fear of hypoglycaemia and gain in body weight act as barriers for initiation of insulin therapy . modern insulin analogues are a convenient new approach or tool to glycaemic control , associated with low number of hypoglycaemia and favourable weight change . a1chieve , a multinational , 24-week , non - interventional study , assessed the safety and effectiveness of insulin analogues in people with t2 dm ( n = 66,726 ) in routine clinical care . please refer to editorial titled : the a1chieve study : mapping the ibn battuta trail . the patient characteristics for the entire cohort divided as insulin - nave and insulin users is shown in the table 1 . the majority of patients ( 77.8% ) started on or were switched to biphasic insulin aspart . other groups were insulin detemir ( n = 1001 ) , insulin aspart ( n = 734 ) , basal insulin plus insulin aspart ( n = 117 ) and other insulin combinations ( n = 189 ) . overall demographic data after 24 weeks of treatment , overall hypoglycaemic events reduced from 0.8 events / patient - year to 0.1 events / patient - year in insulin naive group and from 2.6 events / patient - year to 0.7 events / patient - year in insulin user group . the hypoglycaemia incidence in insulin naive group at 24 weeks was lower than that observed in insulin users at baseline . blood pressure decreased whereas overall lipid profile and quality of life improved at week 24 in the cohort [ tables 2 and 3 ] . all parameters of glycaemic control improved from baseline to study end in the total cohort [ table 4 ] . overall efficacy data of the total cohort , 7217 patients started on biphasic insulin aspart  ogld , of which 5995 ( 83.1% ) were insulin nave and 1222 ( 16.9% ) were insulin users . after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 0.2 events / patient - year to 0.0 events / patient - year in insulin nave group and from 2.2 events / patient - year to 0.1 events / patient - year in insulin users group . body weight decreased and quality of life improved after 24 weeks of treatment [ tables 5 and 6 ] . glucose - lowering drug safety data all parameters of glycaemic control improved from baseline to study end in those who started on or were switched to biphasic insulin aspart for both insulin nave and insulin user groups [ table 7 ] . biphasic insulin aspartoral glucose - lowering drug efficacy data of the total cohort , 117 patients started on basal + insulin aspart  ogld , of which 58 ( 49.6% ) were insulin nave and 59 ( 50.4% ) were insulin users . after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 2.7 events / patient - year to 0.6 events / patient - year in insulin nave group and from 4.9 events / patient - year to 1.4 events / patient - year in insulin users group . body weight decreased and quality of life improved after 24 weeks [ tables 8 and 9 ] . basal+insulin aspartoral glucose - lowering drug safety data all parameters of glycaemic control improved from baseline to study end in those who started on or were switched to basal + insulin aspart  oglds for both insulin nave and insulin user groups [ table 10 ] . basal+insulin aspartoral glucose - lowering drug efficacy data of the total cohort , 1001 patients started on insulin detemir  ogld , of which 865 ( 86.4% ) were insulin nave and 136 ( 13.6% ) were insulin users . after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 1.0 events / patient - year to 0.2 events / patient - year in insulin nave group and from 2.3 events / patient - year to 0.7 events / patient - year in insulin users group . a decrease in body weight and improvement in quality of life was observed at the end of the study [ tables 11 and 12 ] . insulin detemiroral glucose - lowering drug safety data all parameters of glycaemic control improved from baseline to study end in those who started on or were switched to insulin detemir  oglds for both insulin - nave and insulin user groups [ table 13 ] . insulin detemiroral glucose - lowering drug efficacy data of the total cohort , 734 patients started on insulin aspart  ogld , of which 583 ( 79.4% ) were insulin nave and 151 ( 20.6% ) were insulin users . after 24 weeks of starting or switching to insulin aspart , overall hypoglycaemia decreased from 0.6 events / patient - year to 0.0 events / patient - year in insulin naive group and from 2.7 events / patient - year to 0.5 events / patient - year in insulin users group . a decrease in body weight and improvement in quality of life insulin aspartoral glucose - lowering drug safety data all parameters of glycaemic control improved from baseline to study end in those who started on or were switched to insulin aspart  oglds for both insulin nave and insulin user groups [ table 16 ] . of the total cohort , 7217 patients started on biphasic