if you catch patients in their 20-40s That's a big "if" for a Medicare Advantage insurer, since we can't enroll someone unless they're eligible for Medicare. A

if you catch patients in their 20-40s That's a big "if" for a Medicare Advantage insurer, since we can't enroll someone unless they're eligible for Medicare. Although it's possible to become Medicare-eligible prior to age 65, it's much less common, and some of the ways it happens make someone ineligible to enroll in a Medicare Advantage plan (for example, someone with end-stage renal disease is Medicare-eligible regardless of age, but unless already enrolled in one cannot join a Medicare Advantage plan -- they must opt for traditional Medicare instead). So by the time a typical diabetic becomes eligible for a Medicare Advantage plan, the intense regimes you're talking about don't (as far as I know) offer any realistic chance of reverting. Which means most of the effort instead goes into proper management techniques to prevent progression and complications.