What Are The Recommendations For Regular Aspirin Therapy in People 
With Diabetes?
People with diabetes have an increased risk of dying from the complications of cardiovascular disease, especially atherosclerosis and vascular thrombosis. Platelets contribute to the development of these disorders. A major mechanism underlying the activity of platelets involves the increased production of thromboxane, a potent vasoconstrictor. Since aspirin blocks thromboxane synthesis, its use as a primary and secondary strategy to prevent cardiovascular disease has been supported. Indeed, studies have shown that daily low-dose aspirin therapy reduces the risk of cardiovascular disease in patients with diabetes.
This position statement outlines the recommendations for regular aspirin therapy in people with diabetes. These recommendations include the following:
1. Use aspirin therapy as a secondary prevention strategy in diabetic men and women with evidence of large vessel disease. This includes 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.
2. In addition to treating the primary cardiovascular risk factor(s) identified, consider aspirin therapy as a primary prevention strategy in high-risk men and women with type 1 or type 2 diabetes. This includes diabetic patients with the following:
* a family history of coronary artery disease
* cigarette smoking
* hypertension
* obesity (>120% desirable weight); BMI >28 in women, >27.3 in men
* albuminuria (micro or macro)
* lipids: cholesterol >200 mg/dL; LDL-cholesterol >130 mg/dL; HDL-cholesterol <40>250 mg/dL
3. The following individuals may not be candidates for aspirin therapy:
* diabetic individuals under age 30 years without the cardiovascular risk factors listed above
* people with aspirin allergy (ticlopidine may be considered as an aspirin substitute), bleeding tendency, anticoagulant therapy, recent gastrointestinal bleeding, and clinically active hepatic disease
4. Dosage: Use enteric-coated aspirin in doses of 81-325 mg/day.
Ref: Diabetes Care.
With Diabetes?People with diabetes have an increased risk of dying from the complications of cardiovascular disease, especially atherosclerosis and vascular thrombosis. Platelets contribute to the development of these disorders. A major mechanism underlying the activity of platelets involves the increased production of thromboxane, a potent vasoconstrictor. Since aspirin blocks thromboxane synthesis, its use as a primary and secondary strategy to prevent cardiovascular disease has been supported. Indeed, studies have shown that daily low-dose aspirin therapy reduces the risk of cardiovascular disease in patients with diabetes.
This position statement outlines the recommendations for regular aspirin therapy in people with diabetes. These recommendations include the following:
1. Use aspirin therapy as a secondary prevention strategy in diabetic men and women with evidence of large vessel disease. This includes 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.
2. In addition to treating the primary cardiovascular risk factor(s) identified, consider aspirin therapy as a primary prevention strategy in high-risk men and women with type 1 or type 2 diabetes. This includes diabetic patients with the following:
* a family history of coronary artery disease
* cigarette smoking
* hypertension
* obesity (>120% desirable weight); BMI >28 in women, >27.3 in men
* albuminuria (micro or macro)
* lipids: cholesterol >200 mg/dL; LDL-cholesterol >130 mg/dL; HDL-cholesterol <40>250 mg/dL
3. The following individuals may not be candidates for aspirin therapy:
* diabetic individuals under age 30 years without the cardiovascular risk factors listed above
* people with aspirin allergy (ticlopidine may be considered as an aspirin substitute), bleeding tendency, anticoagulant therapy, recent gastrointestinal bleeding, and clinically active hepatic disease
4. Dosage: Use enteric-coated aspirin in doses of 81-325 mg/day.
Ref: Diabetes Care.
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