title: Insulin detemir in the management of type 2 diabetes in non-Western countries: safety and effectiveness data from the A₁chieve observational study.
abstract: OBJECTIVE
  This subgroup analysis of the A₁chieve study examined data from 15,545 people who started treatment with insulin detemir ± oral glucose-lowering drugs in routine clinical care.
  
  
  METHODS
  A₁chieve was a 24-week, international, prospective, non-interventional study of people with type 2 diabetes from non-Western nations starting treatment with basal insulin detemir, bolus insulin aspart or biphasic insulin aspart 30, alone or in combination, to evaluate their safety and effectiveness in routine clinical practice.
  
  
  RESULTS
  HbA₁c for the global cohort improved after 24 weeks from 9.5 ± 1.6% by -2.0 ± 1.6% [80 ± 17 by -22 ± 17 mmol/mol] (-2.1 ± 1.6% [-23 ± 17 mmol/mol] for insulin-naïve participants; -1.6 ± 1.7% [-17 ± 19 mmol/mol] for prior insulin users). Fasting plasma glucose and postprandial plasma glucose were also significantly reduced (p<0.001), irrespective of prior therapy or geographical region. The incidence of major hypoglycaemia decreased significantly over 24 weeks in both the insulin-naïve and insulin-experienced groups (p<0.0001). Mean body weight decreased overall by -0.4 ± 4.0 kg and blood pressure, lipid profiles, and self-reported quality of life improved over 24 weeks for all people starting treatment with insulin detemir.
  
  
  CONCLUSIONS
  People with type 2 diabetes in poor glycaemic control starting treatment with insulin detemir reported significant improvements in glycaemic control with improved treatment tolerability, irrespective of prior treatment and geographical region, after 24 weeks.
authors.affiliation: Department of Endocrinology, First Moscow State Medical University, Moscow, Russia. Electronic address: avzilov@hotmail.com.
authors.forename: Alexey
authors.initials: A
authors.lastname: Zilov
authors.forename: Nabil
authors.initials: N
authors.lastname: El Naggar
authors.forename: Siddharth
authors.initials: S
authors.lastname: Shah
authors.forename: Chunduo
authors.initials: C
authors.lastname: Shen
authors.forename: Jihad
authors.initials: J
authors.lastname: Haddad
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D000069057:Insulin Detemir; D049528:Insulin, Long-Acting / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; D000069057:Insulin Detemir; D049528:Insulin, Long-Acting
keywords: A(1)chieve; Insulin detemir; Non-interventional study; Type 2 diabetes