Biphasic insulin aspart 30 in insulin-naive people with type 2 diabetes in non-western nations: results from a regional comparative multinational observational study (A(1)chieve).
BACKGROUND
A1chieve(®) (Novo Nordisk A/S, Bagsværd, Denmark) was a prospective, multicenter, noninterventional study in 66,726 people with type 2 diabetes mellitus (T2DM) in 28 countries beginning biphasic insulin aspart 30 (aspart premix), insulin detemir, or insulin aspart in routine clinical care.


METHODS
A subgroup of 27,594 insulin-naive people began therapy with aspart premix with or without oral agents. Safety and effectiveness data were taken from clinic records at baseline and after 24 weeks. Seven regional country groupings were prespecified.


RESULTS
Mean final insulin dose ranged from 0.68±0.26 U/kg/day (Middle East/Gulf) to 0.38±0.14 U/kg/day (South Asia). The baseline glycated hemoglobin (HbA1c) level varied from 10.5±2.0% (Latin America) to 9.2±1.3% (South Asia), with reductions from -2.9±2.1% (Latin America) to -1.9±1.3% (South Asia). The proportion of people reaching an HbA1c level of <7.0% was highest in China (56%) and lowest in North Africa (22%). Fasting plasma glucose level reductions were from -6.4±5.3 mmol/L (Latin America) to -3.6±2.6 mmol/L (South Asia). Most people began aspart premix twice daily, varying from 91% (North Africa) to 70% (Latin America). Improvement in HbA1c increased with baseline dose frequency (once daily, -1.5±1.4%; twice daily, -2.2±1.6%; three times daily, -2.9±2.2%).


CONCLUSIONS
Insulin-naive people with T2DM beginning aspart premix insulin in routine clinical practice in non-western nations had clinically useful improvements in blood glucose control after 24 weeks in all seven regions. Improvements from baseline for glucose control variables were greater than cross-regional differences in those variables at 24 weeks.
1 Bhatia Hospital , Mumbai, India .
Siddharth
S
Shah
Wenying
W
Yang
Mohammad Imtiaz
MI
Hasan
Rachid
R
Malek
Ole
O
Molskov Bech
Philip
P
Home
D000352:Africa, Northern / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D001682:Biological Availability; D061265:Biphasic Insulins / Q000008:administration & dosage / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D004334:Drug Administration Schedule; D005202:Asia, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D061267:Insulin Aspart / Q000008:administration & dosage / Q000627:therapeutic use*; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D012426:Russia / Q000453:epidemiology; D016896:Treatment Outcome
D061265:Biphasic Insulins; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D061267:Insulin Aspart