I was diagnosed with this condition at age 54, about 12 years ago. I am still maintaining quite well without insulin, though I have recently had to start taking Metformin (one of the safer and less expensive drugs for diabetes). Two doctors have told me this is a genetic predisposition, and even thin people with good life habits can develop it. However, with enough care, many patients can stall the onset of full-blown diabetes II, and sometimes even reverse it. I've been stalling pretty effectively.
When I was diagnosed, I had gained weight following menopause, though my food habits and exercise were excellent. But when you don't know you have it, a rich meal, a carbohydrate snack, a special dessert can all cause damaging blood sugar spikes. I saw the doctor because of intense burning foot pain from neuropathy, which has never gone away. I worked for months to lose 30 lbs. This helped lower my overall A1c readings, which I can now maintain at a near-normal level.
But my eyes and blood vessels have been compromised, probably before I knew I was having blood sugar issues. And neuropathic pain has actually increased over the years, in spite of good eating and exercise. My podiatrist tells me I'm "lucky" to be in a subgroup of patients who experience heightened sensation in the extremities rather than numbness, and foot pain has become an unrelenting companion. But theoretically, I will keep my feet for my whole life because I can feel if there's an injury.
My diet is mostly plant-based, but combining beans and grains has proved to be too much carbs for me, so I also eat about 4 oz. of animal protein daily for best control. Almost no carbs, only small portions of whole grains, virtually no sugars. My blood tests reveal huge spikes from even minimal amounts of sugar or refined carbs.
Monitoring your blood sugar t learn how you react to foods is probably the other most important thing you can do for yourself. Meters are really cheap, but I hope you have good insurance because the test strips are hellishly expensive for those of us on tiny incomes. My medicare insurance has finally kicked in, but for 10 years, I was spending up to $4 daily on test strips.
I hope you get fabulous results with dietary changes. It can happen! And you will adjust to your new foods, and eventually stop missing the ones you can't eat any more. Wishing you the best!