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61 [95% CI 0.41-0.92]). Metformin alleviated both annual expansion rate and aneurysm rupture frequency in AAA patients with T2DM. PROSPERO, identifier https//www.crd.york.ac.uk/PROSPERO/di....splay_record.php?Rec (CRD42020217859). PROSPERO, identifier https//www.crd.york.ac.uk/PROSPERO/di....splay_record.php?Rec (CRD42020217859). Gender affirming hormone therapy (GAHT), whilst considered the standard of care in clinical guidelines for the treatment of many transgender (trans) people is supported by low quality evidence.