Many diabetics should be on aspirin therapy

Pamela Egan Practical Practitioner

 

By: Pamela Egan, FNP-C CDE

 

 

Many diabetics should be on aspirin therapy

 

 

Many men and women with diabetes should be on aspirin therapy, however be sure to read the following descriptions of who should try aspirin therapy and who should not before starting a treatment regimen.

Candidates for Aspirin therapy include 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 stoke 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 (chest pain 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 03, divide by your height in inches, and divide again by your height in inches).
  • Have protein in their urine.
  • Have high cholesterol (a total cholesterol level higher than 200 mg/dl).
  • Have an LDL (“bad”) cholesterol level of 100mg/dl or higher.
  • Have an HDL (“good”) cholesterol level less than 55 mg/dl (women) or 45 mg/dl (men).
  • Have a triglyceride higher than 200mg/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.

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 and cheap 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.

Even though you can buy 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.

People who should not use aspirin therapy include:

  • Are allergic to aspirin.
  • Have a tendency to bleed.
  • Take a blood thinner, for example, heparin or warfarin (Coumadin).
  • Have recently had bleeding in the stomach or intestines.
  • Have active liver disease.
  • 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.

This article was originally published September 2, 2003 in The St. Tammany News.


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