I don't want to get into a debate here, but as a Type 2 on insulin, who is not obese and fairly active, I'll add my two cents. As I said, I was neither obese (ever) not sedentary and was asymptomatic at diagnosis, so I was put on oral medications immediately. After four months, I had to switch to insulin because orals caused bigger problems than the one they were intended to treat. Note: these medications have side-effects that are often more dangerous than the diabetes itself.
Since Dx, my BG has been considered "controlled". After the initial A1c of 11.8, I have been tested every three months - A1cs of 6.5, 6.0, 5.3, 5.2 and 5.1. In that time, I have exercised at least 30min a day almost every day, often more. Despite all that, two C-Peptide tests taken 5 months apart seem to indicate a significant drop (50%) in my insulin production. My insulin needs have increased 100% (for the same food intake).
With all that, I feel lucky - I currently have no other "metabolic issues" that many T2's have. My cholesterol was only "elevated" at Dx and is now good without medication. No hypertension. No complications from diabetes. Still, I expect to remain on insulin, and probably more of it, going forward.
I think there is a lot of misinformation in the medical community and in the general public about T2DM calling is "essentially a lifestyle disease" or worse, a "disease of choice." It could be that for some weight loss and exercise may control or mitigate the disease; however, there are many for whom this simply is not true. There are several researchers that say that weight gain is a symptom, not a cause, of T2 and is, therefore, virtually unavoidable for some people with T2. Yes, I know people who lost weight and started exercising and stopped needing medication for T2. I also know people who did that and later in life had an interruption (like a broken hip) in their program and immediately had to go on insulin (even without changing diet or gaining weight). The underlying problem doesn't go away.
You know, it's funny. It's only been 16months since I was Dx'd. Prior to that, I read all sorts of papers saying "do this to avoid Type 2 diabetes." I didn't want diabetes and even though it doesn't run particularly strongly in my family, I did many, if not all, of those things. Guess what? It didn't help. Despite all this - I can't remember ever thinking that someone who had Type 2 diabetes was "AT FAULT" for getting the disease. Unlucky, maybe? Unfortunate, certainly. But not at fault. Lots of sedentary overweight people don't get it. Some do. It happens, and it is very challenging.
I don't want to think which is harder T1 or T2. I don't want anyone to have to deal with either one of them. Meanwhile, reality is what it is. We all have challenges, and we all need to be sensitive to the challenges of everyone else.
Are we having fun yet? So far, I'm not.
