title: Health-related quality of life 5 years after carpal tunnel release among patients with diabetes: a prospective study with matched controls.
abstract: BACKGROUND
  Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy encountered in diabetes. The short-term improvement after carpal tunnel release has previously been demonstrated not to differ between patients with and without diabetes, despite a marked impairment in health-related quality of life (HRQL) among the former. In this study, we compare HRQL 5 years after carpal tunnel release between these two groups of patients.
  
  
  METHODS
  In a prospective series, 35 patients with diabetes and CTS were matched with 31 control patients with idiopathic CTS but no diabetes. At the 5-year follow-up patients completed the Medical Outcomes Short-Form 36 (SF-36) and Antonovsky's sense of coherence (SOC) questionnaire. Differences in changes over time were compared between patients with and without diabetes using mixed model analysis.
  
  
  RESULTS
  Although patients with diabetes reported a significant decrease in physical functioning (p =0.004) as compared to patients without diabetes, postoperative improvement was maintained in the physical domains, role physical and bodily pain. A more pronounced decline in the mental health domain, social function (p =0.03), was demonstrated among patients with diabetes. There was no evidence of any difference in SOC between the patient groups.
  
  
  CONCLUSIONS
  Patients with diabetes retained their improvement in physical domains sensitive to changes after carpal tunnel release in the long-term, despite a decline in other domains of both physical and mental HRQL. This differed from patients without diabetes. Differences in SOC could not explain the sharper decline in these domains among patients with diabetes.
authors.affiliation: Department of Clinical Sciences Malmö - Hand Surgery, Lund University and Skåne University Hospital, Malmö, Sweden. niels.thomsen@med.lu.se.
authors.forename: Niels O B
authors.initials: NO
authors.lastname: Thomsen
authors.forename: Jonas
authors.initials: J
authors.lastname: Björk
authors.forename: Ragnhild I
authors.initials: RI
authors.lastname: Cederlund
mesh_terms: D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D019299:Decompression, Surgical; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D009416:Nerve Regeneration; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D060685:Sense of Coherence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human