Switch from biphasic human insulin 30 to biphasic insulin aspart 30 in Pakistani subjects

Objective: To determine the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in type 2 diabetes subjects switched from biphasic human insulin 30 (BHI 30) in the Pakistani subgroup of the multinational, prospective, non-interventional A1chieve study. Methods: Subjects who switched therapy from BHI 30 to BIAsp 30 were included in this analysis. Serious adverse drug reactions (SADRs, including major hypoglycaemia) and effectiveness parameters (glycated haemoglobin [HbA1c], fasting plasma glucose [FPG], postprandial plasma glucose [PPPG], systolic blood pressure [SBP]) and body weight were evaluated at the end of 24 weeks. Results: A total of 152 subjects (79 males, 73 females; mean age, 53.4 +/- 10.3 years; BMI, 28.4 +/- 5.8 kg/m(2)) with an average diabetes duration of 11.2 +/- 4.8 years switched therapy from BHI 30 to BIAsp 30. The mean pre-study BHI 30 dose was 0.66 +/- 0.25 IU/kg and the mean starting BIAsp 30 dose was 0.65 +/- 0.23 U/kg, titrated up to 0.77 +/- 0.22 U/kg after 24 weeks. No SADRs were reported. From baseline to Week 24, overall hypoglycaemia did not change and no major hypoglycaemia was reported at Week 24. HbA1c levels decreased significantly from 9.1 +/- 1.1% at baseline to 7.4 +/- 0.7% (57 +/- 8 mrnol/mol) at Week 24 (p < 0.001). Significant improvements in FPG, post-breakfast PPPG and SBP were reported (p <0.001). Conclusion: Switching from BHI 30 to BIAsp 30 was well tolerated and improved glucose control without an increased incidence of hypoglycaemia in this Pakistani cohort.