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July 4, 1999

Complications, Research: Other

Question from Hartford, Vermont, USA:

Have there been any studies done regarding low-dose aspirin therapy in young Type 1 patients that relates to longer term vascular outcomes?

Answer:

Studies of the role of aspirin in preventing the vascular complications in diabetes have predominantly been in older age groups. In general, the effect of aspirin is only slightly less than in nondiabetic people, i.e., there is a 30% reduction in the incidence of myocardial infarction and a 20% reduction intracerebral infarction. This is offset by a doubling of the incidence of haemorrhagic strokes. These figures however seem to be modified significantly depending on the presence of other high risk factors, for example in low risk patients the increased chance of a haemorrhagic stroke outweighs the benefit to thrombotic events.

Nowadays in young people the emphasis has swung to the advantages of meticulous blood sugar control and to the prophylactic use of antioxidants like Vitamin E in the prevention of peripheral vascular disease.

If you can get access to a Medical Library and are prepared to deal with some rather dense prose you might want to look at a Europaean journal called Diabetologia, volume 39, in 1996. There are three sequential reports starting on page 1402 which deal with this theme.

DOB