Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Diabetes Metab J. 2013 Jun;37(3):181-9. doi: 10.4093/dmj.2013.37.3.181. Epub 2013 Jun 14.
A1chieve® was a noninterventional study evaluating the clinical safety and efficacy of biphasic insulin aspart 30, insulin detemir, and insulin aspart.
Korean type 2 diabetes patients who have not been treated with the study insulin or have started it within 4 weeks before enrollment were eligible for the study. The patient selection and the choice of regimen were at the discretion of the physician. The safety and efficacy information was collected from the subjects at baseline, week 12, and week 24. The number of serious adverse drug reactions (SADRs) was the primary endpoint. The changes of clinical diabetic markers at week 12 and/or at week 24 compared to baseline were the secondary endpoints.
Out of 4,058 exposed patients, 3,003 completed the study. During the study period, three SADRs were reported in three patients (0.1%). No major hypoglycemic episodes were observed and the rate of minor hypoglycemic episodes marginally decreased during 24 weeks (from 2.77 to 2.42 events per patient-year). The overall quality of life score improved (from 66.7±15.9 to 72.5±13.5) while the mean body weight was slightly increased (0.6±3.0 kg). The 24-week reductions in glycated hemoglobin, fasting plasma glucose and postprandial plasma glucose were 1.6%±2.2%, 2.5±4.7 mmol/L, and 4.0±6.4 mmol/L, respectively.
The studied regimens showed improvements in glycemic control with low incidence of SADRs, including no incidence of major hypoglycemic episodes in Korean patients with type 2 diabetes.
A1chieve® 是一项非干预性研究,旨在评估双相门冬胰岛素 30、地特胰岛素和门冬胰岛素的临床安全性和疗效。
本研究纳入未经研究胰岛素治疗或在入组前 4 周内开始使用研究胰岛素的韩国 2 型糖尿病患者。患者选择和治疗方案的选择由医生决定。安全性和疗效信息在基线、12 周和 24 周时从受试者中收集。严重药物不良反应(SADR)的数量为主要终点。与基线相比,12 周和/或 24 周时临床糖尿病标志物的变化为次要终点。
在 4058 名暴露患者中,有 3003 名完成了研究。研究期间,3 名患者报告了 3 例 SADR(0.1%)。未观察到严重低血糖事件,且 24 周内轻度低血糖事件的发生率略有下降(从每名患者每年 2.77 次降至 2.42 次)。总体生活质量评分提高(从 66.7±15.9 分提高至 72.5±13.5 分),而平均体重略有增加(0.6±3.0 kg)。24 周时糖化血红蛋白、空腹血糖和餐后血糖的降低分别为 1.6%±2.2%、2.5±4.7 mmol/L 和 4.0±6.4 mmol/L。
研究方案显示在韩国 2 型糖尿病患者中,SADR 发生率低,包括无严重低血糖事件发生,改善了血糖控制。