Clinics in Shoulder and Elbow(2014). 2025 Dec; 28(4): 8508910. doi: 10.5397/cise.2025.00801
Characteristics and outcomes of cubital tunnel decompression in diabetic patients receiving glucagon-like peptide-1 receptor agonists
Roban Shabbir , Simran Shamith , Paulo E. L. Parente , Luke Nicholson , Azad Ali
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Abstract
Background : Cubital tunnel release (CuTR) relieves ulnar nerve compression; however, about 35% of patients who undergo this procedure develop persistent neuropathy and about 7% require revision. Type 2 diabetes mellitus (T2DM) worsens ulnar neuropathy, whereas glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may be neuroprotective. We compared short- (90-day) and mid-term (2-year) CuTR outcomes in diabetic patients who did or did not receive perioperative GLP-1 RA treatment.
Methods : TriNetX identified adults (≥18 years) with T2DM who underwent primary CuTR during the period 2015–2023, and who underwent at least 2 years of follow-up. The experimental cohort had received an active GLP-1 RA prescription at surgery, while the controls had not. Exclusion criteria were T1DM, pancreatitis, multiple endocrine neoplasia 2, systemic steroids, end-stage renal disease, or prior major CuTR. Propensity-score matching (1:1) balanced demographics, body mass index, glycated hemoglobin (HbA1c), creatinine, and comorbidities. Outcomes were captured using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) and Current Procedural Terminology (CPT) codes.
Results : After matching, 1,766 pairs of patients (mean age, 58 years; 46% female) were analyzed. At 90 days, fewer GLP-1 RA users had emergency-department visits than non-users (8.9% vs. 10.7%, P=0.048). Despite higher HbA1c at each timepoint, GLP-1 RA users showed a larger decline. At 2 years, GLP-1 RA exposure was associated with fewer reoperations (5.2% vs. 6.9%, P=0.028), less frequent neuropathy (23.4% vs. 30.4%, P<0.001), and fewer inpatient admissions (14.6% vs. 17.2%, P=0.030). Major medical complications did not differ in occurrence between the groups.
Conclusions : Perioperative GLP-1 RA therapy in diabetic patients undergoing CuTR correlated with fewer 90-day emergency visits and lower 2-year risks of revisional surgery and ICD-coded ulnar neuropathy (all-cause, non-adjudicated).. These findings support a potential protective role of GLP-1 RAs in this surgical population. -
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References
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1. Wade RG, Griffiths TT, Flather R, Burr NE, Teo M, Bourke G. Safety and outcomes of different surgical techniques for cubital tunnel decompression: a systematic review and network meta-analysis. JAMA Netw Open 2020;3:e2024352
2. Schulte S, Vitale M. Cubital tunnel syndrome [Internet]. Orthobullets; 2025 [cited 2025 Jul 2]. Available from: https://www.orthobullets.com/hand/6021/cubital-tunnel-syndrome.
3. Caliandro P, La Torre G, Padua R, Giannini F, Padua L. Treatment for ulnar neuropathy at the elbow. Cochrane Database Syst Rev 2016;11:CD006839.
4. Staples JR, Calfee R. Cubital tunnel syndrome: current concepts. J Am Acad Orthop Surg 2017;25:e215-24.
5. Smit JA, Hu Y, Brohet RM, van Rijssen AL. Identifying risk factors for recurrence after cubital tunnel release. J Hand Surg Am 2023;48:514.e1-8.
6. Knoedler TG, Gaertner AP, Wilkinson PJ, Salvapongse AN. Incidence, prevalence, and outcomes of hand manifestations in patients with diabetes mellitus: a comprehensive literature review. Hand (N Y) 2025;20:163-9.
7. Jang JE, Kim YT, Park BK, Cheong IY, Kim DH. Subclinical ulnar neuropathy at the elbow in diabetic patients. Ann Rehabil Med 2014;38:64-71.
8. Stirling PHC, Harrison SJ, McEachan JE. The effect of diabetes mellitus on the outcome of surgery for cubital tunnel syndrome. J Hand Surg Eur Vol 2023;48:316-20.
9. Vilsbøll T, Christensen M, Junker AE, Knop FK, Gluud LL. Effects of glucagon-like peptide-1 receptor agonists on weight loss: systematic review and meta-analyses of randomised controlled trials. BMJ 2012;344:d7771.