Aspirin is known to decrease the risk of heart attacks and strokes. For most people with diabetes, it's probably a good idea to take one every day.
One aspirin a day, whether a standard inexpensive tablet, or a coated or buffered version, or even a "baby aspirin," has been shown to decrease the risk of heart attacks and strokes. Since people with diabetes are at increased risk of these devastating problems, it seems reasonable that most people with diabetes take an aspirin tablet daily.
When to start?
There are now studies showing the effectiveness of using aspirin in people with diabetes, but it's still a guess as to whether to wait till trouble shows up to start aspirin, or to start earlier. It's certainly reasonable to start it when there's evidence of blood vessel disease, either extra noises in the blood vessels (called bruits) heard through the doctor's stethoscope, or other evidence of vascular damage. But aspirin is generally a safe drug, and perhaps we should consider recommending it for every adult with diabetes. The American Diabetes Association has given its criteria for starting it (see below).When to avoid using aspirin?
There are several circumstances where it's obvious that it would be would be wiser to avoid taking aspirin:- Bleeding disorders, including bleeding ulcers, and bleeding in the retinal area of the eyes.
- Use of other drugs that interfere with clotting, such as Coumadin, heparin, and Ticlid.
- Active stomach or duodenal ulcer disease
- Allergy to aspirin, or severe gastrointestinal distress from aspirin
Other comments
- Taking aspirin will probably make it a bit easier for you to get blood from your fingertip for blood sugar monitoring.
- You may have more bruises at the sites of injection of your insulin shots
- Be sure to check with your doctor before starting aspirin therapy
American Diabetes Association POSITION STATEMENT:
Aspirin Therapy in Diabetes
- Use aspirin therapy (75–162 mg/day) as a secondary prevention strategy in diabetic men and women with a history of myocardial infarction, vascular bypass procedure, stroke or transient ischemic attack, peripheral vascular disease, claudication, and/or angina.
- Use aspirin therapy therapy (75–162 mg/day) as a primary prevention strategy in men and women with type 2 diabetes at increased cardiovascular risk, including those over 40 years of age or who have additional risk factors (family history of CVD, hypertension, smoking, dyslipidemia, albuminuria).
- Use aspirin therapy as a primary prevention strategy in men and women with type 1 diabetes at increased cardiovascular risk, including those over 40 years of age or who have additional risk factors (family history of CVD, hypertension, smoking, dyslipidemia, albuminuria).
- People with aspirin allergy, bleeding tendency, anticoagulant therapy, recent gastrointestinal bleeding, and clinically active hepatic disease are not candidates for aspirin therapy. Other antiplatelet agents may be a reasonable alternative for patients with high risk.
- Aspirin therapy should not be recommended for patients under the age of 21 years because of the increased risk of Reye’s syndrome associated with aspirin use in this population. People under the age of 30 have generally not been studied.
Also see
Aspirin for the primary prevention of cardiovascular events: recommendations and rationale.
Aspirin Therapy in Diabetes "Meta-analyses of these studies and large-scale collaborative trials in men and women with diabetes support the view that low-dose aspirin therapy should be prescribed as a secondary prevention strategy, if no contraindications exist. Substantial evidence suggests that low-dose aspirin therapy should also be used as a primary prevention strategy in men and women with diabetes who are at high risk for cardiovascular events." From the Clinical Practice Recommendations of the American Diabetes Association
Aspirin use among adults with diabetes: estimates from the Third National Health and Nutrition Examination Survey. Diabetes Care, 2001 Feb;24(2):197-201, Rolka DB, Fagot-Campagna A, Narayan KM. Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomised trial in general practice. Lancet, 2001 Jan 13;357(9250):89-95, Collaborative Group of the Primary Prevention Project.
Management of type 2 diabetes mellitus and cardiovascular risk: lessons from intervention trials. Drugs, 2000 Nov;60(5):975-83, Yki-Jarvinen H. Department of Medicine, University of Helsinki, Finland.
Taking aspirin to lower your risk of heart attack
