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Aspirin Benefit for Diabetics Questioned

Nov 11, 2008 | Parker Waichman Alonso LLP

Emerging research is indicating that taking low-dose aspirin may not prevent diabetes patients from experiencing heart "events."  The new study was published in The Journal of the American Medical Association; another study pointing to similar evidence was published last month in the British publication BMJ.  Those two studies don't question the heart benefits of low-dose aspirin in people who already have heart disease, but do discuss aspirin's effects on those with diabetes and with no history of heart disease.

The researchers say, in an editorial published in The Journal of the American Medical Association that, "the decision to prescribe aspirin should be made on an individual patient basis.”  The two new studies tested whether taking low-dose aspirin helped prevent heart attacks and other cardiovascular events, such as strokes and death from heart disease, in those diabetes patients who had no history of heart disease.

One of the studies, discussed in The Journal of the American Medical Association, was conducted in Japan with 2,539 adults with type 2 diabetes.  Those patients typically remained in the study for about four years; that study did not use a placbo.  The other study, published last month in BMJ's "Online First" edition, occurred in Scotland and involved 1,276 adults with type 1 or type 2 diabetes.  In that study, patients were followed for about six years and half of the patients received antioxidant supplements.  Both studies revealed that there was no indication that taking low-dose aspirin lessened one’s odds of experiencing his/her first cardiovascular event.

In BMJ, editorialist William Hiatt, MD, professor of medicine at the University of Colorado Denver School of Medicine, wrote that "although aspirin is cheap and universally available," it should only be prescribed for those "with established symptomatic cardiovascular disease."  The Journal of the American Medical Association, editorialist Antonio Nicolucci, MD, of Italy's Consorzio Mario Negri Sud encourages doctors and diabetes patients to consider the pros and cons of low-dose aspirin on a case-by-case basis.

Diabetes affects the body's ability to produce or respond to insulin, a hormone that allows blood glucose, or blood sugar, to be used by the body as energy.   Studies indicate that two out of every three people diagnosed with diabetes die from heart disease and stroke, the most life-threatening consequences of diabetes, sriking diabetes patients more than twice as often as those without diabetes.  Most of the cardiovascular complications related to diabetes concern how the heart pumps blood through the body; diabetes can change the chemical makeup of some of the substances found in the blood and this can cause atherosclerosis, or hardening, narrowing, or clogging of arteries and blood vessels.  A diabetes diagnosis as an adult presents the same risk as if one already had one heart attack; over 65 percent of deaths in diabetes patients are attributed to heart and vascular disease.

People with diabetes experience heart disease twice as often as people without diabetes; experience cardiovascular complications at an earlier age, often resulting in premature death; and are two to four times likelier to suffer strokes and once having suffered a stroke, are two to four times likelier to suffer another stroke.