OBJECTIVES: To examine the effects on the health-related quality of life (HRQoL) after starting insulin with, or switching to, biphasic insulin aspart 30 (BIAsp30) in Chinese subjects with type 2 diabetes (T2DM) in the A1chieve study. METHODS: The A1chieve study was a 24-week, prospective, non-interventional, observational study conducted in routine clinical practices in 28 countries. In China, there were 8,578 T2DM patients recruited from 131 hospitals into the BIAsp30 treatment group (starting insulin with or switching to BIAsp30 at baseline based on physicians’ clinical judgments). HRQoL was assessed at baseline and 24 weeks by the validated EQ-5D questionnaire (five dimensions and visual analogue scale (VAS)). Descriptive statistics, paired t-test, and chi-square were conducted for the analyses. RESULTS: The mean age of patients (±SD) was 54.9±14.4 years. 57% were male. The reported HRQoL as measured by VAS score (on a scale of 0-100) increased by 6.2 from 75.8 to 82.0 for the overall cohort (p<0.001). For insulin naïve patients, starting insulin with BIAsp30 was associated with a 6.1 increase in VAS score from 75.9 to 82.0 (p<0.001). Similarly, for insulin experienced patients, switching to BIAsp30 was associated with a 6.7 increase in VAS score from 75.3 to 82.0 (p<0.001). For the overall cohort in the five dimensions of EQ-5D, the percentage of patients reported no problems in walking increased from 88.4% to 91.4% (p<0.0001) after 24 weeks. Similarly, the percentage of patients reported no pain or discomfort increased from 77.3% to 82.8% (p<0.0001), reported not anxious or depressed increased from 74.2% to 77.1% (p<0.001). The percentage of patients reported no problems in self-care and usual activity only slightly reduced (-0.2%, -0.5%, respectively) with no statistical significance. CONCLUSIONS: Starting insulin with, or switching to, BIAsp30 were associated with significant HRQoL improvement in Chinese T2DM subjects of the A1chieve study.