I'm with Ryan, I'm still not really understanding your question. If a patient has a resting blood sugar of 200 before breakfast even, at this point they would be past most medications and require insulin (basal + short acting).
Patients in a pre-diabetic state for type II diabetes (blood sugar 100-125 mg/dl after a fast) or people early on with TIIDM ( fasting blood sugar >126 mg/dl) can control their blood sugar and
HgbA1C (a better marker for diabetic control than day to day blood sugar, see link) through life-style modification. Such as; weight loss, diet control, exercise, etc.
The problem is though, its hard for people to implement and maintain life-style modifications, we are unfortunately, creatures of habit. Which means most people will require a medication to either lower insulin resistance, increase glucose uptake or a combination of both.
Even some patients with longer standing TIIDM will respond well to life-style modification, but this isn't the norm. As a patient's diabetes progresses the constant strain on the pancreas to produce more insulin causes it to "burn out". Early on in TIIDM the problem is more with insulin resistance, but as the disease progresses the problem changes to lack of insulin as well as resistance. At a certain point TII diabetics will become insulin dependent like classical type I diabetics (people who loose their islet cells and are unable to produce insulin, therefore are dependent on exogenous insulin).
I'm not sure if that's what you meant by "natural", but if that doesn't answer your question please clarify it.