Response to Comments on: Inzucchi et al. Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach. Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2012;35:1364–1379

We read the comments of Rodbard and Jellinger (1) with interest, but we feel that perhaps the very problem that the position statement of the American Diabetes Association and the European Association for the Study of Diabetes (2) was trying to circumvent comes across strongly in their communication. We have been cautious of certainty on the basis of the variety of clinical situations, the heterogeneity of response, the disparities of resource, the complexity of social or cultural environments, and the manifold wishes of each of our patients. Indeed, the primary care physician may be best placed to implement a proper individualized and successful therapeutic strategy.Our position statement is not, and was not designed to be, an algorithm. The rationale for this is that we felt that expressing “strong preferences” and a belief that a “specific prescriptive approach …