Last night I watched an episode of 'GPs: Behind Closed Doors'. I was shocked to see a DSN congratulating a fairly recent T2D who's A1c had come down to 84. Fair enough, he had made an "improvement" - but instead of explaining that it should be as low as possible or at least below 48mmol/mol, it was simply a case of: "Good work and I'll see you again in 6 months". There was no referral to a dietician or even a basic dialogue highlighting the importance of weight loss, diet and exercise. I can confidently say that there would definitely have been no mention of testing BG in this instance.
The poor guy probably left thinking that he'd done everything he had to and could continue perfectly fine the way he was. And as you've said
@slip, complications will take hold - especially when sitting up at those numbers. It's not the diabetic's fault; they are blissfully ignorant when not fed the correct information.