Objective: To present the results from the Philippine cohort of the A1chieve study receiving insulin detemir (IDet) ± oral antidiabetic drugs. Methodology: A1chieve is a multinational, 6-month, observational study of 66,726 people with type 2 diabetes mellitus (T2DM), both insulin users and non-insulin users, started on IDet, insulin aspart or biphasic insulin aspart in 28 countries across four continents. This subgroup analysis evaluates the safety and effectiveness of IDet in 988 subjects from the Philippines. Results: At baseline the mean age, duration of diabetes and mean BMI were found to be 57±11.9 yrs, 6.9±5.3 yrs and 26±4.8 kg/m2 respectively. Majority of subjects were insulin-naive (84.3%) and glycemic control was poor in all the groups at baseline. At the end of 24 weeks, there were significant improvements following IDet initiation with a 2.1% reduction in mean HbA1c. The HbA1c target of <7% was achieved by 46.8% subjects at the study end. Although not statistically significant, there was a modest decrease in body weight in all the groups. There was no increase in the incidence of hypoglycemia among baseline insulin-naive subjects, while a significant reduction in hypoglycemia was seen among prior insulin users. Conclusions IDet appears to be an effective and safe option for individuals with T2DM in the Philippines. HbA1C was lowered to target, and there was no increase in incidence of hypoglycemia and body weight with IDet.
Diabetes Mellitus, Type 2 ; Insulin Detemir ; Philippines

Insulin detemir is a long-acting basal insulin analogue recently introduced in veterinary medicine for treatment of canine diabetes mellitus. As there are only limited studies in dogs, long-term evaluation of insulin detemir in veterinary medicine is required. In this study, we investigated trends in12-hour blood glucose concentration during hospitalization and evaluated initial and following doses of insulin detemir for several months in six diabetic dogs. The mean levels of blood glucose over 12-hour periods were between 113.5 to 327.2 mg/dL, and the average glucose nadir was 103 mg/dL in the six dogs. The dogs were treated with a mean dosage of 0.24 U/kg of insulin detemir, but hypoglycemia was observed in four of the dogs at the first monthly follow-up. Thus, insulin doses were adjusted according to the nadir levels of glucose observed during the follow-up periods (range, 1 to 16 months). The total range of insulin doses throughout the study period was between 0.1 and 0.4 U/kg. Changes in insulin doses in each dog during the follow-up period were not variable. We suggest that insulin detemir might be not only an alternative choice against traditional insulin for patients with insulin resistance or concurrent disease but also an effective home therapy medication in canine patients with DM. This study could help inform veterinary practitioners regarding the use of insulin detemir for canine insulin-dependent DM.
Adrenocortical Hyperfunction ; Animals ; Blood Glucose ; Diabetes Mellitus* ; Diabetic Ketoacidosis ; Dogs* ; Follow-Up Studies ; Glucose ; Hospitalization ; Humans ; Hypoglycemia ; Insulin Resistance ; Insulin* ; Insulin Detemir ; Veterinary Medicine

BACKGROUND: A1chieve(R) was a noninterventional study evaluating the clinical safety and efficacy of biphasic insulin aspart 30, insulin detemir, and insulin aspart. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Biphasic Insulins ; Body Weight ; Diabetes Mellitus, Type 2 ; Drug Toxicity ; Fasting ; Glucose ; Hemoglobins ; Humans ; Incidence ; Insulin ; Insulin Aspart ; Insulin, Isophane ; Insulin, Long-Acting ; Patient Selection ; Plasma ; Quality of Life ; Republic of Korea ; Treatment Outcome ; Insulin Detemir