MELBOURNE, Australia — Could anti-inflammatory drugs like aspirin prove useful in the prevention of diabetes? New research out of Australia suggests as much, but study authors also note that there’s still plenty of strong evidence that patients should take aspirin with caution and moderation.
This latest work found that the use of low-dose (100mg daily) aspirin among older individuals (ages 65 years and older) displays a link to a 15-percent lower chance of developing Type 2 diabetes. While these findings are no doubt encouraging — and anti-inflammatory agents like aspirin clearly warrant further study regarding the topic of diabetes prevention — aspirin has a connection to a troubling increased risk of gastrointestinal tract bleeding. In fact, current prescribing guidelines now recommend older adults only take aspirin on a daily basis when there is a medical reason to do so, such as the risk of a heart attack.
So, researchers strongly suggest that patients still follow their doctors’ personalized medical advice regarding aspirin consumption at all times.
This project set out to analyze and better understand the randomized treatment effect of low-dose aspirin on incident diabetes and fasting plasma glucose (FPG) levels among older adults. Researchers performed a follow-up study of the ASPREE trial – a double-blind, placebo-controlled trial of aspirin that had originally been published in 2018. That earlier study found that aspirin conferred a 38-percent increased risk of major hemorrhage among older adults without any drop-off in the incidence of cardiovascular disease.
The study encompassed community-dwelling individuals over the age of 65, free of cardiovascular disease, independence-limiting physical disability, and dementia. From there, the team randomly split these seniors into either a 100mg daily aspirin or a placebo plan. Researchers defined incident diabetes as self-reported diabetes, commencement of glucose-lowering medication, and/or a fasting plasma glucose level of 7.0 mmol/L or higher during annual follow-ups. People with diabetes at the start of the study were not included. Then, computer and statistical modeling analyzed the effect of aspirin on both incident diabetes and FPG levels.
In all, 16,209 participants took part in the analysis (8,086 randomized to aspirin and 8,123 to placebos). Over the course of 4.7 years, on average, 995 incident diabetes cases were recorded (aspirin: 459, placebo: 536). In comparison to the placebo group, the aspirin group displayed a 15-percent reduction in incident diabetes and a slower FPG rate increase (difference in annual FPG change: -0.006 mmol/L).
“Aspirin treatment reduced incident diabetes and slowed the increase in fasting plasma glucose over time among initially healthy older adults. Given the increasing prevalence of Type 2 diabetes among older adults, the potential for anti-inflammatory agents like aspirin to prevent Type 2 diabetes or improve glucose levels needs further study,” study authors say.
“The earlier published trial findings from ASPREE in 2018 showed aspirin did not prolong healthy independent living, but was associated with a significantly increased risk of bleeding, primarily in the gastrointestinal tract,” Prof. Zoungas explains in a media release. “Major prescribing guidelines now recommend older adults take daily aspirin only when there is a medical reason to do so, such as after a heart attack.”
“Although these new findings are of interest, they do not change the clinical advice about aspirin use in older people at this time.”
This research is set to be presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Hamburg, Germany.
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