Virginia Via Research Day Book 2026

Medical Student Research Clinical

25 INCIDENCE OF CARPAL TUNNEL SYNDROME IN TYPE II DIABETICS TAKING GLP-1 RECEPTOR AGONISTS COMPARED TO OTHER STANDARDS OF CARE

Micah Jones, DO; Ramu Anandakrishnan, PhD; Michael DeGrassi, MA OMS-II; Nicolas Kress. MS OMS-II; Patryck Penar, MS, OMS-II Corresponding author: mdegrassi@vcom.edu

LewisGale Medical Center, Salem, Virginia VCOM-Virginia, Blacksburg, Virginia

inhibitors. The second cohort will include individuals who were diagnosed with Type II diabetes mellitus and that were taking glucagon-like peptide-1 (GLP 1) analogues. Both cohorts will exclude individuals who were diagnosed with rheumatoid arthritis hypothyroidism, acromegaly, if they were pregnant at the time of diagnosis, if they had preexisting carpal tunnel syndrome, or if they had undergone bariatric surgery. We will be using R-studio to perform a cox proportional hazards regression to estimate hazard ratios and confidence intervals between the two cohorts. Results: Our analysis revealed a statistically significant difference between the incidence of CTS when GLP-1 receptor agonists were initiated for treatment of T2DM compared to when other standards of care were initiated for the treatment of T2DM. Overall, TZDs demonstrated the lowest hazard ratio (0.67) compared with other therapies. In contrast, sulfonylureas, SGLT-2 inhibitors, and DPP-4 inhibitors showed modestly higher hazard ratios that were similar in magnitude (0.74, 0.72, and 0.74, respectively).

Conclusion: This finding may present CTS as an unrecognized adverse effect associated with GLP-1 receptor agonists. However, statistical significance does not always correlate with clinical significance and would require future research studies to support this conclusion. Acknowledgements: We gratefully acknowledge All of Us participants for their contributions, without whom this research would not have been possible. We also thank the National Institutes of Health’s All of Us Research Program for making available the participant data examined in this study. VCOM IRB Exemption Record # 2405742-1

Context: Carpal tunnel syndrome is a common musculoskeletal condition affecting many individuals in the United States. Several factors increase its incidence, including diabetes, obesity, hypothyroidism, rheumatoid arthritis, and metabolic syndrome. GLP-1 receptor agonists are a relatively new class of medications used to treat type II diabetes mellitus and are rapidly becoming part of the standard of care. Objective: The primary objective of this study is to determine whether GLP-1 receptor agonists decrease the incidence of carpal tunnel syndrome in type II diabetics when compared to other treatments, including sulfonylureas, thiazolidinediones, DPP-4 inhibitors, or SGLT2 inhibitors Methods: We will be using the NIH All of Us database to analyze two cohorts. The first cohort will include individuals that were diagnosed with Type II diabetes mellitus and who were taking sulfonylureas, thiazolidinediones, dipeptidyl peptidase 4 (DPP-4) inhibitors, or sodium-glucose co-transporter 2 (SGLT-2)

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196 Edward Via College of Osteopathic Medicine (VCOM)