Type 2 diabetes is a solved problem, but pharmaceutical companies have yet to find a way to make money from a water fast, so no one tells people about it.
This entirely leaves aside the notion that diabetes (abbreviating as DM2 for diabetes mellitus type 2) is a solved problem. If you can maintain a low calorie diet or a water fast, then yes you will improve and may not benefit from medication. The number of people who can do that sustainably is rather small, as evidenced by the number of people who get the disease in the first place. It's not like it's a mystery that excess caloric intake and weight gain are the major risk factors for DM2.
It's also not a mystery to the patient, they know they should probably cut back a little, but it turns out that diets are extremely difficult to maintain long term. See:
http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-...
So for those people who have difficulty maintaining drastic weight loss for whatever reason, I think it's ok to have a pharmaceutical industry that tries to find alternatives. If an individual patient can do without the drugs, that's great too. In the end, lives will be saved with both approaches, they are not in conflict.
I wouldn't be able to do my job if I did an 850kcal fast for 3 months.
Doing intermittent fasting isn't even that taxing once you adjust. I have been doing it for around 4 years and I work as a developer. My most productive hours are still in the morning, and I don't even eat until noon-1pm on most days.
But to your point, yes, a drastic implementation of a clinical approach can be impractical. Fortunately there're a lot of ways to fix type 2 with diet which aren't as taxing.
So the problem is solved. It's just that most people would rather take insulin than change their diet.
We found a similar problem with smoking. Numbers of smokers have reduced with public education plans and limitations on marketing. Perhaps there are similar things that can be done to help reduce the number of people suffering obesity related illness. Perhaps it's something that will have a net positive impact on society as a whole?
There is of course a balance interfering with individual dietary choices is a slippery slop, freedom must be preserved at all cost.
1/3rd of Americans (over 100 million people) have, or are well on their way to having, Type 2 Diabetes. This is one o the largest cash cows of Big Pharma.
They don't want to fix it, their bottom line depends on this never being fixed, and they will do anything in their power to make sure it is never fixed.
Bullshit. They want to solve it in a way that doesn't involve hard behavioural (exercise, dieting) or industrial changes (nutritional) for the average person. A very rational pursuit given the obvious difficulty in the other factors being slow changing.
There is nothing wrong with offering medication and personal health analysis tools (blood glucose level monitors) which help manage an illness which affects a huge percentage of Americans.
That doesn't mean they are actively making diabetes a widespread condition.