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Diabetes and the risk of entrapment neuropathies of the upper and lower extremity - A propensity score-matched cohort study

Rydberg, Mattias LU orcid ; Lakhlani, Devi ; Sutjiadi, Brian Jonathan ; Fox, Paige M. and Curtin, Catherine (2026) In Journal of Diabetes and its Complications 40(8). p.1-7
Abstract
Aims
To evaluate the association between diabetes and four peripheral nerve entrapment syndromes: carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), radial nerve entrapment (RNE), and tarsal tunnel syndrome (TTS).
Methods
This retrospective cohort study used the Merative™ MarketScan® Commercial Database (2007–2023). Adults ≥18 years were classified as having diabetes or serving as controls. Incident-only cohorts excluded individuals with prior diagnoses during a washout period. Propensity score matching (1:1, sex-stratified) reduced confounding, and Cox proportional hazards regression estimated time to incident diagnosis.
Results
After matching, cohort sizes ranged from 6.5 to 6.8 million individuals. Diabetes... (More)
Aims
To evaluate the association between diabetes and four peripheral nerve entrapment syndromes: carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), radial nerve entrapment (RNE), and tarsal tunnel syndrome (TTS).
Methods
This retrospective cohort study used the Merative™ MarketScan® Commercial Database (2007–2023). Adults ≥18 years were classified as having diabetes or serving as controls. Incident-only cohorts excluded individuals with prior diagnoses during a washout period. Propensity score matching (1:1, sex-stratified) reduced confounding, and Cox proportional hazards regression estimated time to incident diagnosis.
Results
After matching, cohort sizes ranged from 6.5 to 6.8 million individuals. Diabetes was significantly associated with increased risk of all four entrapment neuropathies: CTS (HR 1.35; 95% CI 1.34–1.37), UNE (HR 1.23; 95% CI 1.21–1.24), TTS (HR 1.28; 95% CI 1.24–1.32), and RNE (HR 1.11; 95% CI 1.05–1.17; all P < 0.001). The strongest associations were observed in adults younger than 40 years with CTS (HR 1.68; 95% CI 1.63–1.73) and TTS (HR 1.56; 95% CI 1.42–1.72).
Conclusions
Diabetes is associated with increased risk across multiple anatomically distinct nerve entrapments, supporting generalized nerve vulnerability. Younger adults with diabetes may represent a high-risk subgroup warranting enhanced clinical surveillance. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Diabetes and its Complications
volume
40
issue
8
article number
109364
pages
1 - 7
publisher
Elsevier
ISSN
1873-460X
DOI
10.1016/j.jdiacomp.2026.109364
language
English
LU publication?
yes
id
5c110744-87a6-4495-bb16-a6f7bedaec1f
date added to LUP
2026-07-01 17:37:20
date last changed
2026-07-02 07:54:37
@article{5c110744-87a6-4495-bb16-a6f7bedaec1f,
  abstract     = {{Aims<br/>To evaluate the association between diabetes and four peripheral nerve entrapment syndromes: carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), radial nerve entrapment (RNE), and tarsal tunnel syndrome (TTS).<br/>Methods<br/>This retrospective cohort study used the Merative™ MarketScan® Commercial Database (2007–2023). Adults ≥18 years were classified as having diabetes or serving as controls. Incident-only cohorts excluded individuals with prior diagnoses during a washout period. Propensity score matching (1:1, sex-stratified) reduced confounding, and Cox proportional hazards regression estimated time to incident diagnosis.<br/>Results<br/>After matching, cohort sizes ranged from 6.5 to 6.8 million individuals. Diabetes was significantly associated with increased risk of all four entrapment neuropathies: CTS (HR 1.35; 95% CI 1.34–1.37), UNE (HR 1.23; 95% CI 1.21–1.24), TTS (HR 1.28; 95% CI 1.24–1.32), and RNE (HR 1.11; 95% CI 1.05–1.17; all P &lt; 0.001). The strongest associations were observed in adults younger than 40 years with CTS (HR 1.68; 95% CI 1.63–1.73) and TTS (HR 1.56; 95% CI 1.42–1.72).<br/>Conclusions<br/>Diabetes is associated with increased risk across multiple anatomically distinct nerve entrapments, supporting generalized nerve vulnerability. Younger adults with diabetes may represent a high-risk subgroup warranting enhanced clinical surveillance.}},
  author       = {{Rydberg, Mattias and Lakhlani, Devi and Sutjiadi, Brian Jonathan and Fox, Paige M. and Curtin, Catherine}},
  issn         = {{1873-460X}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{8}},
  pages        = {{1--7}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Diabetes and its Complications}},
  title        = {{Diabetes and the risk of entrapment neuropathies of the upper and lower extremity - A propensity score-matched cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.jdiacomp.2026.109364}},
  doi          = {{10.1016/j.jdiacomp.2026.109364}},
  volume       = {{40}},
  year         = {{2026}},
}