- Diabetes is not protective against ruptured (R) abdominal aortic aneurysm (AAA).
- Diabetes is also not linked to increased 30-day mortality post-RAAA.
Why this matters
- Previous studies have shown a paradoxical protective effect of diabetes on AAA development and progression, but its effect on RAAA and post-RAAA mortality was not known.
- Register-based case-control study of 5395 patients age ≥50 years with RAAA.
- Patients were matched 1:1 for age, sex, and diabetes diagnosis year with those undergoing elective AAA repair.
- 6.7% with RAAA and 8.0% undergoing repair had diabetes.
- Funding: University of Southern Denmark; Danish Diabetes Academy funded by The Novo Nordisk Foundation; Odense University Hospital.
- With a large AAA, RAAA and diabetes were inversely associated:
- Crude OR: 0.82 (95% CI, 0.71-0.95).
- Association was lost after adjustment: aOR, 0.97 (95% CI, 0.83-1.14).
- Of the 3079 (57.1%) who underwent surgery, 94% received outright repair and 6% exploratory laparotomy.
- Overall 30-day mortality:
- 58% among those with RAAA.
- 34.8% in repair group.
- For diabetes vs no diabetes, for 30-day mortality:
- Crude HR: 1.06 (95% CI, 0.93-1.22).
- After adjustment for index year, male sex, and age: HR, 1.11 (95% CI, 0.97-1.28).
- Matching not possible for all cases.
- Possible misclassification.