Many patients with diabetes can benefit from daily aspirin therapy, which helps reduce the risk of cardiovascular disease. The American Diabetes Association (ADA) makes the following recommendations regarding daily aspirin therapy:

• Primary prevention strategy. Aspirin is likely to benefit men and women with type 1 diabetes or type 2 diabetes with risk factors for cardiovascular health disorders, such as:

• Secondary prevention strategy. Patients with diabetes who have some form of cardiovascular disease may help prevent a second occurrence with aspirin therapy. This includes those with a history of:

The ADA recommends that patients use enteric-coated aspirin in daily dosages of between 81 and 325 milligrams, although dosages as low as 75 milligrams may also be beneficial. Enteric coating helps the pill pass through the stomach without dissolving, allowing the aspirin to be absorbed in the intestine and thus reducing side effects. Aspirin therapy is not recommended for patients with any of the following:

• Age of less than 21 years
• Aspirin allergy
• Bleeding tendency
• Anticoagulant (medication to prevent blood from clotting) use
• Recent gastrointestinal bleeding
• Clinically active liver disease
• Uncontrolled high blood pressure
• Asthma

Diseases of the kidneys such as diabetic nephropathy or end-stage renal failure also typically preclude the use of aspirin.

Individuals are advised to ask their physician about the risks and benefits of aspirin therapy. Even in people who do not have diabetic nephropathy, regular long-term use of painkillers such as aspirin can cause a permanent form of kidney damage called analgesic nephropathy that requires dialysis or a kidney transplant, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).