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Carpal tunnel syndrome and Bell’s facial palsy may predate a diagnosis of type 2 diabetes by up to 10 years, according to results of a cohort study. Led by Dr. Martin C. Gulliford, the team at King’s College in London examined medical records from 114 family practices in England and Wales. Among the 644,495 patients, they identified 2647 patients diagnosed with diabetes between November 2003 and October 2004. The 5,294 control subjects were matched for age, gender, and practice.
According to their report, medical records for up to 10 years before diabetes was diagnosed were reviewed for the first occurrences of carpal tunnel syndrome, including carpal tunnel release and carpal tunnel injection. Researchers also identified subjects diagnosed with Bell’s facial palsy and other peripheral neuropathies.
Results showed that the incidence of carpal tunnel syndrome was 425.1 per 100,000 person-years in the pre-diabetes group, versus 260.0 per 100,000 in the control group. After adjusting for known risk factors for carpal tunnel syndrome, the relative risk was statistically significant (1.36, p = 0.039).
Similarly, Bell’s facial palsy occurred twice as often in the pre-diabetes group as in the control group (81.1 versus 41.2 per 100,000 person-years). However, after adjusting for sex, age, and BMI category, the relative risk was no longer statistically significant (1.64, p = 0.128).
The incidence of other peripheral nerve disorders was similar in the two groups.
"Hyperglycemia and associated metabolic abnormalities may contribute to causing these important focal peripheral nerve disorders before the diagnosis of diabetes," Dr. Gulliford and his team suggest.
Diabetes Care 2006;29:1929-1930.
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