The new recommendations are based on close examination of nine studies that found the risks of some aspirin side effects, such as stomach bleeding, should be better balanced against the possible benefits of using aspirin.
The new guidelines have been endorsed by a panel of experts from the American Diabetes Association, the American Heart Association, and the American College of Cardiology Foundation.
"The larger theme here is that use of low-dose aspirin to prevent heart attacks in people who have not already experienced one is probably not as efficacious as we used to believe it was," Craig Williams, PharmD, an associate professor in the College of Pharmacy at Oregon State University, says in a news release.
Williams, one of those on the recent review panel, says doctors need to balance the benefits of any medication against possible side effects, and that even low-dose baby aspirin has some degree of risk, even though it is very low.
"[We] have to be able to show clear benefits that outweigh that risk," he says. "In the case of young adults with diabetes but no other significant risk factors, it's not quite clear that the benefits are adequate to merit use of aspirin."
"The newest studies just weren't showing adequate benefits for some younger diabetics," Williams says.
There is no evidence that higher doses of aspirin, over 75-162 milligrams per day, have added value in heart attack prevention, Williams says.
A baby aspirin, the 81-milligram variety, has achieved an adequate level of protection for diabetes patients with heart attack risk factors, the researchers write.
They also say that ongoing research should provide additional information on the role of low-dose aspirin for the prevention of cardiovascular events, specifically in people with diabetes.
The new advice is published as a position statement of the American Diabetes Association in the journal Diabetes Care.