IGF1 and diabetes mellitus: In the literature reported risk factors for aneurysms pathogenesis in acromegaly include pituitary surgery, local radiotherapy, poor disease control, pituitary adenoma per se, vascular infiltration of adenoma, hypertension, diabetes, dyslipidemia, vascular effects of GH and IGF-1, such as proliferation of smooth muscle and endothelial disfunction, atherosclerosis, and altered turnover of collagen components (42, 161–164).