Carpal Tunnel Syndrome in type 2 diabetic patients

To determine the frequency of carpal tunnel syndrome in type 2 diabetic patients, its clinical profile and its other predisposing factors.

One hundred and forty six consecutive patients (57 male, 89 female) with type 2 diabetes mellitus seen in the diabetic clinic were examined prospectively and submitted to comprehensive electrophysiological studies to detect carpal tunnel syndrome and sensorimotor neuropathy. Those with carpal tunnel syndrome were compared to others to determine the additional predisposing factors for carpal tunnel syndrome in diabetic patients.

The mean duration of diabetes was 11.5 years. Carpal tunnel syndrome was diagnosed in 39% of the patients (28% of the males and 46% of females). Numbness of the hands, Tinel`s sign and Phalen`s sign had poor sensitivity (61%, 54% and 37% respectively) but high specificity (75%, 85% and 91%). The main risk factor for carpal tunnel syndrome in diabetics was the duration of diabetes (p<0.001) and to a lesser degree female gender and obesity (p<0.05).

Carpal tunnel syndrome is quite frequent in type 2 diabetic patients. Its clinical diagnosis may be difficult because of the poor sensitivity of its classical symptoms and signs. It should be suspected mainly in obese women with long-standing diabetes mellitus. Electrodiagnostic studies should be done in these patients because the earlier the diagnosis, the sooner consideration can be given to the need for surgical decompression.