The latest research results to be presented at the European Association for the Study of Diabetes (EASD) annual meeting in Hamburg, Germany, from October 2-6 this year, show that taking 100 mg of aspirin daily may reduce the risk of type 2 diabetes in people aged 65 or older by 15%.
The authors, led by Professor Sophia Zoungas from the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia, stressed that these findings highlight the need to further explore the role of anti-inflammatory drugs such as aspirin in diabetes prevention.
The impact of aspirin on the incidence of type 2 diabetes in older adults remains uncertain. This study investigated the randomized treatment effect of low-dose aspirin on the onset of diabetes and fasting plasma glucose (FPG) levels in older adults. The authors conducted a follow-up study on the ASPREE trial, a double-blind placebo-controlled trial of aspirin, and the main results were published in the 2018 NEJM. Initial research showed that aspirin increased the risk of major bleeding in older adults by 38% without reducing the incidence of cardiovascular disease.
The study recruited community-dwelling individuals aged 65 years or older with no cardiovascular disease, physical disability, or dementia that limited independence. Researchers randomly assigned participants in a 1:1 ratio to take 100 mg of aspirin per day or a placebo. Diabetes was defined as self-reported diabetes, initiation of antidiabetic medications, and/or fasting plasma glucose (FBP) levels of 7.0 mmol/L or above at annual follow-up visits. Patients with diabetes at the start of the study were not included. Computer and statistical models assessed the effects of aspirin on diabetes incidence and fasting blood glucose levels, respectively.
A total of 16,209 participants were included in the analysis (8,086 randomized to aspirin and 8,123 randomized to placebo). The median follow-up was 4.7 years, and a total of 995 cases of diabetes were recorded (aspirin: 459, placebo: 536). Compared with placebo, the incidence of diabetes in the aspirin group was reduced by 15%, and the growth rate of FPG was also slowed down (annual change difference in FPG: -0.006mmol/L).
Author Professor Zoungas said: "Aspirin treatment reduces the incidence of diabetes and slows the increase in fasting plasma glucose in initially healthy older adults. Given the increasing incidence of type 2 diabetes in older adults, the potential of anti-inflammatory drugs such as aspirin to prevent type 2 diabetes or improve blood glucose levels requires further investigation. Results from the ASPREE trial published earlier in 2018 showed that aspirin did not extend the time spent living healthy and independent lives, but was associated with a significant increase in the risk of bleeding, mainly gastrointestinal bleeding. Major prescribing guidelines now recommend that older adults only take daily aspirin if there is a medical reason, such as after a heart attack."
"While these new findings are interesting, they do not currently change clinical recommendations regarding aspirin use in older adults."