14 Oct 2023 • Treatment with low-dose aspirin appeared to reduce incident type 2 diabetes by 15 percent and slow the increase in fasting plasma glucose among healthy older adults, according to study findings presented at the annual meeting of the European Association for the Study of Diabetes, held from Oct. 2 to 6 in Hamburg, Germany.

Study authors conducted a post hoc analysis of the ASPREE trial, a double-blind, placebo-controlled trial of aspirin. The results, published in The New England Journal of Medicine in 2018, showed that aspirin conferred a 38 percent increased risk for major hemorrhage in older adults without any reduction in the incidence of cardiovascular disease.

• The ASPREE trial included community-dwelling adults aged 65 years and older who did not have cardiovascular disease, independence-limiting physical disability, or dementia.
• Participants were randomly assigned 1:1 to 100 mg of enteric-coated aspirin or placebo daily. The researchers defined incident diabetes as self-report of diabetes, initiation of glucose-lowering medication, and/or a fasting plasma glucose of 7 mmol/L or higher at follow-up visits.
• The post hoc analysis included 16,209 participants, of whom 8,086 were randomly assigned to aspirin and 8,123 were randomly assigned to placebo. Patients with diabetes at the beginning of the study were excluded from the analysis.

The researchers found that during a median follow-up of 4.7 years, the aspirin group had a 15 percent reduction in incident diabetes and a slower rate of increase in fasting blood glucose.

“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.” says the author Dr. Sophia Zoungas.

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