Diabetes Mellitus and Aortic Aneurysm Rupture

Abstract

Diabetic patients with aortic aneurysms are significantly less likely to present with rupture or to die from aneurysm rupture when compared to nondiabetic patients with aortic aneurysms. We have identified association only, not causality. However, it is plausible that DM, or the treatment of DM, may have a protective effect on aortic aneurysm rupture.

Negative association of diabetes with rupture of abdominal aortic aneurysm

“…In total, our meta-analysis included 11 studies. [6][7][8][11][12][13][14][15][16][17][18] Study design (Table 1), patient characteristics (Table 1; online Appendices 1 and 2), diabetes prevalence, rupture incidence and relative risk of rupture are summarized in Table 2. In a case-control study by Buijs et al, 11 non-ruptured symptomatic AAA and ruptured AAA were combined and labelled as non-elective AAA.…”

“…In the rupture group of another case-control study by Fillinger et al, 13 emergency AAA repair was performed because of rupture or acute severe pain. As a primary meta-analysis, thus, we combined the remaining nine studies [6][7][8]12,[14][15][16][17][18] reporting data on ruptured (not including non-ruptured symptomatic) AAA. Additionally, all of the 11 studies were combined as a secondary meta-analysis.…”

“…[6][7][8][11][12][13]16 Two 8,16 of these seven studies provided significantly lower diabetes prevalence in AAA rupture (i.e. significantly lower AAA-rupture prevalence in diabetes), which was sequentially eliminated in sensitivity analyses to assess their impact on the pooled effect estimate.…”

“…Of 100 potentially relevant articles screened initially, nine eligible studies 8,[11][12][13][14][15][16][17][18] were identified. Furthermore, two relevant studies 6,7 were added through a manual search.…”

“…The RESCAN individual patient data meta-analysis 5 of only two studies 6,7 including a total of 3153 patients with small AAA, however, revealed no association between diabetes and rupture. Whereas, a recent large (including 188 patients with ruptured and 1482 patients with non-ruptured AAA) retrospective study by Theivacumar et al 8 suggests that diabetes patients with AAA are significantly less likely to present with rupture or to die from aneurysm rupture when compared to non-diabetes patients with AAA. It is still debated whether diabetes is negatively associated with AAA rupture.…”