Antiplatelet drug use in a diabetic clinic

There are definite indications for antiplatelet therapy in diabetes in the presence of large-vessel disease, but in the absence of large-vessel disease, the evidence is less clear. There is also evidence that antiplatelet therapy is under-prescribed.

To investigate the use of antiplatelet drugs in patients attending a diabetic clinic in a large teaching hospital.

Retrospective case-note survey.

We examined the case-notes of 300 consecutive diabetic patients, to determine whether antiplatelet therapy was being used in appropriate patients, including those with established large-vessel disease, hypertension and nephropathy or microalbuminuria.

The patients were of mean +/- SD age 61 +/- 13 years, diabetes duration 10 +/- 8 years, BMI 31.4 +/- 6.7 kg/m(2) and HbA(1c) 8.3 +/- 1.5%; 276 (92%) had type 2 diabetes, and 162 (54%) were male. Antiplatelet drugs were being taken by 157 (52%) who fulfilled the survey standard for treatment; a further 83 (28%) met the survey standard but were not receiving treatment, of whom 48 (16% of the total group) had no valid contraindication.

A significant minority of diabetic patients are being denied antiplatelet drugs despite good indications.