What is the best medicine for diabetes to prevent thrombosis?

In fact, there is no so-called "best" drug at all. The risk levels of blood clots in different diabetic patients are very different, and the suitable drugs are completely different. The most effective one is the one that suits you.

Last week I saw a 62-year-old Aunt Zhang who has had type 2 diabetes for 8 years. Her fasting blood sugar is normally controlled at around 6.5mmol/L, which is still within the standard. However, a physical examination showed that she had a 1.2mm hypoechoic plaque in her carotid artery and her low-density lipoprotein was 3.8mmol/L. She also has a 3-year history of hypertension. , is a clear high-risk group for blood clots. I prescribed her a low-dose aspirin of 100 mg per day combined with a medium-strength statin. After taking it for three months, she came back for a review. She found that the plaque had turned into a more stable strong echo, and there were no common adverse reactions such as stomachache or gum bleeding. The effect of controlling blood clots was quite good.

Of course, not all people with diabetes need to take aspirin to prevent blood clots. In recent years, there has been controversy in the academic community about whether low-risk people with diabetes should routinely use antiplatelet drugs. If you have just been diagnosed with diabetes a few years ago, are under 40 years old, have neither high blood pressure, high blood lipids, nor a family history of cardiovascular and cerebrovascular diseases, you will need to take a physical examination every year. No plaque was found in the carotid artery examination. In this case, many doctors do not recommend taking anticoagulant and antiplatelet drugs in advance. After all, these drugs have a certain risk of bleeding. If the risk of thrombosis itself is very low, the benefits of taking the medicine are not worth the risk of gastric mucosal damage, gum bleeding and even gastrointestinal bleeding, and the gain is not worth the loss.

Speaking of blood clots, they are like time bombs buried in the blood vessels of diabetic patients. Taking medicine to prevent them is essentially to eliminate risks. You must first find out the size of the bomb, its buried location, and whether there is a risk of exploding quickly, then you can choose the right tool. You can't just use the same pliers to remove it regardless of the situation, right? If you have suffered from thrombotic diseases such as cerebral infarction or myocardial infarction, you will basically need to take aspirin or clopidogrel for a long time. If you are also complicated by atrial fibrillation, you may have to switch to new oral anticoagulants such as rivaroxaban. These are all determined by a doctor after a comprehensive assessment of your thrombosis risk and bleeding risk. Buying and taking blindly based on the recommendations of neighbors or netizens is the most likely to cause problems.

I also treated a 41-year-old man with diabetes in the past two months. He was diagnosed with type 2 diabetes only a year ago. He had no problems except for slightly high blood sugar. He heard from neighbors in the community that aspirin can prevent blood clots, so he bought it and took it every day. After half a year of taking it, his stomach hurt unbearably. A gastroscopy revealed a duodenal ulcer. He was originally a low-risk person. He usually controlled his blood sugar, blood lipids, and blood pressure to the standard, and took time to walk more. He did not need to take medicine in advance. He suffered in vain.

If you really want to choose an anti-thrombotic drug that suits you, it is better to save the blood sugar, blood lipids, and blood pressure reports of the past three months, as well as the results of vascular ultrasound, electrocardiogram and other tests, and find an endocrinologist or cardiologist to evaluate the risks. It is much more reliable than searching for the "best drug" on the Internet.