Key result
Diabetes and antidiabetic drugs are linked to reduced AAA growth but worse postoperative surgical outcomes.
Why the study?
It remains unclear whether the inverse relationship between diabetes and abdominal aortic aneurysm is driven by hyperglycemia-related aortic stiffness, antidiabetic medications, or both.
Do diabetes and anti-diabetic medications protect against the development and expansion of abdominal aortic aneurysms, and how do they affect post-operative outcomes?
Do diabetes and anti-diabetic medications protect against the development and expansion of abdominal aortic aneurysms, and how do they affect post-operative outcomes?
While diabetes and anti-diabetic medications may slow the formation and expansion of abdominal aortic aneurysms, diabetes is associated with worse post-operative outcomes following AAA repair, and fluoroquinolone use should be avoided as it exacerbates AAA development.
May support tailored AAA surveillance in diabetes but heightened post-repair caution; leaves open causal medication effects.
Diabetes is a metabolic disease that may result in multiple microvascular and macrovascular diseases. Interestingly, many studies have demonstrated the inverse relationship between diabetes and the development and expansion of abdominal aortic aneurysm (AAA). One hypothesis is that the aortic wall stiffness resulting from hyperglycemia and advanced glycation end products could delay the development and growth of AAA. Other studies have proposed that the concurrent use of antidiabetic medications which promote anti-inflammatory cytokines while hindering pro-inflammatory cytokines may potentially be the reason for this protective effect of diabetes on AAA. Contrastingly, the presence of diabetes has been found to have a negative effect on the outcome of AAA following its repair which may be due to elevated blood glucose negatively affecting the healing process. The current literature has also demonstrated the negative impact of the use of fluoroquinolones on AAA. This comprehensive review critically reviewed and summarized the role of diabetes, anti-diabetes medications and fluoroquinolones on AAA, and on the effect of diabetes and certain anti-diabetes medications on outcomes following its repair.
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Shanmuganathan et al. (2024) conducted a review in Abdominal Aortic Aneurysm (AAA) and Diabetes. Diabetes and antidiabetic medications vs. No diabetes or untreated was evaluated. Diabetes and antidiabetic medications appear to have a protective effect against the development and growth of abdominal aortic aneurysms, though diabetes is associated with worse post-operative outcomes after surgical repair.
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