Well, fasts aren't the only solution here. Changing your and adjusting your carb intake in order to offset insulin requirements can gradually get things back on track.

Doing intermittent fasting isn't even that taxing once you adjust. I have been doing it for around 4 years and I work as a developer. My most productive hours are still in the morning, and I don't even eat until noon-1pm on most days.

But to your point, yes, a drastic implementation of a clinical approach can be impractical. Fortunately there're a lot of ways to fix type 2 with diet which aren't as taxing.

So the problem is solved. It's just that most people would rather take insulin than change their diet.