Objective: To present results from the Bangladesh cohort of
the A1chieve study receiving insulin detemir (Levemir) ±
oral anti diabetic drugs. Methods: Out of 1093 patients
recruited from 49 sites in Bangladesh, 370 were initiated on
insulin detemir (Levemir).Study visits were defined as
baseline, interim (around 12 weeks from baseline) and final
(around 24 weeks from baseline) visit. Results: Glycaemic
control was poor in all the groups at baseline. In the entire
cohort at 24 weeks, significant reductions from baseline were
observed in mean HbA1c (from 10.0 % to 7.2%, p<0.001),
FPG (from 10.5 to 6.7 mmol/L, p<0.001) and PPPG (from
15.3 to 8.9 mmol/L, p<0.001) levels. Overall 45.5% of the participants achieved target HbA1c level of < 7% after 24
weeks. The rate of all hypoglycaemic events in the entire
cohort reduced from 1.34 (baseline) to 0.12 events/person
year after 24 weeks of insulin detemir therapy (p<0.0001).
There was no clinically relevant change in body weight in
insulin naïve or prior insulin users groups after 24 weeks of
insulin detemir therapy. Conclusions: The current study
suggests that insulin detemir may be considered as a safe and
effective option for initiating insulin therapy for type 2 diabetes in Bangladesh.
Keywords: Type 2 diabetes mellitus, Levemir, Bangladesh.
Birdem Med J 2013; 3(1)