Safety & efficacy of biphasic insulin as part in people with type 2 diabetes (T2D) switched from a basal-bolus regimen: results from the A1chieve study (#309)
Aims
As T2D progresses blood glucose control declines and optimisation of treatment becomes inevitable. Basal-bolus therapy is gold standard for diabetes management; however not infrequently, hypoglycaemia associated with intensive therapy can be a clinically-limiting factor for patients. Premix insulin analogues may be an alternative for further optimisation of therapy. This A1chieve study subgroup analysis aimed to examine clinical safety and effectiveness of biphasic insulin aspart (BIAsp30) ±oral glucose-lowering drugs (OGLDs) in people with T2D switching from a basal-bolus insulin regimen±OGLDs.
Methods
A1chieve was a multinational, open-label, non-interventional, 24-week observational study of people with T2D starting insulin analogue therapy in 28 countries worldwide.
Results
Of 1027 patients included in this analysis, mean age (SD) was 55.2 (13.1) yrs; diabetes duration 10.1 (7.7) yrs; mean duration on insulin therapy 2.8 (4.1) yrs. For most people the most frequent reason given for therapy change was to improve glycaemic control (>90%); hypoglycaemic risk reduction was also important (>25%). HbA1c was poor at baseline (mean value 9.7 [1.9]%), which improved to 7.6 (1.3)%. Overall hypoglycaemia decreased from 9.4 events/patient-year at baseline to 3.0 events/patient-year after 24 weeks. Mean daily basal and bolus dose pre-study was 0.36 and 0.37 U/kg, respectively; mean starting dose for BIAsp30 was 0.61 U/kg, increasing to 0.68 U/kg. The majority of patients (81%) switched to twice-daily BIAsp30; by 24 weeks 70% were taking twice-daily BIAsp30 and 22% were taking it three times daily.
Conclusions
Switching from a basal-bolus insulin regimen to treatment with BIAsp was safe and well tolerated.