***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Aim - PREDICTIVE ( Predictable Results and Experience in Diabetes Through Intensification and Control to Target : an International Variability Evaluation ) is a multi-national study design ed to evaluate the safety and efficacy of insulin detemir ( Levemir ® ) in " real world " medical practice . The aim of the study is to report the PREDICTIVE results of the Belgian type 1 diabetic cohort . Methods – Two hundred and thirty-two patients treated with a basal-bolus insulin scheme  were considered for analysis . Seventy-eight percent of those patients were previously treated with insulin glargine as a basal insulin , while 22 % received NPH , before switching to Levemir ® . Results - Mean age and duration of diabetes were 45±15 and 18±13 years , respectively ( means±SD ) .  HbA1C was 8.3±1.2 % . We observed ( at weeks 12 and 26 after baseline ) a significant reduction in all hypoglycaemic events including major hypoglycaemias after switching to detemir ( p<0.0001 ) . There was no change in HbA1C . Fasting blood glucose decreased from 170±49 to 158±45 mg/dl at week 26 ( p<0.009 ) , while fasting blood glucose variability was reduced from 69±35 to 57±30 mg/dl at week 26 ( p<0.0001 ) . Total insulin doses increased during the trial from 0.74±0.28 to 0.82±0.14 U/kg/day ( p<0.0001 ) . No weight gain was observed during the study . Patient ’s satisfaction increased significantly ( from 6.3±1.5 to 7.2±1.6 at week 26 , p<0.0001 ) . Conclusion - This report from the Belgian cohort of PREDICTIVE extends the safety and efficacy data of insulin detemir in type 1 diabetic patients treated with a basal-bolus insulin scheme AIMS The IMPROVE observational study evaluated the safety profile and effectiveness of biphasic insulin aspart 30/70 ( BIAsp 30 )  in patients with type 2 diabetes in routine practice in 11 countries . METHODS Patients who initiated insulin therapy with , or switched existing insulin therapy to , BIAsp 30 in routine care were eligible for this 26-week , non-interventional observational study . Data on adverse events , hypoglycaemia and glycaemic parameters were obtained from patients ' diaries and medical notes . Question naire-based patient treatment satisfaction was also measured . We report global results and , uniquely for a diabetes observational study , country-specific data . RESULTS A total of 52,419 patients were enrolled from three pre study treatment groups :  no pharmaceutical therapy ( n = 8966 , diabetes duration 2.0 years , baseline HbA1c 9.9 % ) , oral antidiabetic drugs ( OADs ) only ( n = 33,797 , diabetes duration 7.4 years , baseline HbA1c 9.2 % ) and insulin + /- OADs ( n = 9568 , diabetes duration 10.4 years , baseline HbA1c 9.3 % ) . At final visit , HbA1c , fasting and postpr and ial blood glucose were significantly reduced from baseline in all subgroups ( no pharmaceutical therapy : -3.1 % , -5.9 and -9.0 mmol/l , respectively ; OADs-only : -2.1 % , -4.1 and -6.1 mmol/l ; insulin + /- OADs : -2.0 % , -3.3 and -5.1 mmol/l ) . Major hypoglycaemia rates decreased in all subgroups ; minor hypoglycaemia increased in the insulin-naïve groups . There was no mean weight gain across subgroups . Across all countries , glycaemic parameters and major hypoglycaemia were reduced ; weight increases were seen in some countries . Treatment satisfaction increased in all subgroups and countries following BIAsp 30 therapy . CONCLUSIONS Initiating insulin with , or switching insulin therapy to , BIAsp 30 in routine care result ed in improved glycaemic control , reduced major hypoglycaemia and greater treatment satisfaction Aims : The international IMPROVE ™ observational study investigated the safety profile and effectiveness of biphasic insulin aspart 30/70 ( BIAsp 30 ) in the routine treatment of patients with type 2 diabetes . We present analyses for the subgroup of patients who switched from basal insulin to BIAsp 30 . Methods : Patients in routine care who started insulin therapy with or switched to BIAsp 30 from existing insulin regimens were eligible for this 26-week study . This analysis includes only patients previously treated with basal insulin . Outcomes including adverse events , hypoglycaemic events and glycaemic profile were recorded from patients ’ notes , recall and diaries . Results : Of the 748 patients included ( age 59.7 ± 11.8 years , diabetes duration 11.4 ± 7.3 years , baseline HbA1c 9.1 ± 1.6 % ) , 497 were previously using human neutral protamine Hagedorn ( NPH ) insulin and 245 analogue basal insulin .  Overall , major and minor hypoglycaemia rates decreased from baseline to final visit ( major : 0.171 to 0.011 ; minor : 9.70 to 5.89 events/patient-year ) and were similar between the subgroups . HbA1c and fasting blood glucose were significantly reduced from baseline ( NPH pre study : −1.6 % , −2.4 mmol/l ; analogue basal pre study : −1.8 % , −2.4 mmol/l ) , as was postpr and ial blood glucose , with 33.8 % of patients achieving the HbA1c target < 7 % without hypoglycaemia . Insulin dose increased slightly from pre study ( 0.33 ± 0.21 U/kg ) , baseline ( 0.40 ± 0.20 U/kg ) to final visit ( 0.52 ± 0.26 U/kg ) ; most patients ( 76 % ) followed a twice-daily regimen at final visit . Body weight did not change significantly and treatment satisfaction increased . Conclusions : Patients with type 2 diabetes inadequately controlled on basal insulins may improve their glycaemic control by intensification to BIAsp 30 therapy Background : The First Basal Insulin Evaluation ( FINE ) Asia study is a multinational , prospect i ve , observational study of