Endocrine Abstracts

BACKGROUND: Diabetes mellitus results in a two to four-fold increased risk of dying from complications of cardiovascular disease. There is growing evidence that this risk can be reduced by low-dose aspirin. Evidence comes from studies of platelet function and aspirin pharmacology and from trials of primary and secondary prevention. The American Diabetes Association produced a position statement regarding guidelines for aspirin use in 1997.

OBJECTIVES: To examine use of aspirin in a diabetic population attending a district general hospital, to compare this with other study populations, and to evaluate this in the light of the ADA recommendations.

METHOD: The study population was all of the diabetic patients reviewed by members of the diabetes medical team over ten days. Patient interview and notes review enabled collection of pre-specified data.

RESULTS: 160 patients were studied. 56.9% were male, 43.1% female, with 76.9% over age fifty. 19.4% were type 1 and 80.6% type 2. 30.6% had proven macrovascular disease, 28.8% had microvascular disease and 69.4% had at least one major risk factor for cardiovascular disease in addition to diabetes. 20% had none of the above characteristics. Of the total, only 27.5% of patients were taking regular aspirin. Of those with proven macrovascular disease, 67.3% were taking aspirin regularly and of those who were not, half had a documented reason. However 66.0% of the patients who had either macrovascular or microvascular disease or at least one major risk factor were no taking aspirin. 54.7% of patients who ought to have been prescribed aspirin according to the criteria in the ADA position statement were not taking it.

COMMENTS: These results were comparable to published data from populations in Australia and the USA. However there is much that could be done to improve identification of patients at risk of cardiovascular disease and institution of risk-reduction measures which would include regular use of low-dose aspirin.