The glycemic efficacies of insulin analogue regimens according to baseline glycemic status in Korean patients with type 2 diabetes: sub-analysis from the A(1)chieve® study

AIMS: In this study, we compared the glucose-lowering effectiveness of insulin analogues and their combination according to baseline glycemic status in patients with type 2 diabetes (T2D) from the A(1)chieve® study conducted in Korea. METHODS: This sub-analysis from the A(1)chieve® study was a 24-week prospective, multicenter, non-interventional, open-labelled study. Of the 4058 patients, 3074 patients who had their HbA(1c) level measured at baseline were included in this sub-analysis. We classified patients into three groups according to baseline HbA(1c) levels: group I (HbA(1c) < 7.5%), group II (7.5% ≤ HbA(1c) < 9.0%) and group III (HbA(1c) ≥ 9.0%). RESULTS: Patients in group I showed no significant HbA(1c) reduction with any insulin regimens (detemir, aspart, detemir and aspart or biphasic aspart 30 (Novo Nordisk A/S, DK-2880 Bagsværd, Denmark) after 24 weeks of treatment. In group II, although HbA(1c) was decreased for all insulin regimens, there was no difference in mean HbA(1c) reduction among the four insulin regimens. In patients with a high baseline HbA(1c) level (group III), mean HbA(1c) reduction was the greatest in patients on a basal-bolus regimen (detemir and aspart, −3.50%) and lowest in patients on a bolus regimen (aspart, −1.81%; p < 0.001). CONCLUSION: For optimal glycaemic control, a basal-bolus regimen may be adequate for Korean patients with poorly controlled T2D (HbA(1c) ≥ 9.0%).