Too much glucose control for diabetes patients may cause aspirin resistance

Aspirin can be particularly useful in small doses at warding off coronary problems, but according to a new report from the University of Turin, aspirin resistance often follows aggressive glucose-lowering therapies for type 2 diabetes, leaving diabetics at a potentially higher risk for heart problems.

Study Participants
Study participants were males about 61 years old with BMIs of 29.6 kg/m2 and an 8.9 percent baseline of HbA1c, an indicator of insulin sensitivity that changes with glucose-lowering treatments.

In an oral presentation for the European Association for the Study of Diabetes, study author Isabella Russo, PhD, said that aspirin may reduce cardiac events such as heart attack by 25 percent. Her study found additionally that while diabetes patients have been shown to reap reduced health benefits from aspirin, their occasionally aggressive glucose reduction regimens, rather than their diabetes, may be at fault.

Study findings
The study found that during a three-month period, when blood glucose was neither over nor under-controlled, aspirin sensitivity improved for previously aspirin-resistant patients, who reduced HbA1c by 1.6 percent and blood glucose levels by 47 mg/dl. Associated inflammation also lowered.

However, after three months of intensive glucose-lowering therapy for patients with no prior resistance, 10 participants (27 percent) had developed an aspirin resistance.

The worse the diabetes, it turns out, the more potential for extreme glucose treatments, and likewise the potential for increased aspirin resistance. Patients who entered the study with aspirin resistance had higher levels of cholesterol and more inflammation biomarkers than non-resistant and aspirin-sensitive patients, suggesting that with or without aspirin, aspirin sensitivity indicates a potentially positive health state.

Gerit-Holger Schernthaner, MD, PhD, professor at the medical university of Vienna, told MedPage Today that the results of Russo's study are encouraging, suggesting that metabolic control improvements may also lower aspirin resistance.

"In early diabetes, aspirin resistance is not a major problem, but after many years of having diabetes, the risk of developing cardiovascular disease is very high," Schernthaner said during the EASD presentation.

Drug treatments are still effective in the right amounts, and the study does not discount traditional diabetes treatments. Patients suffering from type 2 diabetes can ask their doctors if they should buy Actos, while patients with heart disease or other heart-related complications may want to buy Lipitor.

According to the American diabetes Association, tight glycemic control is not necessary for every patient, and can result in increased potential for hypoglycemia and weight gain. The potential benefits from tight glycemic control may be high for some, however, including a reduction in diabetic eye, kidney and nerve diseases. Patients should consult their doctors before changing treatment regimens.