Important study ASCEND published in the NEJM and presented at the European College of Cardiology. Over 15,000 asymptomatic well controlled diabetics studied for 7 1/2 years to whether low dose aspirin prevented their first heart attack or stoke. It did! Reduced the risk by about 12%. However, the number of bleeding events (gastrointestinal bleed, intracranial bleeds) occurred almost just as often as a vascular event was prevented. So in this one study, the risks appear to equal the benefits of low dose aspirin in asymptomatic diabetics over 40. Let’s not throw the baby out with the bathwater! Aspirin is clearly beneficial for anyone who has already had a heart attack, stoke, or vascular issue. The USPTF just last year recommended a baby aspirin for ANYONE over age 50 to prevent vascular events and colon cancer. However well conducted, one study alone cannot answer such an important question as to when people with risks factors for vascular disease should prophylax against such events. At the end of the day, you should have a good primary care physician (like I do). Bounce it off your doc and see what you both come up with for a plan for you.