As a board-certified member of the medical establishment, I'm here to tell you to look elsewhere for answers. Of course there are MDs who are towering academic figures in physiology and metabolism, but they do or should defer to the PhDs on applied matters of athletic performance. My approach would be to switch to a coach with a different training and/or nutritional philosophy. 5000 mi/year also doesn't strike me as a whole lot of volume.
Dr. Iñigo San Millán at the university of Colorado, who coaches Tadej Pogacar and is frequently mentioned here, might be source for a local referral, especially if you tell him specifically about the T2DM. He and many other hotshots have an interest in insulin resistance and many coaches are also getting savvy about it.
Last edited by MoAlpha; 02-15-23 at 09:29 AM.