Does Diabetes Slow the Progression of Abdominal Aortic Aneurysms?
People with diabetes have a reduced risk of developing an abdominal aortic aneurysm, a progressive and potentially fatal dilation of the body’s main artery. This unexpected relationship has been observed in more than thirty studies worldwide. Diabetic patients not only see their risk of aneurysm formation decrease by 20 to 40%, but the growth of the aneurysm also slows by 0.3 to 0.8 millimeters per year. Their risk of rupture, which is often fatal, is also lower than that of non-diabetics.
This protection appears to be linked to specific biological changes. Diabetes causes sugar accumulation in the arterial walls, increasing their stiffness and limiting dilation. Additionally, blood clots present in the aneurysm are more stable in diabetics, thereby reducing the degradation of the arterial wall. Finally, inflammation and tissue destruction by enzymes are less intense, contributing to slower disease progression.
Among diabetes treatments, metformin has attracted particular interest. This widely used medication acts far beyond simple blood sugar regulation. It reduces vascular inflammation, limits oxidative stress, and protects the structure of the arterial wall. Animal studies have shown that metformin decreases the formation and growth of aneurysms, with encouraging results in preserving arterial elasticity. In humans, patients on metformin have smaller aneurysms and slower progression.
Other diabetes medications, such as SGLT2 inhibitors and GLP-1 receptor agonists, also show protective effects in animal models. They reduce inflammation and improve the stability of the arterial wall, but their effectiveness in humans remains to be confirmed by clinical studies.
These findings open a new avenue for aneurysm treatment. If ongoing trials confirm these results, drugs like metformin could become a therapeutic complement to slow disease progression, especially in patients ineligible for surgery. This would represent a major advance, transforming a disease often managed by surgery into a condition that can be stabilized with drug treatments.
Bibliographie
Source de l’étude
DOI : https://doi.org/10.1186/s40842-026-00275-7
Titre : Metformin and beyond: glucose-lowering therapy as a potential modulator of abdominal aortic aneurysm growth and stability- systematic review with narrative synthesis
Revue : Cardiovascular Diabetology – Endocrinology Reports
Éditeur : Springer Science and Business Media LLC
Auteurs : Margaret Plamenova Dimova; Bistra Petrova Boneva; Boris Nikolaev Ilchev; Yanislava Ivo Karusheva
Source de l’image
Photograph from Pixabay, usable commercially in specialized scientific publications.