Novo Nordisk has released its new data from the Achieve study conducted on use of modern insulins stated that type 2 diabetes patients in India can significantly improve their blood glucose control with a low occurrence of low blood sugar (hypoglycaemia).

Achieve is the largest study ever conducted into the safety and effectiveness of insulin treatment and involves 66,726 people with type 2 diabetes from 28 countries across Asia, Africa, Europe and Latin America.

More than 30 per cent of these patients were from India, the largest from any single country. Before entering into the study, people were started on one of three Novo Nordisk insulin analogue regimens: NovoMix 30 (biphasic insulin aspart 30), Levemir (insulin detemir) and NovoRapid (insulin aspart) based on their physicians clinical judgement. The primary aim of the study was to evaluate the clinical safety of the study insulins in routine clinical practice, assessed by the incidence of serious adverse drug reactions (SADRs) including rates of major hypoglycaemia.

After 24 weeks, clinically meaningful improvements in overall blood glucose control were found with all insulin analogue regimens. There are 62.4 million people with type 2 diabetes in India and 77 million people with pre-diabetes. These numbers are projected to increase to 101 million by the year 2030.

The report which is published in the Journal of the Association of Physicians in India, stated that patients before treatment with modern insulin was initiated, their average blood glucose control using the HbA1C among the 20,554 study participants in India was 9.2 per cent, which is well above the internationally recognised target of seven per cent.

Poor blood glucose control puts people at high risk of developing diabetes-related complications; in this study the prevalence of diabetes complications was high, with neuropathy (24.6 per cent) being the most common complication followed by cardiovascular (23.6 per cent), renal (21.1 per cent) and eye (16.6 per cent) complications. Many patients had multiple complications. After 24 weeks of treatment with a modern insulin there was a significant reduction in HbA1c levels of 1.8 per cent, from 9.2 per cent to 7.4 per cent. Reported rates of overall hypoglycaemia also fell. Furthermore, patients’ reported quality of life improved significantly.

According to Dr Sanjay Kalra, Bharti Hospital, Karnal said that the HbA1C of 9.2 per cent in the patient cohort indicates the poor glycaemic control in India. However, the improvement in HbA1C seen in this study following initiation of insulin analogues is of significant clinical importance. “We know that every 1.0 per cent reduction in HbA1c is associated with reducing the risk of long-term diabetes complications. Therefore, the improvements in blood glucose control seen in this study potentially means a better longer term outlook for the people with diabetes involved.”

“Observational studies like Achieve, which looked at the use of modern insulins in real life clinics in India, are important because they give us a true picture of what is happening in the real world. Data on the glycaemic status and burden of complications of type 2 diabetes patients in India was limited before we participated in the Achieve study,” added Dr Kalra.