fear of hypoglycaemia and gain in body weight are barriers for initiation of insulin therapy .
modern insulin analogues are a convenient new approach or tool to glycaemic control , associated with low number of hypoglycaemia and favourable weight change .
a1chieve , a multinational , 24-week , non - interventional study , assessed the safety and effectiveness of insulin analogues in people with t2 dm ( n = 66,726 ) in routine clinical care .
the patient characteristics for the entire cohort divided as insulin - nave and insulin users is shown in table 1 .
the majority of patients ( 61.82% ) started on or switched to biphasic insulin aspart .
other groups were insulin detemir ( n = 89 ) , insulin aspart ( n = 155 ) , basal insulin plus insulin aspart ( n = 45 ) and other insulin combinations ( n = 21 ) . overall demographic data after 24 weeks of treatment , overall hypoglycaemia reduced from 0.7 events / patient - year to 0.2 events / patient - year in insulin nave group and from 1.8 events / patient - year to 0.3 events / patient - year in insulin user group .
the hypoglycaemia incidence in insulin naive group at 24 weeks was lower than that observed in insulin users at baseline .
body weight and blood pressure decreased from baseline , while overall lipid profile and quality of life improved at week 24 in the total cohort [ table 2 and 3 ] .
mean hba1c and fpg values improved from baseline to study end in the total cohort [ table 4 ] .
overall efficacy data of the total cohort , 502 patients started on biphasic insulin aspart  ogld , of which 372 ( 74.1% ) were insulin nave and 130 ( 25.9% ) were insulin users .
after 24 weeks of treatment , hypoglycaemic events reduced for both insulin naive ( from 0.9 events / patient - year to 0.3 events / patient - year ) and insulin user ( from 1.4 events / patient - year to 0.4 events / patient - year ) groups .
body weight decreased and quality of life improved at the end of the study [ table 5 and 6 ] .
biphasic insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to biphasic insulin aspart for both insulin nave and insulin user groups [ table 7 ] .
biphasic insulin aspartoral glucose - lowering drug efficacy data of the total cohort , 45 patients started on basal + insulin aspart  ogld , of which 33 ( 73.3% ) were insulin nave and 12 ( 26.7% ) were insulin users .
after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 0.4 events / patient - year to 0.0 events / patient - year in insulin nave group and from 7.6 events / patient - year to 0.0 events / patient - year in insulin user group .
basal+insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to basal + insulin aspart  oglds for both insulin nave and insulin user groups [ table 10 ] .
basal+insulin aspartoral glucose - lowering drug efficacy data of the total cohort , 89 patients started on insulin detemir  ogld , of which 66 ( 74.2% ) were insulin nave and 23 ( 25.8% ) were insulin users .
after 24 weeks of starting or switching to biphasic insulin aspart hypoglycaemic events reduced from 0.8 events / patient - year to 0.0 events / patient - year in insulin nave group and from 0.6 events / patient - year to 0.0 events / patient - year in insulin user group .
insulin detemiroral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to insulin detemir  oglds for both insulin - nave and insulin user groups [ table 13 ] .
insulin detemiroral glucose - lowering drug efficacy data of the total cohort , 155 patients started on insulin aspart  ogld , of which 122 ( 78.7% ) were insulin nave and 33 ( 21.3% ) were insulin users .
after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 0.1 events / patient - year to 0.0 events / patient - year in insulin nave group and from 1.6 events / patient - year to 0.0 events / patient - year in insulin user group .
insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to insulin aspart  oglds for both insulin nave and insulin user groups [ table 16 ] . insulin aspartoral glucose - lowering drug efficacy data
of the total cohort , 502 patients started on biphasic insulin aspart  ogld , of which 372 ( 74.1% ) were insulin nave and 130 ( 25.9% ) were insulin users .
after 24 weeks of treatment , hypoglycaemic events reduced for both insulin naive ( from 0.9 events / patient - year to 0.3 events / patient - year ) and insulin user ( from 1.4 events / patient - year to 0.4 events / patient - year ) groups .
body weight decreased and quality of life improved at the end of the study [ table 5 and 6 ] .
biphasic insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to biphasic insulin aspart for both insulin nave and insulin user groups [ table 7 ] .
of the total cohort , 45 patients started on basal + insulin aspart  ogld , of which 33 ( 73.3% ) were insulin nave and 12 ( 26.7% ) were insulin users .
after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 0.4 events / patient - year to 0.0 events / patient - year in insulin nave group and from 7.6 events / patient - year to 0.0 events / patient - year in insulin user group .
basal+insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to basal + insulin aspart  oglds for both insulin nave and insulin user groups [ table 10 ] .
of the total cohort , 89 patients started on insulin detemir  ogld , of which 66 ( 74.2% ) were insulin nave and 23 ( 25.8% ) were insulin users .
after 24 weeks of starting or switching to biphasic insulin aspart hypoglycaemic events reduced from 0.8 events / patient - year to 0.0 events / patient - year in insulin nave group and from 0.6 events / patient - year to 0.0 events / patient - year in insulin user group .
insulin detemiroral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to insulin detemir  oglds for both insulin - nave and insulin user groups [ table 13 ] .
of the total cohort , 155 patients started on insulin aspart  ogld , of which 122 ( 78.7% ) were insulin nave and 33 ( 21.3% ) were insulin users .
after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 0.1 events / patient - year to 0.0 events / patient - year in insulin nave group and from 1.6 events / patient - year to 0.0 events / patient - year in insulin user group .
insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to insulin aspart  oglds for both insulin nave and insulin user groups [ table 16 ] .
our study reports improved glycaemic control and quality of life following 24 weeks of treatment with any of the insulin analogues ( biphasic insulin aspart ; basal + insulin aspart ; insulin detemir ; insulin aspart ) with or without ogld . a small weight reduction was noted for all the four regimens .
sadrs including major hypoglycaemic events or episodes did not occur in any of the study patients .
though the findings are limited by number of patients , still the trend indicates that insulin analogues can be considered effective and possess a safe profile for treating type 2 diabetes in gujarat , india .
 background : the a1chieve , a multicentric ( 28 countries ) , 24-week , non - interventional study evaluated the safety and effectiveness of insulin detemir , biphasic insulin aspart and insulin aspart in people with t2 dm ( n = 66,726 ) in routine clinical care across four continents.materials and methods : data was collected at baseline , at 12 weeks and at 24 weeks . this short communication presents the results for patients enrolled from gujarat , india.results:a total of 812 patients were enrolled in the study . 
 four different insulin analogue regimens were used in the study . 
 patients had started on or were switched to biphasic insulin aspart ( n = 502 ) , insulin detemir ( n = 89 ) , insulin aspart ( n = 155 ) , basal insulin plus insulin aspart ( n = 45 ) and other insulin combinations ( n = 21 ) . at baseline 
 glycaemic control was poor for both insulin nave ( mean hba1c : 8.9% ) and insulin user ( mean hba1c : 9.1% ) groups . after 24 weeks of treatment , both the groups showed improvement in hba1c ( insulin nave : 2.2% , insulin users : 2.5% ) . 
 sadrs including major hypoglycaemic events or episodes did not occur in any of the study patients.conclusion:starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia . 
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Biphasic insulin aspart  OGLD
Basal + insulin aspart  OGLD
Insulin detemir  OGLD
Insulin aspart  OGLD
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