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Aspirin therapy

Aspirin therapy
Association Recommends Widespread Use


Shauna S. Roberts, PhD, is a science and medical writer in New Orleans. Published in Diabetes Forecast, October 2003.

"Aspirin Therapy In Diabetes" explains ADA's position on aspirin use for people with diabetes. It addresses who should be taking it, and why.

Recommendations

Many men and women with diabetes should be on aspirin therapy, including those who
Already have disease of the large blood vessels. (This category includes people who have had a heart attack, a bypass operation, a stroke or ministroke ["transient ischemic attack," in which temporary weakness or numbness in the face, arm, or leg or other symptoms suggest that a tiny stroke may have occurred], peripheral vascular disease [narrowed arteries in the legs], claudication [pain in the legs that occurs with exercise and goes away with rest], or angina [chestpain caused by impaired blood flow to the heart].)
Have a family history of heart disease
Smoke cigarettes
Have high blood pressure (higher than 130/80 mmHg)
Are obese (for women, this means a body mass index greater than 27,3; for men, this means a body mass index greater than 27,8; to calculate your body mass index, multiply your weight in pounds by 703, divide by your height in inches, and divide again by your height in inches)
Have protein in their urine
Have total cholesterol level higher than 200 mg/dl
Have an LDL ("bad") cholesterol level of 100 mg/dl or higher
Have an HDL ("good") cholesterol level than 55 mg/dl (women) or 45 mg/dl (men)
Have a triglyceride level higher than 200 mg/dl
Are more than 30 years old

It's not necessary to take high doses of aspirin. In fact, low doses help the heart just as much as high doses do, but with far fewer side effects. ADA recommends taking 81 to 325 mg of enteric-coated aspirin (which may be gentler on the stomach) every day


Background

Men and women who have diabetes have a much higher risk of dying from heart and blood vessel disease than other people do. Many studies (including some with people who have diabetes) have found that low-dose aspirin lowers the risk of a second stroke or heart attack. It also lowers the risk of heart attack in people who have angina. Studies suggest that aspirin can also prevent heart disease from developing in people who are at high risk. So aspirin is a simple andcheap way of lowering your risk of heart disease.
Unfortunately, aspirin does not get rid of your risk of heart disease altogether. Other heart healthy habits are still important. These include keeping your blood sugar level and blood pressure under control, being physically active, not smoking, eating a diet low in saturated fats, and keeping your weight within a healthy range.

Special Considerations

Even though you can by aspirin over the counter, it is a powerful drug that must be used with care. ADA recommends that certain people not be put on aspirin therapy. These include people who
Are allergic to aspirin
Have a tendency to bleed
Take a blood thinner (for example, heparin or warfarin [Coumadin])
Are less than 21 years old, because of the risk of Reye's syndrome (a dangerous childhood illness that sometimes occurs after a virus and is more common when the child has taken aspirin)

Because aspirin therapy has not been studied in people with diabetes who are under 30, it is uncertain whether it would provide any benefit to them.







Aspirin therapy for every diabetic person?

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