Even limiting the comment to type 2 diabetes -
The dietary recommendations by the largest American diabetic groups definition of low carb is several times the amount I can consume and keep my blood glucose in the normal range. So, absent keto cooking (too stringent for most diabetics to maintain), cooking lessons with solve it.
Weight is far less connected to diabetes than commonly assigned. In my family, diabetes is strongly hereditary (all descendants of my maternal grandfather my age or older have diabetes) relatively benign, not connected to cardiac risk, and present regardless of weight (descendants with lower than normal to obese BMI all have it). Personally, my blood glucose is more related to what I put on my mouth over the last 2 hours, than over time. I have had absolutely normal A1C levels - and abnormal ones - at all weights. I take 1000 grams of metformin a day. That's it. My levels aren't normal, but they are considered in control. I am teetering between overweight and obese.
In contrast, my spouse - skinny as a rail - has aggressive T2 diabetes. She was diagnosed with a blood glucose in the 300 range. She immediately went on 2000 mg of metformin, then Jardiance, replaced recently with Januvia, and when she still needed more, glimiperide. They upped her dose at her last visit.
Third - in my experience they are very reluctant to throw insulin at T2 diabetics. I expect to have to fight for it, if my A1C is ever elevated enough to need more than metformin. I won't take any of the medications my spouse is on - the pancreatic squeeze is not something I am willing to risk.
That said, they do need to spend far more time studying diabetes, so they aren't treating all T2 diabetes identically (both in terms of treatment and risks for comorbidities).
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