[ Diabetes Type 2 ]

Is There Any Evidence Base? on JSTOR

A study of the drug — the prescription pain reliever salsalate — also found it reduced inflammation associated with type 2 diabetes. Aspirin, used for decades to treat headaches and minor aches and pains, has been shown to reverse high blood sugar and improve insulin sensitivity when taken in high doses, according a study published in the August 2001 issue of Science. The objective of present study was to inhibit MMP-2 and MMP-9 by combination of minocycline and aspirin to treat diabetic nephropathy. Forty-eight patients (24 subjects with good [HbA(1c) 8.4%] glycemic control) were randomly assigned to treatment with 75 or 320 mg/day aspirin during 4 weeks in a crossover fashion. Platelets from patients with diabetes are more reactive and are turned over more rapidly than platelets from normal individuals; the short inhibitory window provided by once-daily aspirin may therefore be insufficient to provide 24-h protection against CV events. Larger differences were noted for the occurrence of fatal and nonfatal myocardial infarction; the estimate of relative risk was 0.83 for the entire follow-up period (99% confidence interval, 0.66 to 1.04). Primary prevention (PP): 39/103(37%) did not routinely prescribe aspirin whilst 16/121(13.2%) would consider using aspirin in all diabetes patients as primary prevention.

While it is possible that the effects of low dose aspirin may have a minor effect on blood rheology, it is unlikely to have a major effect, so the findings of Berardis et al are not unexpected. Shoelson, a researcher at the Joslin Diabetes Center and the Harvard Medical School in Boston and lead author of the study. While evidence suggests that altering antiplatelet therapy, particularly by increasing frequency of aspirin administration, can overcome incomplete inhibition of thromboxane synthesis, no clinical studies to date have assessed the effectiveness of these in preventing breakthrough atherothrombosis. National Library of Medicine (NLM) in partnership with The Wellcome Trust and the Joint Information Systems Committee (JISC) in the UK. It took place in Japan and enrolled 2,539 people with Type 2 diabetes and no history of cardiovascular disease.

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