I have had type one Diabetes since the spring of 1981, at ten years old, and have had to live through all the carb focused diets that in my opinion have ruined, or at least made diabetes control a nightmare. I have used a insulin pump and CGM the last 12 years, and this helped a lot with getting the HbAic in check well below 7. My current pump is Medtronic Minimed 780G and it's Sensor 4 CGM, my insulin is Humalog
Since February this year I went on a low carb life style, and intermittent fasting and usually omad, but never more than two meals. The less often I eat the easier it is to have my blood glucose a straight line. In all I have lost 17kg of weight, and I am of blood pressure medicine, I work out 2 times a week which includes 3-5 hour hiking trips up in the Norwegian hills and mountains. My last HbAic was 5.3 and my daily insulin intake is 2 4 split in half between basal and bolus.
I am fat adapted and I do get a ketone reading every morning. Sometimes I do fast a day or two, to avoid getting my body adjusted to a steady predictable ritual. Changing the pumps reservoir every three days max four keeps it easier to predict needed insulin, since the longer it has been in the pump the more insulin you need. I use Temporary Basal together with bolus dose when I eat, and I also use the temporary basal adjustment when my reservoir is new or getting older.
If I get a low glucose level, I turn off the pump by myself or automatic at night, and do not correct with any carb unless I really have to (almost never). Another perfect thing with the Temporary Basel adjustment is that you can set it for a time restricted lower insulin supply when you feel the need.
I do feel my low blood glucose incidents, but they are never a problem because of my fat and ketone adaption.
I would never give up anything regarding getting your Diabetes in check, but the longer you wait the less time you have.