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American Diabetes Association Recommendations

1.  Use aspirin therapy as a secondary prevention strategy in diabetic men and women who have evidence of large vessel disease. This includes diabetic men and women with a history of myocardial infarction, vascular bypasss procedure, stroke or transient ischemic attack, peripheral vascular disease, claudication, and/or angina.

2. In addition to treating the primary cardiovascular risk factor(s) identified, consider aspirin therapy as a primary prevention satrategy in high-risk men and women with type 1 or type 2 diabetes. This includes diabetic subjects with the following:

A family history of coronary heart disease.
Cigarette smoking.
Obesity (> 120% desirable weight);
BMI >28 in women, > 27,3 in men.
Albuminuria (micro or macro).

• Cholesterol > 200 mg/dl.
• LDL Cholesterol > 130 mg/dl.
• HDL Cholesterol < 40 mg/dl
• Triglycerides > 250 mg/dl.

3. The following may not be candidates for aspirin therapy:

• Diabetic individuals under the age of 30 years without cardiovascular risk factors listed above.
• People with aspirin allergy, bleeding tendency, anticoagulant therapy, recent gastrointestinal bleeding, and clinically acyive hepatic disease.

4. Use enteric-coated aspirin in doses of 81-325 mg/day.
References Colwell J.A. Aspirin therapy in Diabetes.
Diabetes Care 20: 1767-1771, 1997
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