Reviewed by Robert Ehrman, MD
If you have diabetes, you may take an aspirin each day as a way to help prevent heart attacks and strokes. But the guidelines developed by the American Diabetes Association (ADA) and other organizations about who will benefit from aspirin have recently changed. Although it is frustrating when guidelines change, it can be a very good thing. It means that more and better studies are being done all the time, and people with diabetes will benefit from more accurate, up-to-date information.
Q.WHY TAKE ASPIRIN?
A.Aspirin helps to prevent blood from clotting. While clotting can be a good thing if you are bleeding, a clot that forms inside a blood vessel can block the flow of blood to vital organs. A clot in a blood vessel that supplies blood to the brain can cause a stroke. A clot in a blood vessel that supplies blood to the muscles of the heart can cause a heart attack. Aspirin can help to keep the blood flowing to where it is needed.
Q.WHO SHOULD TAKE ASPIRIN?
A.People with diabetes are at greater risk for heart attacks and strokes than people who do not have diabetes. Because of this risk, people with diabetes who were over 40 were often advised to take one aspirin every day. However, new studies that included more people with diabetes have led to changes in this recommendation. The 2010 guidelines suggest a daily aspirin only for men over 50 who have diabetes, and women with diabetes over the age of 60 who also have another major risk factor for heart disease. Additional major risk factors include high blood pressure, smoking, high cholesterol, albumin in the urine or a family history of heart disease. The guidelines have not changed for people who have had a heart attack or stroke in the past.
Q.SHOULD I TAKE ASPIRIN?
A.You and your health care provider are the best judges of whether aspirin will be helpful and safe for you. You need to take into account your medical history, your family history and any allergies you have or side effects aspirin may cause. If you are already taking aspirin, talk with your provider before you decide to stop taking it.
Q.HOW MUCH ASPIRIN SHOULD I TAKE?
A.Although aspirin is thought of as a safe medicine, it can cause side effects such as upset stomach, ringing in the ears and bleeding. Therefore, the best advice is to take the smallest dose that can help without causing side effects. The usual dose to prevent clotting is between 81 and 325 mg per day. The standard dose of adult aspirin is 325 mg and “baby” aspirin is 81 mg, so it is common to take one baby aspirin or one adult aspirin. Ask your health care provider about the right dose for you. If aspirin upsets your stomach, you could try an enteric-coated form.