The management of type 2 diabetes (T2D) often necessitates treatment intensification, and sometimes simplification to achieve glycaemic targets and mitigate complications. This expert opinion paper evaluates the use and positioning of the fixed-ratio combinations (FRCs) of basal insulin (BI) and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in optimising T2D management. On the basis of the evidence presented and discussions, these FRCs offer a promising approach for both treatment intensification and simplification in people with suboptimal glucose control despite receiving various therapies. In treatment intensification, FRCs provide a synergistic effect by addressing multiple pathophysiological defects contributing to hyperglycaemia. These FRCs effectively control both fasting and postprandial glucose (PPG) excursions, offering significantly improved glycaemic control with a lower hypoglycaemia risk and weight neutrality compared to traditional or complex insulin regimens. Moreover, the reduced injection frequency (once daily) and flexibility in the dosing schedule (with any major meal of the day) help mitigate patient resistance to insulin initiation or titration. This further reduces treatment burden, facilitating treatment adherence and enhancing patient convenience. These key benefits of FRCs over complex insulin regimens play a crucial role in long-term glycaemic management and overall treatment outcomes. Hence, the timely use of FRCs in the treatment algorithm for people with T2D represents a valuable strategy for optimising glycaemic control, addressing treatment barriers and enhancing patient-reported outcomes.

• Klíčová slova
• Clinical criteria, Fixed-ratio combination, Intensification, Simplification, Type 2 diabetes,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

The 4th Cardiovascular Outcome Trial (CVOT) Summit of the Diabetes & Cardiovascular Disease (D&CVD) EASD Study Group was held in Munich on 25-26 October 2018. As in previous years, this summit served as a reference meeting for in-depth discussions on the topic of recently completed and presented CVOTs. This year, focus was placed on the CVOTs CARMELINA, DECLARE-TIMI 58 and Harmony Outcomes. Trial implications for diabetes management and the impact of the new ADA/EASD consensus statement treatment algorithm were highlighted for diabetologists, cardiologists, endocrinologists, nephrologists and general practitioners. Discussions evolved from CVOTs to additional therapy options for heart failure (ARNI), knowledge gained for adjunct therapy of type 1 diabetes and, on the occasion of the 10 year anniversary of the FDA's "Guidance for Industry: "should CVOTs be continued and/or modified?" The 5th Cardiovascular Outcome Trial Summit will be held in Munich on 24-25 October 2019 ( http://www.cvot.org ).

• Klíčová slova
• CARMELINA, CVOT, Cardiovascular risk, DECLARE-TIMI 58, Diabetes, Harmony Outcomes, ODYSSEY OUTCOMES,
• MeSH
• biomedicínský výzkum metody   normy   MeSH
• diabetes mellitus diagnóza   farmakoterapie   epidemiologie   MeSH
• endokrinologie metody   normy   MeSH
• hypoglykemika škodlivé účinky   terapeutické užití   MeSH
• kardiologie metody   normy   MeSH
• kardiovaskulární nemoci diagnóza   epidemiologie   terapie   MeSH
• klinické zkoušky jako téma metody   normy   MeSH
• kooperační chování MeSH
• lidé MeSH
• mezioborová komunikace MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• kongresy MeSH
• Názvy látek
• hypoglykemika MeSH

The 3rd Cardiovascular Outcome Trial Summit of the Diabetes & Cardiovascular Disease EASD Study Group was held on the 26-27 October 2017 in Munich. As in 2015 and 2016, this summit was organised in light of recently completed and published CVOTs on diabetes, aiming to serve as a reference meeting for in-depth discussions on the topic. Amongst others, the CVOTs EXSCEL, DEVOTE, the CANVAS program and the ACE-trial, which released primary outcome results in 2017, were discussed. Trial implications for diabetes management and recent perspectives of diabetologists, cardiologists, endocrinologists, nephrologists and general practitioners were highlighted. The clinical relevance of cardiovascular outcome trials and its implications regarding reimbursement were compared with real-world studies. The 4th Cardiovascular Outcome Trial Summit will be held in Munich 25-26 October 2018 ( http://www.dcvd.org ).

• Klíčová slova
• ACE, CANVAS program, CVOT, CVOT Summit, Cardiovascular risk, D&CVD EASD Study Group, DEVOTE, Diabetes, EXSCEL,
• MeSH
• biomedicínský výzkum metody   MeSH
• diabetes mellitus diagnóza   epidemiologie   terapie   MeSH
• kardiologie metody   MeSH
• kardiovaskulární nemoci diagnóza   epidemiologie   terapie   MeSH
• klinické zkoušky jako téma * MeSH
• kooperační chování MeSH
• lidé MeSH
• mezioborová komunikace MeSH
• týmová péče o pacienty MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• kongresy MeSH

Microvascular complications in diabetes are associated with poor long-term diabetes control as measured by HbA1c levels. Glucose fluctuations are related to oxidative stress, endothelial dysfunction, and inflammation, factors traditionally associated with the pathogenesis of vascular damage. Glucose variability has been associated with macrovascular disease in some studies but any association with microvascular disease remains controversial. This overview summarizes recent findings in the field of glucose variability and its possible relationship with retinopathy, nephropathy and neuropathy. It is concluded that randomized prospective follow-up trials could possibly help estimate whether short-term glucose variability should be considered as an independent risk factor for microvascular complications in diabetes.

• Klíčová slova
• Glucose variability, HbA1c variability, Microvascular complications, Type 1 and Type 2 diabetes,
• MeSH
• diabetické angiopatie metabolismus   MeSH
• glykovaný hemoglobin metabolismus   MeSH
• krevní glukóza metabolismus   MeSH
• lidé MeSH
• mikrocévy patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• glykovaný hemoglobin MeSH
• hemoglobin A1c protein, human MeSH Prohlížeč
• krevní glukóza MeSH