Results of insulin therapy study revealed

MANILA, Philippines - Results of the largest observational study on the use of insulin therapy ever conducted show that 24 weeks of treatment with a Novo Nordisk insulin analogue resulted in significant improvements in blood glucose control with low incidence of major or minor hypoglycemia.

Poor blood glucose control increases the risk of developing diabetes-related complications. Hemoglobin A1c (HbA1c) is a common blood test that reflects an individual’s average blood glucose level for the past two to three months. As such, experts consider HbA1c as a good indicator of blood sugar control.

Hypoglycemia, a condition characterized by an abnormally low level of blood glucose, is common among patients with diabetes mellitus on insulin therapy or who are taking certain oral diabetes medications.

Symptoms include sweating, shakiness, hunger, anxiety, heart palpitations, and tingling sensation around the mouth.

Untreated, hypoglycemia can lead to visual disturbances, confusion, seizures, loss of consciousness, and death. 

Hypoglycemia is a major concern for both patients with diabetes and physicians, particularly hypoglycemic events that occur in the overnight hours during sleep when patients are unaware and therefore unable to take measures to reverse it.

Moreover, hypoglycemia can often lead to under- and sub-optimal treatment.

The A1chieve study involved more than 3,000 physicians across 28 countries (including the Philippines), spanning four continents and recruiting 66,726 people with type 2 diabetes.

Results of the study were first published on December 2011 in the journal Diabetes Research and Clinical Practice.

Before treatment with a Novo Nordisk insulin analogue was initiated, the average blood glucose control (HbA1c) among the A1chieve study participants was 9.5 percent, which is well above the internationally recognized target of seven percent.

In the A1chieve study, up to 80 percent of subjects had diabetes complications while 75 percent already had cardiovascular diseases.

After 24 weeks of treatment with a Novo Nordisk insulin analogue, there was a significant reduction in HbA1c levels of 2.1 percent, from 9.5 percent to 7.4 percent.

Reported rates of overall hypoglycemia slightly increased in those new to insulin and fell in those who switched from other insulin therapies.

Furthermore, patients reported their quality of life improved significantly.

“Every one percent reduction in HbA1c is associated with a reduction in the risk of developing long-term diabetes complications. Therefore, HbA1c reductions achieved in this major study are of significant clinical importance. Such changes can potentially mean a better longer term outlook for the people with diabetes involved,” said Dr. Mary Anne Lim-Abrahan, consultant endocrinologist at St. Luke’s Medical Center and professor at the University of the Philippines College of Medicine.

Lim-Abrahan presented the summary of the A1chieve study results during a press briefing and luncheon held last Monday at the Marriott Hotel in Newport City Complex, Pasay City.

She later delivered a comprehensive presentation of the A1chieve study results during the Novo Nordisk scientific dinner symposium held in the same hotel and attended by top local medical and diabetes specialists.

The International Diabetes Foundation estimates that in 2011 there were 4.2 million Filipinos with diabetes.

This figure is consistent with the results of the National Nutrition and Health Survey (NNHeS) conducted by the Food and Nutrition Research Institute in 2008, which showed that five in every 100 Filipinos have high fasting blood sugar (FBS). 

“The A1chieve study results reinforce the important role of effective and safe insulin analogues in achieving optimal blood glucose control and preventing the serious complications of diabetes,” said Dr. Sjoberg Ang-Kho, consultant endocrinologist at the Santo Tomas University Hospital (STUH), chief of the Endocrinology Section of STUH, and professor at the University of Santo Tomas Faculty of Medicine and Surgery. 

“The low rates of hypoglycemia with Novo Nordisk insulin analogues used in the A1chieve study indicate their excellent safety profile and are certainly reassuring to both doctors and patients. The significant improvements in patients’ blood glucose control also demonstrate that the insulin analogues used in the study are highly effective options for patients with type 2 diabetes,” said Dr. Susan Yu-Gan, president of Diabetes Philippines.