In a majority of cases not all but a good majority, (In some cases can also be due to an injury/drug reaction/ another medical condition) a diagnosis of Type2 diabetes would have been preceded by Insulin Resistance, due to hyperinsulinemia. A person with a diagnosis of T2DM should give dietary changes a chance, for the simple reason that, giving insulin to person who is type 2, is akin to giving lactose to a person that is lactose intolerant, or alcohol to an alcoholic. (channelling Dr Fung)just so the symptoms could go away, but does nothing for the underlying metabolic dysregulation brought on by an inability to metabolise carbs safely. The old hat approach of insulin for T2DM above all else, is what usually results in T2DM being a chronic, condition, that gets worse over time. (Remember that Insulin Resistance is never addressed with any addition of exogenous insulin to a system that is already swimming with excess insulin) T2DM is a condition of too much insulin, because the body is Insulin resistant and insulin is unable to do its work effectively, a Blood Glucose level for which a definitive diagnosis of T2DM is made is then achieved. Too much insulin drives most of the pathology associated with the condition.