Can I Take Aspirin If I Have Prediabetes?

If you have prediabetes, you may be wondering if you can or should take aspirin to protect yourself against heart problems. After all, you want to take your prediabetes diagnosis seriously and do what you can to prevent any serious health issues down the line.

But do you need to take aspirin, and is it even a safe option? Not necessarily.

Read on to discover the benefits, drawbacks, and recommendations for taking aspirin, along with the best alternatives for keeping yourself healthy.

Why do some people take aspirin?

Aspirin is an over-the-counter medication that is often used as a pain reliever. But many people also take low-dose aspirin (often called "baby aspirin") as a preventative measure to ward off health complications related to heart disease.

Aspirin works as a blood thinner, and it helps to stop your blood from clotting. This can be helpful if you are at high risk for cardiovascular disease, because it can help prevent blood clots from forming in your arteries and causing a serious event like a heart attack or stroke.[1]

People who have diabetes are sometimes advised to take low-dose aspirin. This is because people who have diabetes are at an increased risk of cardiovascular problems including heart attack and stroke.[1] Researchers also believe that aspirin may have blood sugar-lowering effects.[2]

It might sound like a good idea to take aspirin at the first sign of health problems like high blood sugar that could put your heart at risk. But not so fast; taking aspirin doesn't come without serious cautions to be aware of.

The risks of using aspirin

The biggest problem with taking aspirin every day is that it increases your risk of gastrointestinal bleeding. This bleeding can cause you to develop a stomach ulcer. And if you already have bleeding in your gut, then aspirin can cause even more bleeding to occur and even put your life at risk.[1]

Other non-steroidal anti-inflammatory medications (like ibuprofen) and alcohol also increase your risk of stomach irritation and bleeding, so they can be dangerous to use alongside aspirin. Aspirin can also have adverse effects when mixed with various supplements, herbs, and natural remedies.[1]

It's not safe to take aspirin if you have another health condition that increases your risk of bleeding or other adverse effects (for example a bleeding disorder, clotting disorder, stomach ulcer, or aspirin allergy).[1]

Do I need to take aspirin if I have prediabetes?

If you've been told you have prediabetes, you may be desperate to do anything you can to protect yourself from future health complications – including adding aspirin to your care regime. But that is not always the best idea.

You may remember the days when people were advised left and right to take a baby aspirin every day for heart health. That is not the case anymore. It has become clear with additional research in the years since that not everyone benefits from taking aspirin, and that taking it can oftentimes do more harm than good.

Several studies have suggested that the potential benefits of aspirin are outweighed by its adverse effects.[3-6] For example, one study in diabetics showed that daily aspirin use for seven years reduced the risk of serious cardiovascular events by 12% but increased the risk of major bleeding by 29%.[3]

To reflect the growing body of research questioning the effectiveness and safety of aspirin use in people with diabetes, the guidelines set by organizations like the American Diabetes Association and the American Heart Association were updated in 2010. Nowadays, low-dose aspirin use is only really considered for people with diabetes who already have cardiovascular disease or who are at seriously high risk for it.[4,5,7]

Aspirin may have its place in diabetes management and can sometimes be useful for reducing cardiovascular disease risk, but it isn't even recommended for everyone with a diabetes diagnosis, let alone those with only a prediabetes diagnosis.[3-7]

If you actually have diabetes and also have high risk factors for cardiovascular disease, your doctor may recommend aspirin to prevent further complications down the line. But if you only have prediabetes and don't have a high risk for cardiovascular disease, your doctor may advise against it.

Make sure to discuss aspirin use with your doctor to design an appropriate treatment plan that is right for you. And keep in mind that aspirin may change your blood sugar readings, as it is thought to lower blood sugar levels in the body.[2,8]

Alternative approaches to focus on instead

The good news is that aspirin isn't the only thing that can reduce your risk of cardiovascular complications and protect your health in the long run. There are many other things you can do to take action and lower your chances of developing both diabetes and cardiovascular problems without the risks and side effects.

Here are the top things you can do to stay healthy and reduce your risk:

1. Eat better. Improve your diet by focusing on fresh foods and eating less processed foods full of sugar, trans fats, refined carbs.

2. Move your body. Regular exercise is good for the whole body, especially for your heart and blood sugar levels. Even simply taking short walks around the neighborhood can do wonders.

3. Cut down on alcohol. Alcohol consumption is one of the risk factors for both diabetes and heart problems. Cut back and only drink in moderation.

4. Quit smoking. Smoking increases your risk for heart attack and stroke. Get support if you need it to help you quit.

5. Manage stress. Stress ups your risk for all sorts of health problems, including cardiovascular disease. Experiment with stress management techniques that will help you rest, recoup, and stay balanced.[1,9]

As you can see, you can boost your health by focusing on lifestyle and dietary changes that support both healthy blood sugars and a healthy heart – whether or not you are advised to take aspirin by your physician.

Conclusion

In the past, daily low-dose aspirin was a common recommendation. But researchers now know that the risk of aspirin use (gastrointestinal bleeding) is often not worth the benefits (reduced risk of cardiovascular complications).

That means that aspirin isn't right for everyone, especially if you don't already have cardiovascular disease or you aren't at high risk for it. So if you have prediabetes and are otherwise healthy, your doctor might say you are better off without it.

Whether or not you should take aspirin also depends on what else you are doing to reduce cardiovascular disease risk.[6] If you have prediabetes, there are many other strategies you can lean on to prevent serious complications of unregulated blood sugars down the road.

Lifestyle modifications are key. Focus on eating well, moving your body, cutting down on alcohol, quitting smoking, and reducing the effects of stress. With some healthy changes to your daily routine, you just might be able to get your blood sugars back in balance and restore your body to full health.

    References

1. Low-dose aspirin. UK National Health Service. Reviewed November 15, 2018. https://www.nhs.uk/medicines/low-dose-aspirin/
2. Coe LM, Denison JD, McCabe LR. Low dose aspirin therapy decreases blood glucose levels but does not prevent type i diabetes-induced bone loss. Cell Physiol Biochem. 2011;28(5):923-32.
3. ASCEND Study Collaborative Group. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. N Engl J Med. 2018;379(16):1529-1539.
4. Khalil S, Darmoch F, Shah Z, Alraies MC. Should all diabetic patients be on aspirin for primary prevention? Expert Rev Cardiovasc Ther. 2019 Aug;17(8):557-560.
5. Armstrong, C. Updated Recommendations on Daily Aspirin Use in Patients with Diabetes. Am Fam Physician 2010;82(12)1559-1563.
6. Capodanno D, Angiolillo DJ. Aspirin for Primary Cardiovascular Risk Prevention and Beyond in Diabetes Mellitus. Circulation. 2016;134(20):1579-1594.
7. Cosentino F, Grant PJ, Aboyans V, et al; ESC Scientific Document Group. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255-323.
8. Drugs That Can Affect Blood Sugar Levels. Diabetes In Control. Published April 2011. https://www.diabetesincontrol.com/wp-content/uploads/PDF/druglistaffectingbloodglucose.pdf
9. Prevent Heart Disease. Centers for Disease Control and Prevention. Reviewed April 21, 2020. https://www.cdc.gov/heartdisease/prevention.htm.