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17793

Comparison between the Effects of Insulin versus Corticosteroid Local Injections in Diabetic Patients with Carpal Tunnel Syndrome

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Last updated: 03 Jan 2025

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Abstract

Background: Carpal tunnel syndrome (CTS) is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. Carpal tunnel syndrome is the most commonly diagnosed and treated entrapment neuropathy and is a significant cause of morbidity. It is estimated to affect one out of ten people during their lifetime. Diabetic patients have a higher incidence with carpal tunnel syndrome. It has been reported that insulin improves the nerve regeneration and myelination through its role as neurotrophic factor.
Aim of the Work: was to compare the short-term effects of insulin and corticosteroid local injections in the treatment of diabetic patients with carpal tunnel syndrome.
Patients and Methods: Fifty diabetic patients with clinical and electrophysiological evidence of mild to moderate carpal tunnel syndrome were included in this study. All Patients had been sub-classified into two equal groups:- Group (1): Twenty five patients have received local insulin injection of 10 IU Neutral Protamine Hagedorn (NPH) {Insulinagypt N} into the affected carpal tunnel at the first visit and the same dose of insulin after 2 weeks. Group (2): twenty five patients have received a single dose of 40 mg triamcinolone acetonide {Epirelefan} local injection into the affected carpal tunnel. Nerve conduction study (NCS), Boston Carpal Tunnel Questionnaire (BCTQ) and clinical evaluation were carried out for both groups at baseline and four weeks after second dose of insulin injection and one month after steroid injection.
Results: In steroid group, significant improvement in nerve conduction study as regard distal sensory latency and sensory conduction velocity without significant improvement in distal motor latency and motor conduction velocity and significant improvement in (BCTQ). In insulin group, a more significant improvement in all parameters of nerve conduction study and also in (BCTQ) was observed with insulin injection than steroid done. Also, there were significant differences between results of both groups for insulin injection group.
Conclusion: Local insulin injection is an effective treatment for restoring median nerve function in diabetic patients with mild to moderate carpal tunnel syndrome and produce significant improvement in NCS and BCTQ.

DOI

10.21608/ejhm.2018.17793

Keywords

Carpal tunnel syndrome, diabetes, Insulin, Steroid, local injection

Authors

First Name

Ahmed Ismail Ali

Last Name

Shalaby

MiddleName

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Affiliation

Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Al- Azhar University, Cairo, Egypt

Email

dr.ahmedismail.rheumatologist@gmail.com

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Orcid

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First Name

Kalthom Mohamed

Last Name

Abd El Hamid

MiddleName

-

Affiliation

Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Al- Azhar University, Cairo, Egypt

Email

-

City

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Orcid

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First Name

Ibrahim Abd Alsamie

Last Name

Emam

MiddleName

-

Affiliation

Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Al- Azhar University, Cairo, Egypt

Email

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City

-

Orcid

-

First Name

Adel Ibrahim

Last Name

Azzam

MiddleName

-

Affiliation

Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Al- Azhar University, Cairo, Egypt

Email

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City

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Orcid

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First Name

Mohamed Ahmed

Last Name

Zaki

MiddleName

-

Affiliation

Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

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-

City

-

Orcid

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Volume

73

Article Issue

8

Related Issue

3731

Issue Date

2018-10-01

Receive Date

2018-10-28

Publish Date

2018-10-01

Page Start

7,211

Page End

7,219

Print ISSN

1687-2002

Online ISSN

2090-7125

Article File

EJHM_Volume 73_Issue 8_Pages 7211-7219.pdf

PDF . 362.0kB

Link

https://ejhm.journals.ekb.eg/article_17793.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=17793

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3

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Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Comparison between the Effects of Insulin versus Corticosteroid Local Injections in Diabetic Patients with Carpal Tunnel Syndrome

Details

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Article

Created At

22 Jan 2023