My nephew has Kaiser, developed Diabetes as a young adult, presenting with ketoacidosis. He got diagnoses as a type II insulin resistant, even though he had DKA, and had to drop his BMI down from 28 to 19, eat no carbs, and be chronically ketotic (and feeling ill all the time) to keep his glucose under 500. He was OBVIOUSLY insulin deficient. But endocrine refused to see him because his internist considered him insulin resistant, and his Nurse Practitioner told him to follow a low carb diet, exercise more.
It took me and an old friend of his, each with backdoor connections to Kaiser to get an endocrinologist to review his case. Once that happened, he finally got appropriate treatment. Now he’s fighting to get insurance to cover the money he spent on insulin (on my advice) because it ‘wasn’t necessary for him’.
I loathe what so much of the US health care system has become.