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Diabetes Mellitus, Type 1 > Drug Therapy Author: Maureen D. Passaro, MD; Robert E. Ratner, MD
Editorial changes - 2012-02-07
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Rationale:

  • Patients with diabetes have a two- to four-fold increase in the risk of mortality due to cardiovascular disease. One mechanism for this risk is related to increased thromboxane production, which is blocked by aspirin therapy.
  • There is no evidence about which patients with diabetes should be treated with aspirin therapy. The risk of cardiovascular disease is low in patients <30 years and the risk-to-benefit ratio must be considered before initiating therapy.

Evidence:

  • A meta-analysis of antiplatelet trials showed that aspirin decreased the risk of recurrent vascular events. The U.S. Physicians Health Study showed decreased MIs from 10% to 4% in physicians treated with aspirin (102; 103; 104).

Comments:

  • None.
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Abd A. Tahrani, MD, MRCP, editorial consultant, received a grant from the UK Novo Nordisk Research Foundation. Maureen D. Passaro, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Robert E. Ratner, MD, is a consultant for Amylin Pharmaceuticals, AstraZeneca, GlaxoSmithKline, Lifescan, Inc., NovoNordisk, Sanofi-Aventis, Takeda, owns stocks in Merck, Johnson & Johnson, Abbott, received grants from Amylin, AstraZeneca, Bayhill Therapeutics, Boehringer Ingelheim, Conjuchem, Inc., Eil Lilly, GlaxoSmithKline, Merck, NovoNordisk, Pfizer, Sanofi-Aventis, Takeda.
Deborah Korenstein, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Richard B. Lynn, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.

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