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Switching from biphasic human insulin 30 to biphasic insulin aspart 30 in type 2 diabetes is associated with improved glycaemic control and a positive safety profile: Results from the A1chieve study

Nabil K. El Naggar, Pradana Soewondo, Mohammad E. Khamseh, Jian-Wen Chen and Jihad Haddad

Diabetes Research and Clinical Practice, 3, 98, pages 408 - 413

Published online Dec-2012


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References

Label Authors Title Source Year
[1]
L. Monnier, C. Colette Targeting prandial hyperglycemia: how important is it and how best to do this? Curr. Diab. Rep.. 2008;8:368-374 2008
[2]
H.J. Woerle, C. Neumann, S. Zschau, S. Tenner, A. Irsigler, J. Schirra, et al. Impact of fasting and postprandial glycemia on overall glycemic control in type 2 diabetes Importance of postprandial glycemia to achieve target HbA1c levels Diabetes Res. Clin. Pract.. 2007;77(2):280-285 2007
[3]

References in context

  • PPG has also been identified as an independent risk factor for diabetic complications such as cardiovascular disease [3].
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  • In addition, lowering PPG is associated with reduced cardiovascular risk [3].
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A. Ceriello, J. Davidson, M. Hanefeld, L. Leiter, L. Monnier, D. Owens, et al. Postprandial hyperglycaemia and cardiovascular complications of diabetes: an update Nutr. Metab. Cardiovasc. Dis.. 2006;16:453-456 2006
[4]

References in context

  • Therefore, clinical guidelines such as those published by the International Diabetes Federation recommend targeting both FPG and PPG at all HbA1c levels in order to achieve glycaemic targets, and to minimise the development of diabetic complications [4].
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  • Baseline data from this study show that post-breakfast PPG was in the range of 12.9–15.1 mmol/l depending on region, well above the IDF recommended PPG target of <9 mmol/l [4].
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  • Baseline data from this study show that post-breakfast PPG was in the range of 12.9–15.1 mmol/l depending on region, well above the IDF recommended PPG target of <9 mmol/l [4].
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International Diabetes Federation. Guideline For Management Of Postmeal Glucose In Diabetes 2011. International Diabetes Federation 2012. Accessed: August 22. Available from: URL: http://www.idf.org/2011-guidelinemanagement- postmeal-glucose-diabetes.
[5]

References in context

  • Biphasic insulin aspart 30 (BIAsp 30; NovoMix® 30, Novo Nordisk) has been shown to provide better control of PPG than BHI 30 in a meta-analysis including data from nine randomised controlled trials (RCTs) in patients with Type 2 diabetes mellitus (T2D) [5].
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  • Significant reductions in major and nocturnal hypoglycaemia were also observed in a meta-analysis of trials comparing BIAsp 30 and BHI [5].
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J.A. Davidson, A. Liebl, J.S. Christiansen, G. Fulcher, R.J. Ligthelm, P. Brown, et al. Risk for nocturnal hypoglycemia with biphasic insulin aspart 30 compared with biphasic human insulin 30 in adults with type 2 diabetes mellitus: a metaanalysis Clin. Ther.. 2009;31:1641-1651 2009
[6]
S. Shah, M. Benroubi, V. Borzi, J. Gumprecht, R. Kawamori, J. Shaban, et al. Safety and effectiveness of biphasic insulin aspart 30/70 (NovoMix 30) when switching from human premix insulin in patients with type 2 diabetes: subgroup analysis from the 6-month IMPROVE observational study Int. J. Clin. Pract.. 2009;63:574-582 2009
[7]
M. Shestakova, S.K. Sharma, M. Almustafa, K.W. Min, N. Ayad, S.T. Azar, et al. Transferring type 2 diabetes patients with uncontrolled glycaemia from biphasic human insulin to biphasic insulin aspart 30: experiences from the PRESENT study Curr. Med. Res. Opin.. 2007;23:3209-3214 2007
[8]

References in context

  • It is important to select insulin therapy according to individual needs and the A1chieve® study is the first observational study that included individuals who were switched to BIAsp 30, insulin detemir (Levemir®, Novo Nordisk) or insulin aspart (NovoRapid®, Novo Nordisk) alone or in combination as part of their routine clinical care [8].
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  • The A1chieve® study was an international prospective, obser vational, multicentre, open label, non-interventional, 24-week study in people with T2D who were treatment naïve or who had been using anti-diabetic medication other than Novo Nordisk insulin analogues being evaluated and who had started treatment with BIAsp 30, insulin detemir or insulin aspart (alone or in combination) in routine clinical practice [8].
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  • This hypothesis was supported by the overall A1chieve® data, which showed minimal body weight gain in association with improved HbA1c, as well as improved blood pressure and lipid profile [8].
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P. Home, N.E. Naggar, M. Khamseh, G. Gonzalez-Galvez, C. Shen, P. Chakkarwar, et al. An observational non-interventional study of people with diabetes beginning or changed to insulin analogue therapy in non-Western countries: the A1chieve study Diabetes Res. Clin. Pract.. 2011;94:352-363 2011
[9]
P.T. McSorley, P.M. Bell, L.V. Jacobsen, A. Kristensen, A. Lindholm Twice-daily biphasic insulin aspart 30 versus biphasic human insulin 30: a doubleblind crossover study in adults with type 2 diabetes mellitus Clin. Ther.. 2002;24:530-539 2002
[10]
B.O. Boehm, P.D. Home, C. Behrend, N.M. Kamp, A. Lindholm Premixed insulin aspart 30 vs. premixed human insulin 30/70 twice daily: a randomized trial in Type 1 and Type 2 diabetic patients Diabet. Med.. 2002;19:393-399 2002
[11]
K. Hermansen, M. Colombo, H. Storgaard, A. OStergaard, K. Kolendorf, S. Madsbad Improved postprandial glycemic control with biphasic insulin aspart relative to biphasic insulin lispro and biphasic human insulin in patients with type 2 diabetes Diabetes Care. 2002;25:883-888 2002
[12]

References in context

  • This improvement in PPG may reflect the earlier and higher peak postprandial insulin concentrations achieved by BIAsp 30 compared with BHI 30 [12].
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  • A crossover study by McNally et al 2007 employed continuous glucose monitoring to examine the frequency of low interstitial glucose values in individuals treated with BIAsp 30 or BHI 30 [12].
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P.G. McNally, J.D. Dean, A.D. Morris, P.D. Wilkinson, G. Compion, S.R. Heller Using continuous glucose monitoring to measure the frequency of low glucose values when using biphasic insulin aspart 30 compared with biphasic human insulin 30: a double-blind crossover study in individuals with type 2 diabetes Diabetes Care. 2007;30:1044-1048 2007
[13]
Qayyum R, Wilson LM, Bolen S, Maruthur N, Marinopoulos SS, Feldman L, et al. Comparative Effectiveness, Safety, and Indications of Insulin Analogues in Premixed Formulations for Adults With Type 2 Diabetes. Rockville (MD): Agency for Healthcare Research and Quality (US). Available from: http://www.ncbi.nlm.nih.gov/books/NBK43174/.
[14]
B.O. Boehm, J.A. Vaz, L. Brondsted, P.D. Home Long-term efficacy and safety of biphasic insulin aspart in patients with type 2 diabetes Eur. J. Intern. Med.. 2004;15:496-502 2004

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