The diabetic nurse mentioned that might pancreas might be getting “tired” and that perhaps insulin would be beneficial. Is there a way they could actually check how my pancreas is functioning? I’d like to see my hba1c in 3 months ideally when I’ve been on keto for much longer and been on this medication but I’m not sure if any of that will help of my pancreas may be “tired” . Thanks
There is indeed a way to tell whether your insulin production is insufficient. It's called a cpeptide test, and measures how much insulin you are producing, though you may need to up the amount of carbs you eat before you do the test (check with the doctor before they do the blood test). However I'm not sure whether GPs are allowed to order this test, it may need to be ordered by an endocrinologist...
They normally do a cpeptide test when they think there's a chance that a person may be a slow onset T1 (LADA), whose diabetes is caused by lack of insulin production rather than insulin resistance (T2). They often combine it with a GAD test which checks whether you have antibodies that are present if your immune system is attacking your pancreas. But long term T2s can progress onto insulin either because their insulin producing cells have been damaged by long term high sugar levels (possibly what your nurse meant by a tired pancreas?) or because they are so insulin resistant that the pancreas just can't produce enough insulin to cope. (There may be other reasons, I am not a doctor or a T2, so happy to be corrected by those more knowledgeable).
My father moved on to gliclazide from metformin without any ill effects and was on it for several years before going low carb reduced his levels and his doctor took him off diabetic medication. (He's on a ton of drugs for other medical issues). His current hba1c of around 55 might warrant meds if he were younger, but as he's 91 his doctor would prefer that he didn't have to worry about hypos (he's prone enough to falling as it is). Mind you, I don't think he got any hypos while he was taking gliclazide.
My understanding (possibly incorrect from what
@Bittern is saying) was that NHS guidelines state that they have to give you a meter if you are on gliclazide, so you can check for hypos. I suggest that you ask about one if they don't offer it to you automatically. My dad ended up with several different meters and a plethora of strips, none of which he used until he came to visit me and I encouraged him to test while he moved to lower carb.
Good luck.