Clinical trials have demonstrated that aspirin therapy is a cheap and effective intervention for preventing serious cardiovascular events such as myocardial infarctions and stroke among diabetics. Enteric coated aspirin in dosages of 81–162 mg/day should be considered a standard part of treatment for most diabetic patients. Aspirin is indicated for the following diabetic inmates unless medically contraindicated, as follows:
• If there is evidence of atherosclerosis (e.g., coronary artery disease, peripheral vascular disease).
• If the person is >40 years of age with one or more cardiovascular risk factors (hypertension, smoking, dyslipidemia, albuminuria, or family history of CHD).
Other antiplatelet agents may offer reasonable alternatives for patients who are high-risk, but have conditions that contraindicate aspirin therapy: an aspirin allergy, receiving anticoagulant therapy, a bleeding tendency, recent gastrointestinal bleeding, or clinically active hepatic disease.
Clinical Precaution:
Do not routinely use aspirin in inmates <21 years of age, due to the increased risk of Reye’s syndrome.