# Impact of Perioperative HbA1c Levels on Functional Outcomes Following Open Carpal Tunnel Release: A Prospective Study

## TL;DR

This study found that higher HbA1c levels in diabetic patients did not worsen outcomes after carpal tunnel surgery compared to non-diabetic patients.

## Contribution

The study is the first to prospectively evaluate the impact of HbA1c levels on functional outcomes after open carpal tunnel release.

## Key findings

- No significant differences in grip or pinch strength were observed between diabetic and non-diabetic patients pre- and postoperatively.
- Both groups showed similar improvements in pain, DASH, and Mayo Wrist Scores after surgery.
- HbA1c levels were not correlated with objective or subjective postoperative outcomes.

## Abstract

Purpose: The purpose of this prospective study was to evaluate the influence of perioperative glycemic control, as detected by glycosylated hemoglobin (HbA1c) levels, on clinical outcomes after open carpal tunnel release (CTR) surgery.

Methods: The demographic and clinical data of the study participants were prospectively collected prior to surgery and at one year postoperatively. Objective evaluations included grip and pinch strength, along with sensation testing over the index finger using Semmes-Weinstein monofilaments (SWMF). Subjective assessments, including pain intensity (measured by the visual analog scale (VAS)), the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and the Mayo Wrist Score, were also recorded.

Results: The study included 50 patients, comprising 27 with type 2 diabetes mellitus (mean HbA1c: 7.49 ± 1.42) and 23 without diabetes. HbA1c levels were measured up to one month prior to surgery. No statistically significant differences were found in grip strength, pinch strength, or Semmes-Weinstein monofilament (SWMF) values pre- and postoperatively in both diabetic and non-diabetic groups. Pain intensity decreased in both groups at 12 months postoperatively, but the degree of pain improvement was not statistically different between groups. Both groups showed postoperative improvement in DASH and Mayo Wrist Scores, with no significant difference in the level of improvement between the groups. Pearson analysis showed no correlation between objective and subjective measures pre- and postoperatively and HbA1c levels.

Conclusions: Elevation of perioperative HbA1c levels in diabetic patients did not negatively affect surgical outcomes compared to non-diabetic patients. Both groups demonstrated significant functional improvements, with no notable differences in recovery or postoperative hand function.