It depends on which Ame you talk to what the plan is
Our ame is a mid 40's doctor that fly's himself. And if he is on our company aircraft normally he comes on the jumpseat with company permission. Multicrew he is more than happy to play the are they going to die in the next year card.... No let's have a play.
He has 30 odd pre and 20 confirmed diabetes on his books. Of that 20 he has got 10 off the drugs. He is class ii himself I was/am a pre.
Give the zero carbs a shot you might be surprised at the results.
We are all different apparently and what works for me might not work for you. But the extreme low carbs is a good start. I did a test every 30mins for 18 hours duty day and had 5 spikes to 10 with the area under the graph average 6.1 now it never goes above 7 and average 5.3.
The standard treatment he has given up on as utter bollocks. And that's 40 pilots who are working without stabbing themselves every approach for a blood test without a multicrew restriction.
What gets me is the negative down right hostility of most medics to giving the middle finger to the national treatment plan. If what you doing works why give the person ear ache because they are not eating 60% carbs as per the guidelines.