Aspirin use in diabetes

Since the 1970s aspirin has been used to help prevent major cardiac events in patients at risk. Up until recently that recommendation was also made to patients diagnosed with diabetes. It simply made sense to advise these patients who were at risk of developing heart disease to take a low dose aspirin as a preventive measure. That advice held up until recent research showed some fallacies in this reasoning.

Why is aspiring recommended?

Among diabetics, there is a two to four-fold increase in the risk of them developing heart disease. This is equally true among both men and women. As a result, doctors advised their patients to take a low dose aspirin as a preventive measure.  The idea is that aspirin appeared to prevent red blood cells from clumping together to create blood clots, which tends to happen to diabetics. Sounds reasonable, right?

In recent studies, however, they found that many patients who have not had a previous heart event nor have other mitigating health factors may develop gastrointestinal bleeding or they developed peptic ulcers that might otherwise not have occurred had they not taken low dose aspirin in the first place. As a result of those studies, recommended dose protocols have been changed.

New recommendations for aspirin in diabetes

If the diabetic presents with other factors that also may lead to cardiovascular disease such as being a female older than 60 or a male older than 50 who has other factors that are true for them such as:

  • Past or present smoker
  • Family history of heart disease
  • Previous heart event

Not Safe for everyone, but good for some folks

Those people who are allergic to aspirin, have a tendency to bleed, including any recent G.I. bleeding, active liver disease, or under the age of 21 should not take aspirin, especially without consulting a doctor.

Also, it is not recommended for adult women over 60 or men over 50. Adults who have none of the pre-existing health factors listed above are not advised to use low-aspirin therapy. If a patient takes non-steroidal anti-inflammatories, it is also advised they not participate in aspirin therapy.

When is it safe to use aspirin to prevent a cardio event?

Diabetics who have had a previous heart attack or event should take aspirin as a preventative measure to avoid another attack in the future. The recommended dose of each pill is 75-162 mg. Most OTC low dose aspirin is 81 mg in bottles marked “baby aspirin.”  The best form to take to prevent stomach ailments is the enteric coated pills that prevent the pills from dissolving until they have passed through the digestive tract and then safely absorb in the intestine which will reduce the chance of adverse side-effects.

Before starting a regimen that includes a low-dose of aspirin discuss with your doctor your health history and risk-factors. If you have no allergy to aspirin and you meet the ADA guidelines for this therapy, you and your doctor may decide it is a good part of your health plan.

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