Wow. I am overwhelmed with deja vú reading this thread. Often I feel as though I am preaching to the choir. This time, I'm listening to the choir. Practically everything here I have said somewhere, sometime, to somebody. Feels like old home week.
Like all of you who commented here, I get very plugged in by the all-too-prevalent mindset that says insulin use is a last resort, or an admission of failure. How absurd! It ought to be just the opposite. If you can't achieve control by other means, and you have this incredibly powerful therapy available, it's insane not to take advantage of it. That's how I see it, anyway.
If you had a broken leg, would you put off getting a cast a long as possible? Would you consider it a last resort, or view the need for it as failure? Of course not! You'd want it RIGHT NOW, the sooner to begin healing.
For the record: I have been T2 for almost 20 years. For most of that time I controlled it casually and somewhat haphazardly with exercise, oral meds, and a (semi) reasonable diet. About a year ago I realized that my A1c was creeping upward no matter what I did so I began an intensive course of self study. One of the first conclusions I reached was that insulin was a big part of the answer. Fortunately, I have a really terrific PCP who didn't need much convincing.
For whatever it's worth, I agree with jims about the etiology of T2. A century ago the average American consumed around 4 pounds of sugar a year. Today (according to the USDA), it's more than 150 pounds per person per year, and that's not counting the 50-plus pounds that are concealed in packaged process foods. So, we eat 30 or 40 times the sugar our great-grandparents did, and diabetes is spreading at epidemic rates. Could there be a connection? Nahhh . . . .
We evolved eating protein and vegetables. We didn't even eat grains in any significant quantity until agriculture was invented, and that's only been about 10,000 years. We simply aren't engineered to process large amounts of carbohydrate. Evolution just doesn't work that quickly.
Okay. I'll shut up now.