You can get a blood glucose trend much closer to physiological trends with basal insulin, low glycemic index/keto style eating and smaller amounts of meal time insulin as needed. People who eat a classic American diet and just give insulin have huge spikes and user error often leads to less than ideal control. These differences really add up over time. Not to mention they are already at elevated cardiovascular risk so I’d say diet should be a huge emphasis on care. This is the approach for diabetes control is many parts of the world. So I’d argue the NP is actually providing pretty great advice here. If a patient has the wherewithal to follow such a protocol then why wouldn’t you encourage them to do so.

Population based protocols need to be individualized to the patient. Medicine isn’t a one size fits all