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I hear your frustration. T2 can be an umbrella definition. Perhaps it's time for a second opinion from another endo. If it's insulin dependant T2 and then a reactive hypo period. I wouldn't dismiss a low carb diet helping a bit. Nor one of the newer meds like GLP-1 or DPP4, that can also be used...

A couple of things, first I would see an endo. It sounds very complicated for a local doctor. Generally a lower carb diet helps stabilise BG, there are also some newer meds that may also help. The endo will have an opinion on your 3-4, when not on hypo inducing meds. When you are on insulin...

That is good news. You have turned the corner, to have it under control. I think the Libre should give a good estimate.

I would ask the doctor about a physio, to manipulate the shoulder. I didn't find exercises successful

I'd also google low FODMAPS diet. In general, it's very good for gut issues. You could alter it to suit lower carb for diabetes.

I think the target of <6.5 with low hypo risk, remains the same. It's just the trigger points for a med increase is higher. Given you are doing the right thing on keto and I would double check my carb inputs, they can sneak back in. I wouldn't be happy with an A1c of 7% regardless. My endo put...

See what the doctor says, I wouldn't expect diabetic weight loss with "43 mmol ..My blood sugar spiked at 2.50 hours at 9.8! At 3 hours went down to 8.7. Had I not re-tested after 2 hours when it was 6.8" given this isn't a typical meal for you. If you are eating enough total calories and I...

If it were me. I would go very low carb of 10-25g a day and give it a month. I would get a BG meter and strips to home test. To see how I am going. A food list. https://www.ketogenic-diet-resource.com/support-files/kd-basics.pdf A 20g carb, set menu. I would consider protein of about 60g a day...

Depending on your severity, some meds including just probiotics can help. From a part of a paper on RH. Alpha Glucosidase Inhibitors Inhibitors of α-glucosidase (acarbose and miglitol) can reduce the levels of GIP, which is released from K cells in the duodenum, which can be stimulated through...

As you know the pred will raise your BG in the short term. Have you spoken with your doctor? If you are going for a general aesthetic, there may be a BG requirement. I hope the colonoscopy goes well. I saw that your have IBS. Have you looked at a low FODMAPS diet. It was designed by an...

I also found, just use a good sauce in a small bowl. To dip my food into to add flavour. Also reduced as a topping for steak etc. I personally find most spag substitutes unfulfilling. However I find eggplant lasagne is a nice dish.

With a FODMAPS keto diet, it may reduce your inflammation and allow less steroid use.

I'd look at the anti-inflammatory benefits of a low carb FODMAPS diet. I'd still base it around a 20g carbs a day keto diet.

I'm on Stelara biologic. I googled Enbrel and it's said not to raise insulin resistance. I'm also on Ozempic GLP-1, which is worth googling and asking your doctor about it reducing insulin resistance. Your SGLT2 could be switched to it, or both can be used with your insulin. AS you know the...

What meds are you on for the arthritis? Would there be any that could raise your insulin resistance?