Antiplatelet Treatment in Diabetes

INTERVENTION: Subjects with type 2 diabetes currently taking aspirin 75 mg. Following a 2‐week run in period, they will be randomised to receive either clopidogrel 75 mg or prasugrel 10 mg daily for 4 weeks. Following this they will be switched to receive whichever treatment they did not receive during the first phase. At the end of a further 4 weeks study treatment they will recommence aspirin therapy as before. Follow‐up length: 4 months Study entry: single randomisation only CONDITION: Topic: Diabetes Research Network; Subtopic: Type 2; Disease: Cardiovascular disease ; Nutritional, Metabolic, Endocrine ; Non‐insulin‐dependent diabetes mellitus PRIMARY OUTCOME: Comparison of the biochemical efficacy of aspirin, clopidogrel and prasugrel in subjects with type 2 diabetes SECONDARY OUTCOME: To study the mechanisms of antiplatelet treatment failure in individuals with type 2 diabetes INCLUSION CRITERIA: 1. Aged 18 less than 75 years, either sex 2. Type 2 diabetes mellitus 3. Currently taking aspirin 75 mg per day 4. Weight 60 kg or over 5. Must be able to give informed consent and comply with the protocol 7. Using reliable contraception, i.e., oral contraceptive pill, intrauterine device, diaphragm + condom