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 hypos 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 ( 71.28% ) started on or switched to biphasic insulin aspart . other groups were insulin detemir ( n = 28 ) , insulin aspart ( n = 24 ) , basal insulin plus insulin aspart ( n = 13 ) and other insulin combinations ( n = 3 ) . overall demographic data after 24 weeks of treatment , overall hypoglycaemic events reduced from 2.1 events / patient - year to 0.0 events / patient - year in insulin nave group and from 6.8 events / patient - year to 0.0 events / patient - year in insulin users group . the hypoglycaemia incidence in insulin naive group at 24 weeks was lower than that observed in insulin users at baseline . major hypoglycaemic events decreased from 0.5 events / patient - year to 0.0 events / patient - year in insulin nave group while no change from baseline ( 1.3 events / patients - year ) was observed for insulin user group . mean hba1c and fpg values improved from baseline to study end in the insulin nave group [ table 4 ] . overall efficacy data of the total cohort , 340 patients started on biphasic insulin aspart  ogld , of which 153 ( 45% ) were insulin nave and 187 ( 55% ) were insulin users . after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 2.3 events / patient - year to 0.0 events / patient - year in insulin nave group and from 6.3 events / patient - year to 0.0 events / patient - year in insulin users . quality of life improved at the end of the study [ table 5 and 6 ] . biphasic insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to biphasic insulin aspart for insulin nave group [ table 7 ] . biphasic insulin aspartoral glucose - lowering drug efficacy data of the total cohort , 7 patients started on basal + insulin aspart  ogld , of which 2 ( 28.6% ) were insulin nave and 5 ( 71.4% ) were insulin users . after 24 weeks of treatment , hypoglycaemic events reduced from 10.4 events / patient - year to 0.0 events / patient - year in insulin users whereas hypoglycaemia remained nil in insulin naive group , similar to baseline . quality of life improved after 24 weeks of treatment [ table 8 and 9 ] . basal+insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to basal + insulin aspart  oglds for insulin nave group . of the total cohort , 90 patients started on insulin detemir  ogld , of which 57 ( 63.3% ) were insulin nave and 33 ( 36.7% ) were insulin users . after 24 weeks of starting or switching to insulin detemir , hypoglycaemic events reduced from 2.5 events / patient - year to 0.0 events / patient - year in insulin nave and from 6.3 events / patient - year to 0.0 events / patient - year in insulin user groups [ table 10 and 11 ] . insulin detemiroral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to insulin detemir  oglds for insulin - nave group [ table 12 ] . insulin detemiroral glucose - lowering drug efficacy data of the total cohort , 37 patients started on insulin aspart  ogld , of which 26 ( 70.3% ) were insulin nave and 11 ( 29.7% ) were insulin users . after 24 weeks of treatment , hypoglycaemic events reduced from 14.2 events / patient - year to 0.0 events / patient - year in insulin users whereas , hypoglycaemic events remained nil in insulin users , similar to baseline . quality of life improved at the end of the study [ table 13 and 14 ] . insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to insulin aspart  oglds for insulin nave group [ table 15 ] . of the total cohort , 340 patients started on biphasic insulin aspart  ogld , of which 153 ( 45% ) were insulin nave and 187 ( 55% ) were insulin users . after 24 weeks of starting or switching to biphasic insulin aspart , hypoglycaemic events reduced from 2.3 events / patient - year to 0.0 events / patient - year in insulin nave group and from 6.3 events / patient - year to 0.0 events / patient - year in insulin users . quality of life improved at the end of the study [ table 5 and 6 ] . biphasic insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to biphasic insulin aspart for insulin nave group [ table 7 ] . of the total cohort , 7 patients started on basal + insulin aspart  ogld , of which 2 ( 28.6% ) were insulin nave and 5 ( 71.4% ) were insulin users . after 24 weeks of treatment , hypoglycaemic events reduced from 10.4 events / patient - year to 0.0 events / patient - year in insulin users whereas hypoglycaemia remained nil in insulin naive group , similar to baseline . quality of life improved after 24 weeks of treatment [ table 8 and 9 ] . basal+insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to basal + insulin aspart  oglds for insulin nave group . of the total cohort , 90 patients started on insulin detemir  ogld , of which 57 ( 63.3% ) were insulin nave and 33 ( 36.7% ) were insulin users . after 24 weeks of starting or switching to insulin detemir , hypoglycaemic events reduced from 2.5 events / patient - year to 0.0 events / patient - year in insulin nave and from 6.3 events / patient - year to 0.0 events / patient - year in insulin user groups [ table 10 and 11 ] . insulin detemiroral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to insulin detemir  oglds for insulin - nave group [ table 12 ] . of the total cohort , 37 patients started on insulin aspart  ogld , of which 26 ( 70.3% ) were insulin nave and 11 ( 29.7% ) were insulin users . after 24 weeks of treatment , hypoglycaemic events reduced from 14.2 events / patient - year to 0.0 events / patient - year in insulin users whereas , hypoglycaemic events remained nil in insulin users , similar to baseline . quality of life improved at the end of the study [ table 13 and 14 ] . insulin aspartoral glucose - lowering drug safety data mean hba1c and fpg values improved from baseline to study end in those who started on or were switched to insulin aspart  oglds for insulin nave group [ table 15 ] . our study reports improved glycaemic control ( hba1c , fpg ) 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 . major hypoglycaemic events decreased from 0.5 events / patient - year to 0.0 events / patient - year in insulin nave group while no change from baseline ( 1.3 events / patients - year ) was observed for insulin user group . overall , body weight reduced in insulin nave group whereas no change in body weight was observed for insulin users . 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 rajasthan , 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 rajasthan , india.results:a total of 477 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 = 340 ) , insulin detemir ( n = 90 ) , insulin aspart ( n = 37 ) , basal insulin plus insulin aspart ( n = 7 ) and other insulin combinations ( n = 2 ) . at baseline 
 glycaemic control was poor for both insulin nave ( mean hba1c : 8.3% ) and insulin user ( mean hba1c : 8.4% ) groups . 
 after 24 weeks of treatment , both the groups showed improvement in hba1c ( insulin nave : 0.9% , insulin users : 1.2% ) . 
 major hypoglycaemic events decreased from 0.5 events / patient - year to 0.0 events / patient - year in insulin nave group while no change from baseline ( 1.3 events / patients - year ) was observed for insulin users . 
 sadrs were not reported 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 .