I'm not sure that the majority do fail to follow it. In the UK dieticians will suggest foods to fit in with family meals and favourites. This is free.
Exactly! The foods I was advised to eat - the 'healthy plate' with carbs with every meal would have been a disaster for me. As it was I had read about eating your way out of T2, I bought a blood sugar meter, Reverse your T2 Diabetes by Dr David Cavan, discovered this site and LCHF and in the process discovered that it was exactly the 'healthy' stuff on the 'healthy plate' pyramid that was causing the spikes in my blood sugar.
I recorded everything I ate and eliminated the foods that spiked my blood mostly the foods that I was advised to eat most of, once I did that I lost weight - an unexpected but added bonus believe me - and my HbA1c is now below pre diabetes level.
In my case I really don't feel I was at all well advised. For a start I wasn't given a blood sugar meter, I was told 'my diet sounded alright ( so alright I was classed as - but not told I was! - pre diabetic. I was toldto stick to not more than one banana a day and to avoid pineapples and grapes and come back in three months' time. When I asked what would happen if diet and exercise didn't work I was told I'd be put on the diabetic register.
OK blood sugar meters cost money - but surely if they can get people to keep be really aware of what is going on and keep their blood sugar as low as they can it will cost the NHS less in the long run.
I really don't think a lot of people - especially the ones who don't use this site - can be aware of the progressive consequences of T2, metformin and then insulin.