insulin-naïve Type 2 diabetes mellitus ( T2DM ) patients in Asia , uncontrolled ( A1c ≥ 8 % ) on oral hypoglycemic agents , design ed to evaluate the impact of basal insulin initiation . Methods : Basal insulin was initiated with or without concomitant oral therapy and doses were adjusted individually . All treatment choices , including the decision to initiate insulin , were at the physician 's discretion to reflect real-life practice . Results : Patients ( n= 2679 ) from 11 Asian countries were enrolled ( mean [ ±SD ] duration of diabetes 9.3 ± 6.5 years ; weight 68.1 ± 12.7 kg ; A1c 9.8 ± 1.6 % ) . After 6 months of basal insulin ( NPH insulin , insulin glargine , or insulin detemir ) , A1c decreased to 7.7 ± 1.4 % ; 33.7 % patients reached A1c < 7 % . Fasting blood glucose ( FBG ) decreased from 11.7 ± 3.6 to 7.2 ± 2.5 mmol/L and 36.8 % of patients reached FBG < 6.1 mmol/L. The mean daily insulin dose prescribed increased marginally from 0.18 to 0.23 U/kg per day at baseline to 0.22–0.24 U/kg per day at Month 6 . Mean changes in body weight and reported rates of hypoglycemia were low over the duration of the study . Conclusions : Initiation of insulin therapy is still being delayed by approximately 9 years , result ing in many Asian patients developing severe hyperglycemia . Initiating insulin treatment with basal insulin  was effective and safe in Asian T2DM patients in a real-world setting , but insulin needs may differ from those in Western countries BACKGROUND The Initiation of Insulin to reach A1C Target ( INITIATEplus ) trial studied the effect of self-titrating biphasic insulin aspart 70/30 ( BiAsp 30 ) twice daily during 24 weeks in insulin-naïve patients with type 2 diabetes who were poorly controlled by oral medication , and originally r and omized according to frequency of dietary counseling interventions . OBJECTIVE The purpose of this study was to compare the efficacy and tolerability of biphasic insulin aspart 70/30 ( BIAsp 30 , NovoLog Mix 70/30 ) in INITIATEplus patients ≤65 versus > 65 years old , irrespective of dietary counseling frequency , and to test the hypothesis that self-titrating BIAsp 30 in patients > 65 years old could be well-tolerated and effective in this age group . METHODS An exploratory post hoc sub analysis , using st and ard statistical methods , was performed on patients stratified according to age . Data collected from 3492 patients in the intent-to-treat population who were ≤65 years old and 716 patients who were > 65 years old  compared glycosylated hemoglobin ( HbA(1c ) ) and plasma glucose changes from baseline . Hypoglycemia rates and adverse event ( AE ) incidence were compared for the tolerability population of 4007 patients ≤65 years old and 805 patients > 65 years old . RESULTS Baseline-adjusted HbA(1c ) changes for patients ≤65 versus > 65 years old were -2.38 % versus -2.73 % ( P < 0.0001 ) , with final HbA(1c ) achieving 7.55 % and 7.06 % , respectively . Thirty-nine percent of patients ≤65 years old achieved HbA(1c ) ≤7 % compared with 51 % of patients > 65 years old . Baseline-adjusted fasting plasma glucose decreases were greater for the > 65 year old population ( 85.2 vs 91.2 mg/dL ; P = 0.004 ; ≤65 vs > 65 years old , respectively ) . Minor hypoglycemia was reported in 9.7 % and 7.7 % of patients ≤65 versus > 65 years old , respectively ( 0.52 vs 0.41 episodes per patient per year [ ppy ] ; P = 0.01 ) . Major hypoglycemia occurred in 1.5 % and 3.1 % of patients ( 0.05 vs 0.14 episodes ppy , ≤65 vs > 65 years old , respectively ; P < 0.0001 ) . Nocturnal major hypoglycemia was reported for 0.4 % and 0.6 % of patients ( P = 0.0028 ) , whereas nocturnal minor hypoglycemia was reported for 3.8 % and 2.6 % ( P = 0.007 ) of patients ≤65 and > 65 years old , respectively . AEs were reported for 24 % and 28 % of patients ≤65 and > 65 years old , respectively , serious AEs were reported for 4 % and 9 % of patients , respectively , and AE-related withdrawals were reported for 1.3 % and 2 % of patients , respectively . CONCLUSIONS Self-titrated biphasic insulin aspart 70/30 was found to be well-tolerated and effective in type 2 diabetes patients > 65 years old , as well as in patients ≤65 years old . HbA(1c ) and fasting plasma glucose decreases were significantly ( P < 0.05 ) higher for patients > 65 years old versus patients ≤65 years old . Tolerability was indicated by major and minor hypoglycemia rates at or below < 0.5 episodes ppy in both age groups . Overall rates of AE and serious AEs were higher among patients > 65 years ; withdrawals related to AEs were 2 % compared with 1.3 % in the younger age group AIM To examine the criteria that may influence physicians ' choice of starting insulin in type 2 diabetes patients in routine practice in Algeria as a sub- analysis of the A₁chieve study . METHODS A₁chieve was a 24-week international , prospect i ve , non-interventional study conducted to evaluate the safety and effectiveness of biphasic insulin aspart 30 ( BIAsp 30 ) , insulin detemir ( IDet ) , or insulin aspart alone or in combination , in real-life clinical setting s. We report an analysis of baseline data from insulin-naive patients initiating basal or premix insulin from the Algeria cohort ( n = 1494 ) . Demographic and anthropometric data , blood glucose control at inclusion , microvascular complications , and pre- study therapy was compared between the two groups . RES 
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Conclusions Our review indicates that SHE rates differ between patients depending on treatment regimen .
However , SHEs are also driven by other factors .