Type 2 diabetes is a choice?
Perhaps, for some.
Genetics have a say in it as well.
I had/have a heart condition (genetic) drove my weight to 245 before I got things fixed through open heart surgery . I was 72 inches tall and sub-200 pounds for many years post-college. Still, as my weight climbed, I became insulin dependent.
I was and still am an avid hiker and cyclist.
My insulin usage is now 1/2 what it was when I weighed 245. But, I can't break the 200 barrier even on Ozempic. I came close with Mounjaro and then my insurance stopped covering it. I take a low dose of Ozempic (0.5ml/wk) to keep my blood sugars around 100. It was NOT for weight loss.
Off it, my blood sugars would be all over the place-the month I went without anything was horrific. And, my weight climbed back to 220. I'm back at 210 now.
When I was at 206, I was taking 8 units of long lasting insulin just once a day. My A1C was down to 5.7 (non-diabetic levels) on meds. Insurance companies want you over 6.4 or they threaten cutting you off. They cut me off. I went back to over 7.1 before they authorized Ozempic.
Pisses me off that some "doctor" who knows nothing of my medical history can over-ride the advice of my board certified endocrinologist and who knows my medical history intimately. Anyway, I digress.
That being said, exercise and diet help significantly (assuming no other health issues) and should be the first line of treatment. I will agree with you there.
My sweet spot is anything below 210 pounds - but, staying there is tough. Below 210, insulin needs drop. Above, and the need jumps. I am also 60 yo. I had been diagnosed with my heart condition (bad valve) and diabetes for 20 years before they cracked me open and fixed my heart.
Sadly, too many Americans are used to (and expect) instant gratification. They want a med instead of healthy lifestyle changes. They want super-sized everything-especially, fast food. Couple that with a sedentary lifestyle and high l-stress jobs and we are doomed.
Lastly, the side-effects from Ozempic and similar can be nasty. Took me almost 6 months to tolerate it without nasty gut pain. I had no side effects on Mounjaro. I really wish I was back on Mounjaro if I have to be on anything.
I'll be damned if I take a knock-off of Ozempic.