Because the current treatment approach for type 2 diabetes is based on the blood glucose paradigm and views Type 2 diabetes (T2D) as a chronic condition that can be managed but cannot be reversed. Under this paradigm, most of the toxicity of T2D is due to the high blood sugar (hyperglycemia). Therefore, it follows that lowering blood glucose will ameliorate the complications even though we are not directly treating the T2D itself (high insulin resistance).
While clinicians may be increasingly more aware that T2D can be reversed, most think it is only possible through drastic means like bariatric surgery.
The first grievous error of considering insulin insufficiency as the cause of T2D has misled generations of doctors, leading to the mistreatment of hundreds of millions of people with prediabetes and T2D. In reality, hyperinsulinism predates T2D for five to ten or more years. T2D is really just advanced insulin resistance.
Insulin in excess is proinflammatory, pro-infections, pro-cancer, pro-premature aging, and pro-degenerative disorders and yet insulin tests are seldom, if ever, done by most doctors.
We must shift from our previous paradigm with its monocular focus on control of blood glucose and HbA1c, to one of control of blood glucose plus preventing cardiovascular disease and death from cardiovascular causes.