The prevalence of Type 2 diabetes mellitus (T2DM) continues to grow worldwide. Blood glucose control represents a central feature of risk factor management in patients with T2DM and several therapeutic options are now available to enforce blood glucose control. As a matter of fact, while before the year 2000 we only had 3 classes of drugs for diabetes (insulin, sulfonylureas, and metformin), 9 classes of drugs are now available, and several more are in a late development phase. This expands the range of clinical choice, but also forces the physician to face a more complicated array of options, where efficacy, safety, tolerability, and cost need to be carefully balanced. In the recent years, several scientific organizations have issued guidelines and proposed therapeutic algorithms allegedly intended to help care providers in making the “right” choice when treating patients with T2DM. Thus, in a fast-paced sequence the 2007 Texas Diabetes Council Glycemic Control Algorithm (1), the 2008 American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) Road Map (2), the 2009 AACE/ACE treatment algorithm (3), the 2008 Canadian Diabetes Association (CDA) Clinical Practice Recommendations for T2DM (4), the 2010 ADA Standards of Medical Care (5), and the 2009 ADA/EASD writing group consensus statement and algorithm on the medical management of hyperglycemia in Type 2 diabetes (6) appeared. On one hand, such a wealth of algorithms and guidelines does reinforce attention on a crucial topic for public health such as metabolic control in diabetes. On the other hand, different organizations can review the same body of evidence and yet not arrive to the exact same conclusions, with the ultimate result of increasing confusion rather than simplifying the issue. Furthermore, as Kahn and Gale have sharply noticed in a recent editorial (7), “…(guidelines) also serve a vital function for the organization that produces them. This need means that a guideline all too easily becomes an assertion of authority…..”. If one takes this concept a step further, he might be inclined to think that the slight or more consistent differences in the algorithms proposed could stem more from the desire of expressing an “original” point of view than from an objective and unbiased analysis of the evidence available.