD in diabetes. In the general population, 0.4– 1.4 decompressions are conducted per 1,000 person-years (3), but the relative CTS prevalence suggests a higher rate in diabetes. Our aim was, therefore, to de-termine the incidence and predictors of CTD in well-characterized type 2 diabetic patients