Author Affiliations: Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy (email@example.com).
In Reply: Drs Mohan and Phillips focus on clinical inertia in the management of the diabetic patient. This is an area of expanding interest because in the United States, physicians can now choose a diabetes medication from no fewer than 10 pharmacologic classes, including the newest entries, the bile acid sequestrant colesevelam and quick-release bromocriptine. We agree that clinical inertia will remain an important problem, given the continuous evolution of clinical guidelines, and that physicians must interpret data and introduce treatments that benefit patients the most. However, the clinical benefit of intensifying drug therapy may be uncertain.
Giugliano D, Esposito K. Clinical Inertia and Uncertainty in Medicine—Reply. JAMA. 2011;306(4):383-384. doi:10.1001/jama.2011.1045