Is Aspirin Therapy Necessary in Diabetics?

• What is Low-dose Aspirin therapy?

For most people, this is taking a baby aspirin (81mg) on a daily basis. Some doctors have their patients on a full aspirin (325mg), but this seems to be declining these days. It doesn’t matter if the tablet is a chewable, regular, or an enteric coated aspirin, that only determines how quickly the aspirin is absorbed by your body. Enteric coated aspirin is coated so it is less irritating to your stomach and lessens the chances of bleeding in your stomach.

• What are the new guidelines?

In a joint statement in June 2010 from the American Diabetes Association (ADA), the American Hear Association (AHA), and the American College of Cardiology (ACC), it was recommended that stricter guidelines be followed for initiating low-dose aspirin therapy in patients with diabetes. Previously, the recommendations were to start low-dose aspirin therapy in any person with diabetes older than 40, regardless of  other risk factors. The guidelines now recommend low-dose aspirin therapy be started only in men older than 50 and women older than 60 that have diabetes and 1 additional major risk factor for cardiovascular events. These would include smoking, high lipids or cholesterol, high blood pressure, family history of disease, or albumin in your urine.

Two major studies in Japan and the US showed no significant benefits to aspirin therapy in diabetics. The benefits of aspirin therapy have to be weighed against the risks , especially the risk of developing bleeding problems.

• So what do I do?

I would recommend that if you are currently on aspirin therapy, that you continue as you have been. If you are newly diagnosed with diabetes, I would check with your doctor and see if he feels that aspirin therapy is of any benefit for you, since he knows your medical history and will be able to weigh the benefits and risks for you individually.

Brian Ray, The Diabetic Pharmacist