Left atrial appendage closure: Does 'leak' matter?

摘要

Aim: To determine the safety and effectiveness of insulin analogues in type 2 diabetes (T2D) patients in the Algerian cohort of the A1chieve study and to examine the status of T2D management across different regions in Algeria. Methods: Patients starting therapy with biphasic insulin aspart 30, insulin detemir, insulin aspart (IAsp) or IAsp + basal insulin at their physicians' decision were included. The primary outcome was the incidence of serious adverse drug reactions (SADRs), including major hypoglycaemia. Secondary outcomes included changes from baseline to Week 24 in hypoglycaemia, glycated haemoglobin A1c (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), weight and quality of life (QoL, evaluated using the EQ-5D questionnaire). Results: Overall, 1494 patients (mean±SD age: 60.1±10.3 years; body mass index: 28.1±4.9kg/m2; HbA1c: 9.2±1.8%) were enrolled. Poor baseline glucose control was revealed across the different Algerian regions with mean HbA1c varying from 8.9% to 9.6%. Two SADRs were reported during the study. The proportion of patients reporting major hypoglycaemic events decreased from 1.1% at baseline to 0.2% at Week 24 (p = 0.0017). Significant improvements in mean HbA1c (-1.3±2.0%), FPG (-38.8±79.9 mg/dL) and post-breakfast PPPG (-51.4±97.1 mg/dL) were observed in the entire cohort (all p 0.001). The mean body weight increased by 0.9±3.8kg, while QoL increased by 9.2±16.7 points after 24 weeks. Conclusions: Insulin analogue therapy was well-tolerated and significantly improved blood glucose control over 24 weeks in the Algerian cohort.