Correct. I did have mild hypo's while I adjusted my Glic dose from 4 x 80 mg a day down to 1 x 40mg in the morning. Because I was testing 3 or 4 times a day (more if driving) then I had a reasonable view on how things were progressing while I dropped my carb intake relatively slowly. I kept to a regular pattern so things became stable and repeatable before I changed any med treatment, and thus I quickly got an indication of how any such changes either to diet or meds or their timing affected me ( a day or two to see a change in averages) So as I approached hypo land, I became aware of what symptoms I got with low bgl, and thus became hypo aware. I had a rule that I had to be 5 or higher both when driving, and also at bedtime which was always 4 hours after my last meal and last Glic dose, so that it was unlikely that I would go any lower in the night. If my 4hr PP reading was below my pre meal reading then I would eat some carbs just to make sure I was safe in the night.
When I was happy that a dose level was working ok, then I sent a letter to my GP requesting that the change become officially entered in my records and in my prescription. I have a good GP and he is supportive, so I have demonstrated by graphs in the letter what level of control I was getting, and there was never a problem.
One thing I did was to collect the unused pills so that I have a bottle to hand in case I need to bolus for a bad meal choice, and take an extra Glic to compensate on a temporary basis. I do not need to do that now, as I rarely get low bgl. I seem to be in the range 4.5 to 8 mmol/l with a medium carb intake so no longer going keto by choice. My HbA1c this month was 42, and my daily average today is 6.8 which I am happy with. I went softly softly catchee monkey, and I avoided keto flu, and my hypo's were always manageable on my own. Also the hypo's were shallow and naturally self correcting as the glic is excreted, so I never needed the massive sugar hit that someone on insulin might need. I never felt in danger.
PS: as my FBG dropped, I benefitted not only from lower diabetes meds, but also had to reduce my BP and heart meds too, and drop my statins off the scrip. So my LC journey has significantly reduced my NHS footprint.
