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Item
#13
Carpal Tunnel Syndrome in
People With Diabetes
People with
diabetes are at increased risk of carpal tunnel syndrome
Not only are
people with diabetes are at increased risk of carpal tunnel
syndrome, but the testing commonly used to diagnose the painful
condition may not be accurate in diabetics, researchers report.
Due to
the difficulty of diagnosing carpal tunnel syndrome in people with
diabetes, doctors should rely more on symptoms when examining
diabetics, according to the investigators.
Carpal
tunnel syndrome occurs when one of the nerves that passes through
the wrist becomes compressed. Symptoms include numbness, weakness,
tingling and pain in the fingers and hand.
People
with diabetes are at risk for several different kinds of nerve
problems, the most common being a type of nerve injury called
diabetic polyneuropathy, says Dr. Vera Bril of the University of
Toronto. Bril noted that people with diabetes often develop carpal
tunnel syndrome, too.
The usual
way to diagnose the disorder is a noninvasive test called nerve
conduction study. However, the criteria for interpreting the
results of this testing were developed without including patients
who have both diabetic polyneuropathy and carpal tunnel syndrome.
So the accuracy of the criteria for diagnosing carpal tunnel
syndrome in people with diabetes is uncertain, Bril and co-author
Dr. Bruce A. Perkins of Harvard Medical School in Boston,
Massachusetts, note in the March issue of the journal Diabetes
Care.
To see
how often carpal tunnel syndrome occurs in diabetics as well as to
determine the accuracy of the conventional diagnostic test, Bril
and Perkins evaluated 478 people for the condition. The study
included people with diabetes who had mild, moderate or severe
neuropathy or none at all.
Based on
clinical symptoms, the researchers determined that 2% of the
reference group had carpal tunnel syndrome, compared with 14% of
diabetics who did not have neuropathy and 30% who did. But among
diabetics, electrodiagnostic testing used to diagnose carpal
tunnel syndrome did not accurately distinguish between those with
carpal tunnel syndrome and those without it, the report indicates.
The study
shows that conventional diagnostic testing "does not seem to apply
in those with diabetes," according to Bril. Calling the diagnosis
of diabetes "tricky," she said, "The results of this study suggest
that doctors should put more weight on the symptoms that people
describe rather than sophisticated lab tests."
Bril advised
people with diabetes "to pay attention to symptoms of numbness,
tingling, weakness or pain in their hands and tell their doctors
about these symptoms."
Diabetes Care 2002;25:565-569.
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DID YOU
KNOW:
India has 19.4
million diabetics and the number is expected to reach 57.2 million
by the year 2025.
The
United News of India reported, quoting the study published in the
Journal of Indian Medical Association, said nearly 300 million
people worldwide are likely to be affected by diabetes by the year
2025.The study said the number of diabetics in India has hit
epidemic proportions.
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