Carpal tunnel release surgery at a young age indicates need for diabetes mellitus screening

Patients with carpal tunnel syndrome (CTS) often suffer from comorbid medical conditions, including diabetes mellitus (DM), hypothyroidism, rheumatoid arthritis, hypertension and hyperlipidemia. There is no conclusive evidence about causation link between these disorders and CTS. It can be proposed that both are caused by a common pathophysiological process, and early CTS diagnosis can be a predictor of future diagnosis of one of the above disorders. A long-term follow-up study was designed to investigate this hypothesis. This is a retrospective cohort of 90 consecutive patients aged 18-40 years who underwent either carpal tunnel release (CTR, the study cases, n = 36) or ankle fracture repair (the controls, n = 54). The latter were otherwise young and healthy patients, and were considered representative of the general population. The average postoperative follow-up was 18.75 years (range 16-26) for the CTR group and 19.39 years (16-25) for the control group. DM was diagnosed in 26.5% of the CTR patients compared to 9.3% of the controls (P = 0.04). No group differences were detected for the four other investigated chronic disease states. The findings of this study suggest that CTS may be predictive of DM in young patients, thus calling for screening of CTS patients for DM.