This is mainly because of the total cost. Pills and (minor) insulin intake is usually sufficient, especially if combined with some minor lifestyle changes. Big

This is mainly because of the total cost. Pills and (minor) insulin intake is usually sufficient, especially if combined with some minor lifestyle changes. Big changes can probably delay the requirement of most medication if detected early. But most people go to doctors way too late if it's not free and thus causes more damages in the end. This is simply a cost question. In countries where the healthcare gives out the required pumps/injectors and medication for 'free', it is usually a cost/benefit tradeoff. On the other hand: Not providing proper insulin dispensers costs a lot more in the end. The world has moved from simple throw away injectors (i mean the ones with no proper dosage dispensers and bottles as a storage medium) for years and the benefits far outweigh the cost of relatively simple modern injectors or pumps. > maybe because it is felt that the patient is partly to blame for the disease Since there is a very big spread in onset age even for overweight people it would be very bad for a doctor to have these kind of thoughts