But I think that part of the reason that many T2s are not very involved in their treatment is that they actually don't know what's happening in their bodies, and have not been given the education or equipment that would teach them that intensive care NOW means less chance of complications later.
I really, really, really hope you
don't get offended and upset at my having a different opinion about this, and feeling entitled to share it here.
I'm highly skeptical of this view. I look at smokers, and the intensive campaign our society has had over the last 50+ years to discourage this suicidal habit on the sort of motivation you speak of above, and it has been pretty much ineffective.
Far more effective has been social acceptability/stigma. There are quite a few studies over the past decades trying to figure out why the billions spent on "it's bad for you", "look at the scary things you're facing down the road", etc. basically didn't work.
The answer is, deferred consequences. The problems associated with smoking are just too distant, abstract, and uncertain. People often will put it off, forever, saying, "I'm gonna quit next week" and then never do.
The high addiction potential of nicotine isn't the reason -- sugar can be just as addicting, and food generally has a strong attraction for situations other than basic nutrition (where did the phrase, "comfort food" come from? :-))
The point is, most people are pretty much "don't care" about things that are not immediate or near-term problems. It's human nature. Resources, time, energy, etc. are limited... it's hard to get people to focus on things that are abstract possibilities.
The problem is, even for diabetics the stats are not that scary. A relatively small proportion of T2s with reasonably controlled BG (a1c <8%) never get any complications worse than some mild neuropathy. The large majority never have kidney failure, heart disease, eye problems, strokes, vascular issues, amputations, and all the really bad bad complications. If simply told the truth, most diabetics are likely to shrug and take their chances. Again, human nature. I simply disagree with Jim (and perhaps you, and some others) that large numbers of current T2s would be knocking down the barn door for CSII and pumps, CGMs, etc. if only they were better educated about the disease. What's being proposed here is trying to convince people who's lives are relatively unaffected by their diabetes to take on all the issues we insulin-using diabetics complain about regularly, the intrusion into their lives, etc., for what? Reducing a1c by 1-2%, reducing their risk of nephropathy from 1% to say 0.5% ("Although people with diabetes remain the largest clinical category on the dialysis register,[15,16] probably < 1% of type 2 diabetes patients will reach end-stage renal disease and require haemodialysis or transplantation" Medscape).
Short of dialysis, treating kidney impairment for the vast majority of T2s consists of taking a pill. Again, try to convince someone to hook up to a pump, wear a CGM, start counting carbs, deal with hypos now and then, etc. etc. etc. instead of just popping a pill once or twice a day. Not gonna happen.
We are a self-selected group here. Hardly representative of the average PWD. We take an interest in this condition, and a fire in the belly to treat it as best as possible, that the vast majority of PWDs don't. Including those Kings and Queens T1s jim refers to. Outside of this forum, there are plenty of reckless T1s, people who aren't interested in a CGM and/or pump. Heck, getting them to simply inject and dose insulin properly at all is a quite a project for their doctor, family, and friends.
So understand that I'm not arguing the point that all diabetics could benefit from the use of these treatments. Anyone that's been reading my posts around here over the last year know that I advocate as much. I agree with that opinion completely.
Where I differ is in the, in my opinion, (vastly) overly-optimistic view that the rest of the D world is more or less similar to our tiny enclave here on TuD. My experience with people generally, and other diabetics "in the wild" more specifically gives me absolutely no confidence, at all, that what's missing for them is information. Rather, the problem is their own priorities, and that's about it.