Additional care

People who have diabetes have a higher risk of cardiovascular disease, such as heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. and stroke. There is good evidence that among people who have already had one cardiovascular event, taking a low dose of aspirin every day helps to prevent another one.

This is known as secondary prevention, and your doctor is likely to advise this, provided it is safe for you to take aspirin. You should not have aspirin if you are allergic to it, or if you have a history of stomach ulcers, or have any condition that increases your risk of bleeding.

Adults who have diabetes should also have at least one lifetime pneumococcal vaccine, and annual fluA viral infection affecting the respiratory system. vaccinations

Some doctors also advise people with diabetes who do not have established cardiovascular disease to take low-dose aspirin in the hope of preventing a possible future event. This is known as primary prevention. The evidence for primary prevention of cardiovascular disease by aspirin in people with diabetes is less clear.

One study in 2008[1] showed no significant difference in the number of first events between people with diabetes who took low dose aspirin and those who did not. As the side-effects of aspirin, particularly bleeding, can be serious, some experts believe that low-dose aspirin should not be recommended for primary prevention.

It is important that you discuss with your doctor whether or not taking low-dose aspirin might be helpful in your case.

Other medications that are recommended for people with diabetes and a high risk of cardiovascular disease include:[2]

  • Blood pressure-lowering medication, preferably with an angiotensin-converting enzymeA protein that speeds up chemical reactions in the body without being used up itself. (ACE) inhibitor or angiotensin receptor blockerOne of a group of drugs used to treat high blood pressure.
  • Lipid-lowering medication, using a drug called a statinOne of a class of drugs that inhibit cholesterol formation in the liver. with or without another medication, a fibrate.

Adults who have diabetes should also have at least one lifetime pneumococcal vaccine, and annual fluA viral infection affecting the respiratory system. vaccinations.[3]

Finally, any problems that are noted during regular check-ups and examinations warrant early and effective treatment.[3]

References: 
  1. Jill Belch, Angus MacCuish, Iain Campbell et al. The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ 2008; 337: a1840.
  2. Harris M. Challenges in diabetes management. Australian Family Physician. 2008; 37: 716-20.
  3. Ahmann AJ. Guidelines and performance measures for diabetes. Am J Manag Care. 2007; 3: S41-6.