An observational non-interventional study of people with diabetes beginning or changed to insulin analogue therapy in non-Western countries: The A 1chieve study

摘要

Aim: The aim of A 1chieve was to remedy the deficit of data on the efficacy and safety of insulin analogues in routine clinical care in less well-resourcedewly 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±3.7kg), while lipid profile and systolic blood pressure (-6.3±17.1mmHg) 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.