Is my doctor right to be concerned?

I'd suggest you should do something about this early rather than leaving things. It's easier to tackle things before they progress.
Lowering carbohydrates is likely to give you good results fairly quickly.

Paulcornwall said:

I really don't understand the 10.4 as I has nothing to eat or drink prior to testing? Can anyone explain this?

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This is quite common. Search for dawn phenomenon and liver dumping.
Basically your liver is "dumping" stored glucose in your blood to provide you the energy you need when waking up. But because you probably are insulin resistant this glucose is not being used but circulates in your blood.
If you are not medicated (I guess not yet) I assume you see the levels drop to your 6's after about 13:00 ?

Paulcornwall said:

It drops pretty quickly down to high 6's within the hour

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I'm no doctor of course but that seems a rather sharp (and short?) peak for it to be dawn phenomenon. Did you ever test at night in the late am's? Depending on what you ate the night before it could also be that you go to bed with an acceptable reading but that your bs goes up at night and drops when you wake up and things get really going again.
You might look into using a cgm. If only the free sample because they are expensive if you have to self fund. But I found the results to be an absolute eye opener. Wished I had known about them years sooner. Can't really afford them but I don't want to do without them anymore.

btw 6's are not "good" values. Not bad, but not good either.

Paulcornwall said:

During light/medium exercise, I also get the shakes

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You have the equipment, so test! But I guess you will see that this is more a trick of the mind/body than that you really need food. (You basically never "need" sugar)

Paulcornwall said:

From my limited testing, I seem to be up and down like a yoyo.

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And this is where a cgm device shines in my opinion. No limited testing but continuous testing for 14 days straight. You get a real sense (and visual feedback) of what a certain type of food does for/to you.

Paulcornwall said:

and cram in food before I go to bed (not ideal also)

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Good conclusion. And it probably isn't the best type of food either... (which could explain the high morning reading)

Paulcornwall said:

What is the criteria for a diagnosis of type 2 diabetes?

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I'm from the Netherlands so different criteria. But 6's is the point at which I started some 18 years ago and yes, that meant metformin and the never ending mantra of "eat less, exercise more". Which for me doesn't help at all.
The only advise I can give is read up on this forum and everywhere else, get informed but be critical, don't believe everything, ask questions and use your common sense. On this forum you will find that many do either keto or low carb high fat diet 's and/or indeed fasting.
You will also see that what works for some will not work for others and vice versa.
Don't for example switch your bread for wholegrain bread thinking it's better. It's at most a little less bad. Try to avoid carbs as much as possible. A way of looking at diabetes is saying you are allergic to carbs.
If you stick to the finger prick sensor, test before eating and 1 and 2 hours after eating. This way you can find out what raises your blood sugar to much. After a while you have a list of food to avoid and a list of what you can eat. And you can start to test less often. Extra warning here, food containing lots of carbs and lots of fat like chips/pizza/egg rol will spike your bs much later then the 2 hours.

Most of all, do take this seriously. The sooner you do the better of you are in the long run. (but having bought a meter is a very good first step!)