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ASA Therapy in Diabetes
Is it right for you?

If you have diabetes, your risk of blood vessel disease is increased. People with diabetes have platelets that are more sensitive to natural substances in the blood that start the clotting process. (Platelets are particles in blood that allow it to clot.) When clots form, they can stick to the sides of blood vessels. Over time, the build-up of clots can block blood from flowing smoothly through these vessels. Narrowing and clogging of the arteries can lead to heart attack and stroke.

Acetylsalicylic acid, (also known as ASA and Aspirin™), has been used to treat pain, inflammation, and fever for over a century. ASA also blocks the release of thromboxane, a natural substance in the blood that can cause clotting. When less thromboxane is released, fewer clots form. With fewer clots, blood vessels are less likely to narrow or clog. The risk of having a heart attack or stroke is lowered.

Research has recently been done to see if ASA helps reduce the risk of blood vessel disease in people with diabetes. It confirms that daily ASA therapy lowers the risk of having a heart attack, stroke, or dying from cardiovascular disease.

Using ASA can help prevent a stroke or heart attack before it happens. ASA can also be used after a stroke or heart attack to prevent it from happening again. Blood vessel disease often has no symptoms. Though just having diabetes puts you at higher risk of blood vessel disease, daily ASA use can reduce your chances.

ASA for daily therapy is available as 81 or 325-milligram enteric-coated tablets or caplets. Enteric coating allows the tablet to pass through the stomach to the small intestine before dissolving. Taking ASA each day becomes much safer since less irritation occurs in the stomach.

Talk to your doctor to see if ASA therapy will work for you. Be sure to take only the amount recommended by your doctor or pharmacist. Too much ASA can be harmful, and may also change your blood glucose levels. ASA therapy is not right for everyone. If you are allergic to ASA, bleed easily, have liver disease or have had recent gastrointestinal (stomach or intestine) bleeding, ASA should not be used.

If you take medicines that thin your blood, your doctor may more carefully monitor the ability of your blood to clot or recommend against using ASA altogether. Medications that thin the blood include Coumadin™ (warfarin), Heparin, Plavix™ (clopidogrel), Persantine™ (dipyridamole), or Ticlid™ (ticlopidine). If you aren’t sure whether your current medications may interact with ASA, ask your pharmacist.

Much research is being done to improve the lives of people with diabetes. Although ASA has been available to us for years, this drug is now proving to have hidden benefits. Your doctor and pharmacist can help decide whether daily ASA therapy is right for you.

If I am taking an NSAID, can I be on daily ASA therapy?

Non-steroidal anti-inflammatory drugs or NSAIDs are commonly used to treat arthritis and other conditions that cause swelling and pain in the joints and muscles. Some examples of NSAIDs are Celebrex™, Vioxx™, Voltaren™ and Naprosyn™. These medications effectively reduce the pain and swelling caused by arthritis. If you have taken an NSAID before, the pharmacist may have counselled you to avoid taking ASA while you were on this medication. Taking an NSAID and ASA together can increase the risk of developing ulcers or gastrointestinal (stomach or intestine) bleeding.

So can you take an NSAID and daily ASA therapy together? Yes. People who are taking NSAIDs can also take ASA to prevent blood vessel disease. Your doctor may suggest taking an additional medication to prevent you from developing ulcers or gastrointestinal (stomach or intestine) bleeding while you are on both medications. Ask your doctor or pharmacist if you require this additional protective medication.