insulin aspart  ogld , of which 5995 ( 83.1% ) were insulin nave and 1222 ( 16.9% ) were insulin users . after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 0.2 events / patient - year to 0.0 events / patient - year in insulin nave group and from 2.2 events / patient - year to 0.1 events / patient - year in insulin users group . body weight decreased and quality of life improved after 24 weeks of treatment [ tables 5 and 6 ] . biphasic insulin aspartoral glucose - lowering drug safety data all parameters of glycaemic control improved from baseline to study end in those who started on or were switched to biphasic insulin aspart for both insulin nave and insulin user groups [ table 7 ] . of the total cohort , 117 patients started on basal + insulin aspart  ogld , of which 58 ( 49.6% ) were insulin nave and 59 ( 50.4% ) were insulin users . after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 2.7 events / patient - year to 0.6 events / patient - year in insulin nave group and from 4.9 events / patient - year to 1.4 events / patient - year in insulin users group . body weight decreased and quality of life improved after 24 weeks [ tables 8 and 9 ] . basal+insulin aspartoral glucose - lowering drug safety data all parameters of glycaemic control improved from baseline to study end in those who started on or were switched to basal + insulin aspart  oglds for both insulin nave and insulin user groups [ table 10 ] . of the total cohort , 1001 patients started on insulin detemir  ogld , of which 865 ( 86.4% ) were insulin nave and 136 ( 13.6% ) were insulin users . after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 1.0 events / patient - year to 0.2 events / patient - year in insulin nave group and from 2.3 events / patient - year to 0.7 events / patient - year in insulin users group . a decrease in body weight and improvement in quality of life was observed at the end of the study [ tables 11 and 12 ] . insulin detemiroral glucose - lowering drug safety data all parameters of glycaemic control improved from baseline to study end in those who started on or were switched to insulin detemir  oglds for both insulin - nave and insulin user groups [ table 13 ] . of the total cohort , 734 patients started on insulin aspart  ogld , of which 583 ( 79.4% ) were insulin nave and 151 ( 20.6% ) were insulin users . after 24 weeks of starting or switching to insulin aspart , overall hypoglycaemia decreased from 0.6 events / patient - year to 0.0 events / patient - year in insulin naive group and from 2.7 events / patient - year to 0.5 events / patient - year in insulin users group . a decrease in body weight and improvement in quality of life insulin aspartoral glucose - lowering drug safety data all parameters of glycaemic control improved from baseline to study end in those who started on or were switched to insulin aspart  oglds for both insulin nave and insulin user groups [ table 16 ] . our study reports improved glycaemic control ( hba1c , fpg , pppg ) and quality of life following 24 weeks of treatment with any of the insulin analogues ( biphasic insulin aspart ; basal + insulin aspart ; insulin detemir ; insulin aspart ) with or without ogld . sadrs including major hypoglycaemic events or episodes did not occur in any of the study patients after 24 week of treatment . though the findings are limited by number of patients , still the trend indicates that insulin analogues can be considered effective and possess a safe profile for treating type 2 diabetes in south india .
background : the a1chieve , a multicentric ( 28 countries ) , 24-week , non - interventional study evaluated the safety and effectiveness of insulin detemir , biphasic insulin aspart and insulin aspart in people with t2 dm ( n = 66,726 ) in routine clinical care across four continents.materials and methods : data was collected at baseline , at 12 weeks and at 24 weeks . this short communication presents the results for patients enrolled from south india.results:a total of 9273 patients were enrolled in the study . 
 four different insulin analogue regimens were used in the study . 
 patients had started on or were switched to biphasic insulin aspart ( n = 7217 ) , insulin detemir ( n = 1001 ) , insulin aspart ( n = 734 ) , basal insulin plus insulin aspart ( n = 117 ) and other insulin combinations ( n = 189 ) . at baseline glycaemic control was poor for both insulin nave ( mean hba1c : 9.2% ) and insulin user ( mean hba1c : 9.1% ) groups . 
 after 24 weeks of treatment both the groups showed improvement in hba1c ( insulin nave : 1.6% , insulin users : 1.3% ) . 
 sadrs including major hypoglycaemic events or episodes did not occur in any of the study patients.conclusion:starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia .