Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which of the following is NOT included in the ADA's Standards of Care for aspirin therapy?

1. Secondary prevention in those who have a history of stroke

2. Primary prevention in men over 50 with CVD risk

3. Secondary prevention in those with a history of myocardial infarction

4. Primary prevention in adults of any age with retinopathy

The correct answer is: Primary prevention in adults of any age with retinopathy

The correct answer, which indicates that primary prevention in adults of any age with retinopathy is not included in the ADA's Standards of Care for aspirin therapy, highlights an important aspect of the guidelines. The ADA recommends aspirin therapy primarily for individuals at increased cardiovascular risk, which includes secondary prevention strategies for those with a history of cardiovascular events such as strokes or myocardial infarctions. Primary prevention recommendations are usually targeted at specific populations, particularly those with demonstrated cardiovascular disease (CVD) risk factors. While retinopathy is a complication associated with diabetes that indicates increased risk for cardiovascular disease, the ADA does not endorse routine aspirin therapy solely based on the presence of retinopathy independent of other risk factors. This distinction emphasizes the focus on a comprehensive evaluation of overall cardiovascular risk rather than isolated conditions. In the other scenarios mentioned, such as individuals with a history of stroke or myocardial infarction, aspirin is recommended as a means of secondary prevention, aimed at reducing the risk of future events. The guidelines show a clear approach to applying aspirin therapy based on defined cardiovascular risks rather than indiscriminate use for all diabetes-related complications.