Low-Dose Aspirin May Reduce Diabetes Risk in Older Adults

A new study suggests that taking low-dose aspirin daily may reduce the risk of developing type 2 diabetes in adults 65 and older. However, the findings do not change recommendations on aspirin use in older adults.

The study that will be presented at this year’s Annual Meeting of the European Association for the Study of Diabetes (EASD) indicates that the use of 100 mg aspirin daily may cut the risk of diabetes by 15%.

However, due to the risk of bleeding, older adults are recommended to take daily aspirin only when there is a medical reason, such as after a heart attack.

The researchers at Monash University, Australia, examined how low doses of aspirin affect the incidence of diabetes and fasting plasma glucose (FPG) levels in older adults. The FPG test is used to measure blood glucose and diagnose pre-diabetes or diabetes.

The authors did a follow-up study of the ASPREE trial, the principal results of which were published in NEJM in 2018. The original study associated daily aspirin with a 38% increased risk of major hemorrhage (bleeding), primarily in the gastrointestinal tract, in older adults. Moreover, using low-dose aspirin did not appear to reduce the incidence of cardiovascular disease.

The study enrolled 16,209 participants aged 65 years and older who were free of cardiovascular disease, independence-limiting physical disability, dementia, and diabetes at the beginning of the study. The participants were randomized into two groups, taking either a 100 mg daily aspirin or a placebo.

During an average follow-up time of 4.7 years, 995 people developed diabetes — 459 in the aspirin group and 536 in the placebo group. People who started using glucose-lowering medication or had an FBP level of 7.0 mmol/L or higher at annual follow-up visits were considered as having diabetes.

“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,” the authors concluded.

The study, however, has not been peer-reviewed yet.

Sophia Zoungas, professor at the School of Public Health and Preventive Medicine at Monash University and the study’s lead author, says that the findings do not change the clinical advice about aspirin use in older adults at this time.

The U.S. Preventive Services Task Force recommends against initiating low-dose aspirin use to prevent cardiovascular disease in people 60 years or older. According to the guidelines, the benefits of aspirin become smaller with increasing age, and data suggest that patients should consider stopping aspirin use around age 75 years.

While more research is needed on whether low-dose aspirin can reduce the risk of diabetes in older adults, following a healthy diet, being physically active, and quitting smoking can help to maintain healthy glucose levels.