Diabetes Masks Signs of Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) might not be detected by standard testing methods in people with diabetes, according to researchers in the United States and Canada, who urge doctors to evaluate clinical symptoms.

In a study published in the March 2002 issue of Diabetes Care, co-investigator Vera Brill, MD, FRCPC, and colleagues screened 478 subjects for CTS using the standard method of electrodiagnostic testing (a nerve conduction study). The subjects included individuals who had diabetes but no neuropathy; individuals who had diabetes and either mild, moderate or severe neuropathy; and reference subjects who had neither diabetes nor neuropathy.

Clinical carpal tunnel syndrome was diagnosed in 2 percent of the reference subjects, in 14 percent of the subjects who had diabetes but no neuropathy and in 30 percent of the subjects who had both diabetes and neuropathy. Electrodiagnostic testing was not completely accurate in detecting CTS in the subjects with diabetes.

Because electrodiagnostic testing often fails to detect carpal tunnel syndrome in people with diabetes, the researchers recommend that doctors make therapeutic decisions based on symptoms of carpal tunnel syndrome in individuals with diabetes, independent of electrodiagnostic findings.

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