title: An observational non-interventional study of people with diabetes beginning or changed to insulin analogue therapy in non-Western countries: the A1chieve study.
abstract: OBJECTIVE
  The aim of A(1)chieve was to remedy the deficit of data on the efficacy and safety of insulin analogues in routine clinical care in less well-resourced/newly developed countries.
  
  
  METHODS
  A non-interventional, 6-month, observational study of 66,726 people with type 2 diabetes, both insulin users and non-insulin users, started on insulin detemir, insulin aspart or biphasic insulin aspart in 28 countries across four continents.
  
  
  RESULTS
  Baseline HbA(1c) (±SD) was poor: 9.5 ± 1.8%. At 6 months, improvement was -2.1 ± 1.7% in the entire cohort, and -2.2 ± 1.7% and -1.8 ± 1.7% for prior non-insulin users and insulin users. All three analogue therapies gave similar results, again independently of prior insulin use, but also from seven pre-specified country groupings. Overall, hypoglycaemia did not increase in those new to insulin, and fell in those switching insulins. There was no change in body weight (-0.1 ± 3.7 kg), while lipid profile and systolic blood pressure (-6.3 ± 17.1 mmHg) were improved.
  
  
  CONCLUSIONS
  Beginning insulin analogue therapy in people with type 2 diabetes and poor blood glucose control is associated with marked improvements in diverse aspects of vascular risk factor profile without evidence of clinically significant safety or tolerability problems.
authors.affiliation: Institute of Cellular Medicine - Diabetes, Newcastle University, Newcastle upon Tyne, UK. philip.home@newcastle.ac.uk
authors.forename: Philip
authors.initials: P
authors.lastname: Home
authors.forename: Nabil El
authors.initials: NE
authors.lastname: Naggar
authors.forename: Mohammed
authors.initials: M
authors.lastname: Khamseh
authors.forename: Guillermo
authors.initials: G
authors.lastname: Gonzalez-Galvez
authors.forename: Chunduo
authors.initials: C
authors.lastname: Shen
authors.forename: Praful
authors.initials: P
authors.lastname: Chakkarwar
authors.forename: Yang
authors.initials: Y
authors.lastname: Wenying
mesh_terms: D019049:Developed Countries; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin