We thank Giugliano et al. (1) for their comments on our article (2) bringing to light two important issues. First, while we highlighted the importance of problematic medication adherence in diabetes care in our article and briefly examined several of the key contributors, we did not explore the physician’s influence on the development of problematic adherence. We agree that physicians’ confusion and/or lack of enthusiasm regarding the selection and use of diabetes medications and the manner in which such recommendations are communicated to patients and subsequently reinforced over time may be critical in determining patients’ interest and willingness in continuing to follow such recommendations. Second, by encouraging us to consider the physician’s role, we are reminded to reemphasize that the observation of problematic adherence to prescribed medications must never be used as an excuse to blame patients for a “lack of motivation” or “being in denial.” We believe that our patients, like all of us, are doing their best to respond rationally given the pressures they face and the information and guidance they receive.

Duality of Interest. No potential conflicts of interest relevant to this article were reported.

1.
Giugliano
D
,
Maiorino
MI
,
Bellastella
G
,
Esposito
K
.
Comment on Edelman and Polonsky. Type 2 diabetes in the real world: the elusive nature of glycemic control. Diabetes Care 2017;40:1425–1432
(Letter).
Diabetes Care
2018
;
41
:
e17
.
2.
Edelman
SV
,
Polonsky
WH
.
Type 2 diabetes in the real world: the elusive nature of glycemic control
.
Diabetes Care
2017
;
40
:
1425
1432
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