Evidence map›Paper›PMID 31209710›Full record

Trial reportClinical rheumatology2019

Ultrasound-guided insulin injection for carpal tunnel syndrome in type 2 diabetes mellitus patients.

Shereen Refaat Kamel, Hanaa A Sadek, Ahmed Hamed, Omima A Sayed, Mona H Mahmud, Fatma A Mohamed, Ghada M El Sagher, Lamia H Aly

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical rheumatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04142411 early_phase1unknown statusnot on this map

Combined Effect of Insulin and Sodium Hyaluronate Injection Guided by Ultrasound in Carpal Tunnel Syndrome

TypeinterventionalSponsorAssiut UniversityRan2019 to 2020Enrolled90ConditionsCarpal Tunnel SyndromeArmsInsulin, Sodium Hyaluronate, Ultrasound
NCT05496764 phase4unknown statusnot on this mapstarted 2021, after this paper: background citation

The Therapeutic Effect and Quality of Life After Local Injection of Steroid VS. Glucose 5% for Carpal Tunnel Syndrome : Double-blinded Clinical Trial

TypeinterventionalSponsorAssiut UniversityRan2021 to 2023Enrolled52ConditionsCarpal Tunnel SyndromeArmsDexamethasone, Glucose Injection
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Shereen Refaat KamelRheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt. shereen.refaat@mu.edu.eg.ORCID http://orcid.org/0000-0001-9896-9028
Hanaa A SadekRheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt.
Ahmed HamedRheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt.
Omima A SayedRheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt.
Mona H MahmudRheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt.
Fatma A MohamedRheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt.
Ghada M El SagherInternal Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt.
Lamia H AlyClinical Pathology Department, Faculty of Medicine, Minia University, Minia, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare effectiveness of ultrasound-guided local insulin injection, local steroid injection, and local steroid followed by insulin injections in treating mild to moderate carpal tunnel syndrome (CTS) in type 2 diabetes mellitus (DM).

methodStudy included 60 patients with electrophysiologic evidence of mild to moderate CTS. They were randomly divided into three groups: group I received insulin injection locally into the affected carpal tunnel at first visit and a similar dose after 2 weeks; group II received single injection of 40 mg methylprednisolone acetate injection; and group III received steroid injection then followed by insulin injection twice after 2 and 4 weeks. All injections were performed with ultrasonographic guidance. All patients were assessed by modified Boston Carpal Tunnel Questionnaire (FD score), CTS severity score (SS score), and neurophysiological and ultrasonographic assessments at baseline and 10 weeks after treatment.

resultsA significant improvement in mean FD score, SS score, DML (distal motor latency), SNCV (sensory nerve conduction velocity), PSL (peak sensory latency), Samp (sensory amplitude), and CSA (cross-sectional area of median nerve) observed in all groups (with exception of mean DML and Samp in the second group and mean Samp in the third group). Group III showed significant improvement in CSA especially when compared to group II by post hoc analysis (P = 0.005).

conclusionsLocal insulin injection is as effective as steroid in treating mild to moderate CTS in type 2 DM and is a safer alternative. Adding insulin injections after steroid shows more sonographic improvement than steroid alone. Key Points • Local insulin injection is as effective as steroid in treating mild to moderate CTS in type 2 diabetic patients. • Measuring CSA of median nerve at CT inlet by US is a better tool for monitoring median nerve changes after treatment. • Adding insulin injections after steroid has more sonographic improvement than steroid alone.

Indexed as

UltrasonographyAdolescentAdultAgedCarpal Tunnel SyndromeDiabetes Mellitus, Type 2ElectrophysiologyFemaleHumansInsulinMaleMedian NerveMethylprednisolone AcetateMiddle AgedNeural ConductionSeverity of Illness IndexInsulinMethylprednisolone AcetateSteroidsCarpal tunnel syndromeLocal insulin injectionType 2 diabetes mellitusUltrasound guided

Identifiers

PMID31209710

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.