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An aortic abdominal aneurysm (AAA) is a potentially lethal disease. In a population with one or multiple cardiovascular risk factors, its prevalence is estimated at 1.6% (aneurysm size >3 cm) and 0.5% (aneurysm size >4 cm), with a higher occurrence in male vs. female patients. In the presence of type II diabetes, the prevalence of all cardiovascular disease (including carotid stenosis, AAA, and peripheral artery disease) is doubled.1 The Veterans Affairs Cooperative Study Investigators study showed a higher prevalence of AAA in their screened population. In addition, a negative association was found between AAA and the presence of diabetes (with no difference in male vs. female).2 Despite the fact that AAA is an expression of atherosclerotic disease (with a large amount of pro-inflammation), the prevalence of AAA in diabetic patients is less than expected. In other words, AAA in diabetes is a non-frequent macrovascular complication related to atherosclerotic disease. Such a conclusion appears quite remarkable; premature macrovascular disease in other vascular beds (e.g. presence of microalbuminuria and increased intima-media thickness of the carotid artery) is already present in an early (pre-) diabetic stage.

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