An Aspirin a Day?

What people with diabetes should know about taking aspirin


By Merle Myerson, MD

You have probably heard the commercials on TV saying that an aspirin a day can keep a heart attack away, but is aspirin really for everyone? What does the person who has diabetes need to know about aspirin use?

Aspirin is an old medicine that comes from the bark of the willow tree. Aspirin works by preventing platelets (cell-like particles in the bloodstream) from forming clots that could cause a heart attack or stroke. This effect is irreversible, meaning that once a platelet interacts with aspirin, it is permanently affected. A platelet lasts for about 5-10 days and the body makes new platelets every day. This is way it is important to take an aspirin every day.

Non-coated aspirin works within minutes, which is why people who are suspected of having a heart attack are told to take aspirin right away. Coated aspirin (the coating helps protect the stomach) takes longer to work. It is recommended that you chew a coated aspirin if a heart attack is suspected.

Based on the research, the daily dose required to help prevent clots is about 81 mg. This dose is known as "low-dose aspirin" or "baby aspirin." Higher doses are needed for treating fevers and pain.

While aspirin is available without a prescription, it is still a drug and it has side effects. Most important are problems with the gastrointestinal system, including abdominal pain, bleeding, and ulcers. You can reduce this risk by taking a coated aspirin or using a medication called a "proton pump inhibitor" along with your aspirin. Tinnitus, or a ringing sensation in the ears, is uncommon but may occur, especially in children and adolescents. Rarely, a person can have an allergy to aspirin, causing asthma or anaphylaxis, a life-threatening reaction. Your healthcare provider should ask questions about your risk prior to starting you on aspirin.

So, who should take an aspirin? The American Diabetes Association published the "Standards of Medical Care in Diabetes" in 2010 with the following recommendations:

  • Consider aspirin therapy as a primary prevention strategy in those with type 1 or type 2 diabetes at increased risk. This includes most men >50 years and women >60 years of age who have at least one additional risk factor (hypertension, high cholesterol, etc.)
  • There is not sufficient evidence to recommend aspirin for primary prevention in low risk individuals. This includes men <50 years or women <60 years of age without other major risk factors.
  • Use aspirin therapy as a secondary prevention strategy in those with diabetes and a history of cardiovascular disease.

You should discuss the use of aspirin with your healthcare provider to see if you will benefit from taking aspirin.


American Diabetes Association. 2010. Standards of Medical Care in Diabetes — 2010. Diabetes Care, Volume 3, Supplement 1.

Read Dr. Myerson's bio here.

Read more of Dr. Myerson's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

Last Modified Date: July 03, 2013

All content on is created and reviewed in compliance with our editorial policy.

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