Glucagon-like Peptide-1 Receptor Agonist Therapy Is Associated With Fewer Medical Complications After Carpal Tunnel Release in Diabetic Patients.

Background: Diabetic patients experience carpal tunnel syndrome (CTS) at high rates, have increased symptom severity, and experience prolonged recovery after carpal tunnel release (CTR). This study assessed the association of glucagon-like peptide-1 receptor agonist (GLP-1) therapy with postoperative outcomes after CTR in type II diabetic patients with CTS.

Methods: Using the PearlDiver database, 25 229 diabetic patients with CTS who underwent CTR and were prescribed GLP-1 therapy were identified and exact matched to 25 229 controls based on age, sex, Elixhauser comorbidity index, tobacco use, obesity, hypothyroidism, and body mass index where available. Demographic variables and comorbidities were compared between groups using Kruskal-Wallis analyses for continuous variables and chi-square tests for categorical variables. Bivariate logistic regression analysis was conducted for 90-day outcomes and 2-year CTR revision.

Results: Patients on GLP-1 therapy had decreased risk of 90-day medical complications (odds ratio [OR] = 0.90; 95% confidence interval [CI], 0.84-0.96) and hospital readmission (OR = 0.85; 95% CI, 0.77-0.94) of 0.5% and 0.4%, respectively, compared with controls. No significant differences were found in 90-day surgical complications or 2-year revision rates between cohorts. There were no cases of aspiration pneumonia. The GLP-1 cohort had increased odds of higher 90-day total costs of care (OR = 2.42; 95% CI, 1.88-3.15).

Conclusions: GLP-1 therapy is associated with reduced risk of 90-day medical complications and hospital readmission following CTR in diabetic patients, suggesting these medications may optimize comorbidity profiles via glucose control preoperatively. Future studies may examine whether GLP-1 therapy is associated with minimum clinically important difference in patient-reported outcome measures for CTS in diabetic patients.