Probably a bit, T2DM is a progressive disease driven by insulin resistance by glucose receptors.
Stage 1 - BG is within range, but insulin levels high. Many have reactive hypoglycemia causing lows between meals.
Stage 2 - BG elevates to what is considered pre-diabetes as the Beta cells cannot secrete enough insulin to overcome resistance.
Stage 3 - BG is becoming dangerously high, insulin resistance increases, person has decreasing energy as cells are starving for fuel, glucose may be spilling into urine. Various diabetic complication may begin.
2 and 3 stages can often be treated with a carb restricted diet, daily exercise with or without oral or injectable drugs, not insulin as insulin levels are high.
Stage 4 - As Beta cells weaken from over work the type 2 DM will need to add drug therapy to diet and exercise. Some of these drugs will stimulate the Beta cells to secrete even more insulin.
Stage 5 - At this point oral and non-insulin injectables have limited effect because the Beta cells are worn out and dying. At this point the T2DM may start using a basal insulin.
Stage 5 - Drugs and basal insulin are not enough and the T2DM begins bolus insulin before meals.
Not all type 2 diabetes will progress this far. In my 30 years since diagnoses I have carb restricted, daily exercise and learned which foods I should avoid using my meter. This gave me normal or near normal BG for 10 years. Then BG spiked, eating nearly zero carbs and exercising more did nothing. I was prescribed Metformin. Over the years the dose was increased to the max. Then I was prescribed Lantus. In the fall of 2020 I noticed my fBG and other tests was rising.
My HbA1c in December was a full percentage point higher than the previous one 6 months before. My new doctor and I decided it was time for MDI and a CGM. I was using syringe and vials, change to pens because of a lack of syringes locally (COVID related supply problems?)
Anyway, it was rocky for a while. I consumed more glucose tablets in the night then in 30 years. I also would have exercise induced lows. My BG could be 140+ and 15 minutes of brisk walking or bicycling or yard work could cause it to plummet to a hypo. Decreasing the Metformin has really helped with hypos.
Being on MDI as a type 2 DM has challenges as I suspect I still secrete some insulin, insulin resistance and sensitivity rises and falls. My total daily insulin basal/bolus is about 33u with 25u basal and 6 to 8u bolus. I know this ratio is not the usual for T1DMs. My last HbA1c was 5.3% and my time in range is 98 to 99%. Usually the 1 -2% is an occasional low, not very low.
Type 2 DMs in stage 5 should probably be called Non-immune Insulin Dependent Diabetics.
Well, I gotta go, Marilyn, stuff to do before my Friday 30 mile group ride. I hope I didn’t bore you.