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The benefits of aspirin for primary prevention are decreased and the risks of bleeding are increased in patients with diabetes.
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Generally aspirin for primary prevention should only be considered in patients with a 5 year CVD risk > 15% with a low risk of bleeding
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For secondary prevention (i.e. a previous vascular event), all patients with diabetes should be treated with aspirin 100 mg orally daily unless contraindicated
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Clopidogrel may be used as an alternative if aspirin is not tolerated