This isn't medical advice just some observations from my own experience.
My HbA1c was 113 at the start of April and I was prescribed Gliclazide and Metformin, and told by a GP to take them 12 hours apart with meals. Nothing about what should be in those meals! I was also given a BG meter in order to test for hypos.
Now I've been low carbing for about 8 years, so some of my meals are zero carb, and so far I've never come anywhere near a hypo. A confident-sounding doctor (when I rang 111 in a bit of a state after not managing to get a blood drop out to test) said the chances of a hypo with such a high initial blood sugar were virtually zero and that I should go ahead and take the meds. I keep a sugary drink and sweets by my bed just in case.
Also, low carb can be anything up to 130g carbs per day, which allows me to take my meds, but still way better than the "standard western diet". It's not all or nothing - I expect I'll have to take meds for a while, possibly for life, but I can still help myself by making better food choices at the same time.
Silly of the nurse to panic, I too had a number of staff at my surgery metaphorically flapping their hands and threatening all kinds of dire consequences, which didn't help my stress levels in the slightest.
I've been lucky not to have any obvious side effects with the Gliclazide, and over the last 4 weeks my BG readings have come down significantly. Hopefully this will work for you too and you'll be able to reduce your dose or even stop needing meds altogether.
All the best
Debs