This matches my experience in India. A dietician consultation is recommended on diagnosis of diabetes, however adherence to low carb diet is low. Still, insulin

This matches my experience in India. A dietician consultation is recommended on diagnosis of diabetes, however adherence to low carb diet is low. Still, insulin is considered last line of defence if diet control, drugs like metformin, glimiperide, sitagliptin etc are not sufficient to keep blood glucose in check. Indians typically follow either a rice based diet in southern regions or wheat based diet in northen regions. Doctors down south recommend eating limited or no rice and switching to wheat based roti, whereas northen doctors recommend switching to rice. I suspect this is to reduce overall consumption, in anecdotal experiences it works better than just asking people to limit their preferred grain. People eat less of unfamiliar foods.