title: The effectiveness and safety of beginning insulin aspart together with basal insulin in people with type 2 diabetes in non-Western nations: results from the A₁chieve observational study.
abstract: OBJECTIVE
  The aim of this A₁chieve sub-group analysis was to examine populations beginning insulin aspart together with any basal insulin, all ± oral glucose lowering drugs: insulin aspart added to existing basal insulin (n=519); switched from biphasic insulin (n=947); switched from NPH plus human meal-time insulins (n=586); and insulin-naïve begun with basal plus insulin aspart (n=1594).
  
  
  METHODS
  A₁chieve was a 24-week non-interventional study evaluating insulin analogues in 66,726 people with type 2 diabetes in routine clinical care in 28 non-Western countries. Major endpoints were analysed as change from baseline using Student's paired t-test.
  
  
  RESULTS
  Baseline glycaemic control was poor (mean HbA1c: 9.4-10.1% [79-87 mmol/mol]). HbA₁c, FPG and PPPG improved significantly from baseline in all groups (mean change from baseline in HbA1c: -2.8 to -1.8% [-31 to -20 mmol/mol]; FPG: -4.9 to -2.9 mmol/L; PPPG: -6.7 to -3.9 mmol/L; p<0.001 for all), resulting in a similar level of blood glucose control for all groups at study end. Unsurprisingly, hypoglycaemia rates increased in those starting insulin, but decreased in the other groups. Clinically significant improvements in serum lipids and quality of life occurred across all groups.
  
  
  CONCLUSIONS
  These data support the use of basal plus prandial insulin regimens in routine clinical practice in people with type 2 diabetes with inadequate glycaemic control.
authors.affiliation: Newcastle University, Newcastle upon Tyne, UK. Electronic address: philip.home@newcastle.ac.uk.
authors.forename: Philip D
authors.initials: PD
authors.lastname: Home
authors.forename: Zafar A
authors.initials: ZA
authors.lastname: Latif
authors.forename: Guillermo
authors.initials: G
authors.lastname: González-Gálvez
authors.forename: Vinay
authors.initials: V
authors.lastname: Prusty
authors.forename: Zanariah
authors.initials: Z
authors.lastname: Hussein
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D061267:Insulin Aspart / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D007328:Insulin; D061267:Insulin Aspart
keywords: A(1)chieve; Insulin aspart; Non-interventional study; Type 2 diabetes