Diyabetik Polinöropati ve Karpal Tünel Sendromu İlişkisi: Glisemik Kontrol ve Mikrovasküler Komplikasyonların Rolü

Abstract

Amaç: Karpal tünel sendromu (KTS) diabetes mellitusta (DM), özellikle de diyabetik polinöropatisi (DPN) olan bireylerde daha sık görülmektedir. Bu çalışmada, DPN'li hastalarda yüksek glikozile hemoglobin (HbA1c) düzeylerinin, diyabet süresinin ve DM'nin diğer mikrovasküler komplikasyonlarının KTS sıklığı ve şiddeti üzerindeki etkilerinin retrospektif olarak araştırılması amaçlanmıştır. Gereç ve yöntemler: 124 DPN hastası çalışmaya dahil edildi. Bu hastalarda; açlık kan şekeri (AKŞ) ve HbA1c düzeyleri, DM süresi, kullanılan antidiyabetik ilaçlar, eşlik eden hastalıklar ve diyabetin diğer komplikasyonları sorgulandı. Elektrofizyolojik inceleme sonuçlarına göre hastalar sadece DPN olanlar ve DPN + KTS olanlar olmak üzere 2 gruba ayrıldı. Bulgular: Diyabet komplikasyonları araştırıldığında, diyabetik nefropati sadece DPN + KTS olanlarda saptandı (p=0.045). Elektrofizyolojik olarak tüm hastalarda duyusal liflerde; 43 hastada (%34,7) ise motor liflerde tutulum eşlik etti. KTS şiddeti ile diyabet süresi, AKŞ ve HbA1c düzeyleri ve subkutan insülin kullanımı arasında pozitif korelasyon bulundu (sırasıyla p=0.018, p=0.014, p=0.003, p=0.029). Sonuç: İyi glisemik kontrol, diyabetin mikrovasküler komplikasyonları ile KTS gelişme riskini azaltabilir. Bu nedenle hastaların diyabetin komplikasyonları hakkında bilgi sahibi olarak el fonksiyonlarını korumaları ve KTS gelişimini önlemeleri önemlidir.

Keywords

• Karpal tünel sendromu
• Diyabetik polinöropati
• HbA1c
• Mikrovasküler komplikasyonlar
• Glisemik kontrol

Association of Diabetic Polyneuropathy and Carpal Tunnel Syndrome: Role of Glycemic Control and Microvascular Complications

Abstract

Introduction: Carpal tunnel syndrome (CTS) is more common in diabetes mellitus (DM), especially in individuals with diabetic polyneuropathy (DPN). This study aimed to retrospectively investigate the effects of elevated glycosylated hemoglobin (HbA1c) levels, duration of diabetes, and other microvascular complications of DM on the frequency and severity of CTS in patients with DPN. Material and methods: 124 DPN patients were included in the study. In these patients, fasting blood glucose (FBG) and HbA1c levels, duration of DM, antidiabetic drugs used, comorbidities, and other complications of diabetes were questioned. According to the results of the electrophysiological examination, the patients were divided into 2 groups: those with only DPN and those with DPN + CTS. Results: When diabetes complications were investigated, diabetic nephropathy was found only in those with DPN + CTS (p=0.045). Electrophysiologically, in sensory fibers in all patients, In 43 patients (34.7%), involvement of motor fibers was accompanied. A positive correlation was found between the severity of CTS and duration of diabetes, FBG and HbA1c levels, and subcutaneous insulin use (p=0.018, p=0.014, p=0.003, p=0.029, respectively). Conclusion: Good glycemic control can reduce the risk of developing CTS with microvascular complications of diabetes. Therefore, it is important for patients to protect their hand function and prevent the development of CTS by being informed about the complications of diabetes.

Keywords

• Carpal tunnel syndrome
• Diabetic polyneuropathy
• HbA1c
• Microvascular complications
• Glycemic control

Thanks

I would like to thank Prof. Dr. Zeliha Matur from Bezmiâlem Vakıf University Faculty of Medicine, Department of Neurology for her contribution to the statistical analysis and revision of the manuscript.

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