Safety and effectiveness of insulin aspart in basal-bolus regimens regardless of age: A1chieve study results

Abstract

Introduction: Hypoglycemia is a complication in the management of type 2 diabetes, and elderly people are at greater risk of experiencing hypoglycemia events than younger patients. Insulin analogs achieve glycemic control with minimal risk of hypoglycemia and may therefore be a good treatment option for all patients. Methods: A1chieve was an international, multicenter, prospective, open-label, noninterventional, 24-week study in people with type 2 diabetes who started/switched to therapy with biphasic insulin aspart 30, insulin detemir or insulin aspart (alone/in combination) in routine clinical practice. This sub-analysis evaluated clinical safety and effectiveness of insulin aspart as part of a basal-bolus regimen (±oral glucose-lowering drugs) in three agegroups (B40,[40-65, and[65 years) of insulinexperienced and insulin-naive people with type 2 diabetes. Results: In total, 4,032 patients were included in the sub-analysis. After 24 weeks of insulin aspart treatment, significant improvements versus baseline were observed in all age-groups for: proportion of people with C1 hypoglycemia events (18.3-27.1% and 11.0-12.7%, at baseline and 24 weeks, respectively), C1 major hypoglycemia events (3.3-6.7% and 0-0.2%), and C1 nocturnal hypoglycemia events (9.2-13.7% and 2.9-4.9%); glycated hemoglobin (9.6-9.8% and 7.4%); fasting plasma glucose (change from baseline ranged from -3.6 to -4.4mmol/l); and post-breakfast post-prandial plasma glucose (change from baseline ranged from -5.5 to -5.9mmol/l). Fourteen serious adverse drug reactions were reported. Healthrelated quality of life was significantly improved for all age-groups (all, p\0.001). Conclusion: All age-groups showed improved glycemic control and reduced risk of hypoglycemia when starting/switching to insulin aspart therapy within a basal-bolus regimen; this may be particularly important for elderly patients given their greater risk of hypoglycemia versus younger patients. © The Author(s) 2013.