[codingdave]

As an analogy, when my driveway is covered in snow and ice, the root cause is precipitation. But my immediate need is to get my car out, so I shovel the drive.

Yes, treating symptoms is not the ideal, but if you can fix the immediate need of getting blood sugar down, that is still helpful.

[givemeethekeys]

In your story, your driveway was designed to be shoveled like the body is designed to deal with small amounts of sugar.

Let's say we had a particularly bad winter that required the use of power tools, which had the effect of damaging the driveway. Your body on diabetes is like a damaged driveway.

At some point you'll need to fix the damaged driveway. It will require a change in lifestyle while the driveway is being fixed, and perhaps even a change SOP's to reduce the risk of future damage.

Most people never give up on the power tools (supplemental insulin). Most doctors don't know any better.

[devmor]

Your analogy doesn't really apply to anyone with type 1 diabetes, which is an autoimmune disorder and roughly 10% of all diabetes cases. A lifestyle change cannot fix type 1 diabetes.

Additionally, partial remission in type 2 diabetes has a success rate of just 0.007% per 5 year post-remission cohort. The idea that a lifestyle change can "fix the damaged driveway" is essentially a statistical anomaly - it's not grounded in evidential standards has yet to be proven.

[nobodyandproud]

What factors contribute to the poor success rate?

[devmor]

Does it matter? A success rate of 0.007% is practically a statistical error. It signifies that the method is not feasible regardless of individual factors.