Adherence to diabetic treatment programs

Explain why adherence to diabetic treatment programs is so difficult for most people to achieve.
Many diabetics do not adhere to treatment programs as they do not get any severe symptoms until years later. This causes people to not fear diabetes which deters to follow a regimen. There are diabetics that do not monitor glucose levels and rely based on how they feel which is not always reliable. Many regimens require the obvious such as diet and exercise which is not always a possibility for many and/or taking proper medication. For those who do not have insurance, they can just afford vials of insulin.