Diabetic retinopathy as a predictor for peripheral compression neuropathies, a registry-based study

Area of Science:

• Endocrinology and Neurology
• Ophthalmology
• Diabetology

Background:

• Diabetes mellitus is linked to various complications, including retinopathy and peripheral nerve entrapment neuropathies like carpal tunnel syndrome (CTS) and ulnar nerve entrapment (UNE).
• While a correlation exists between retinopathy and entrapment neuropathies, the predictive value of retinopathy for developing CTS and UNE remains unclear.

Purpose of the Study:

• To investigate whether diabetic retinopathy can serve as a predictive factor for the development of CTS and UNE.
• To analyze the association between retinopathy status and the prevalence of CTS and UNE in a large diabetic population.

Main Methods:

• Utilized data from 95,437 individuals in the National Diabetes Registry, merged with the Skåne Healthcare Registry.
• Employed Chi-squared test, Student's Independent T-test, and Mann-Whitney U-test for population characteristic analysis.
• Applied logistic regression models to determine the odds ratio (OR) for CTS and UNE development based on retinopathy status, adjusting for confounders.

Main Results:

• Both CTS and UNE were significantly more frequent in individuals with retinopathy compared to those without (CTS: 6.5% vs. 3.3%; UNE: 1.2% vs. 0.7%).
• Individuals with type 1 diabetes and retinopathy showed a significantly higher OR for developing CTS (2.40) and a trend towards higher OR for UNE (1.53).
• For type 2 diabetes, retinopathy was not significantly associated with increased odds of developing CTS (OR 0.93) or UNE (OR 1.02).

Conclusions:

• Diabetic retinopathy is associated with an elevated risk of developing CTS and UNE, with the association potentially mediated by diabetes duration.
• Longer diabetes duration, higher HbA1c levels, and increased BMI are identified as significant risk factors for both CTS and UNE in diabetic patients.
• Retinopathy serves as an indicator for increased risk of nerve entrapment syndromes, especially in type 1 diabetes, highlighting the importance of comprehensive diabetes management.