Diabetes care according to the CCM, including the involvement of trained practice nurses, is a reasonable tool to improve care in the long-term. CCM training of the whole team is essential to overcome organisational challenges. Continuous team education, technical decision support, and recognition of the importance of these new structures in healthcare policy might improve the long-term clinical effect of the team approach.

Koch et al. address in their letter [1] the following two aspects.Firstly, they consider the use of the term "practice nurse" an inadequate translation of the term "Medizinische Praxisassistenin (MPA)". As mentioned in our publication, there is no comparable English term for the Swiss term MPA, the German term "Medizinische Fachangestellte (MFA)" or the Austrian term "Arzthelferin". This is mainly because in most countries we have either administrative personnel in practices, named "practice secretaries", or personnel with a medical background, most commonly nurses. There is no exact equivalent to the Swiss MPA in an international context. Naming them "practice secretary" would not reflect their medical background. In most studies from German speaking countries, MPAs have been called "health care assistant" or labelled with the term chosen by us, "practice nurse". In principle, we are grateful to Koch et al. for pointing out an important issue when reporting about studies with MPAs. We are willing to use the suggested new term in future publications, but we are aware of the risk that an international reviewer might not readily accept this term.

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