Hi
@Madisons (with apologies to Helen because it's your thread!). If I were you I would just pick one issue to focus on as it's impossible to come up with a strategy that appears to suit every single condition bearing in mind contrasting issues. For me, that would be the pre/diabetes. You do not have to go full keto at all, that is not for everybody and many can be put off by the very low carb aspect. I'm different to you but I eat between 70 &100 carbs each day which is low carb. For my carbs, I eat vegetables (most kinds) but I roast them in the oven with a bit of olive oil or butter and they taste so much richer and nicer than a bit of boiled broccoli. I have them with salmon or fish, or steak or chicken or any other kind of meat. I eat meat around 2/3 times a week.
I eat cheese or Greek yogurt and sometimes (shock, horror) I even have a slice of toast on occasions. I know I am an insulin user so it's not the same but if you continue to agonise over every single food group you will become ill. My cholesterol is up there at 7.6, but my ratios are excellent, I too was sent off to a Lipidologist and it came back that my LDL was polygenic. They mentioned statins and I refused, my HDL was 2.45, my trigs 0.5 so as far as I'm concerned there s nothing to suggest I will drop down from a heart attack. The Consultant did say that it mattered not what you ate regarding cholesterol as the body makes most of it and the food you eat makes virtually no difference, in fact he said cutting out cholesterol containing foods just means your body makes more of it to top it up to the level it is happy with. In other words it likes to keep its balance. The myth around eggs etc, was debunked long ago, even he said that. Of course I am only talking about those with no other conditions related to 'high' cholesterol and is mine even high, I don't think so, it's normal for me, just not 'average' evidenced by the ratios.
I would say try and calm down, maybe go for a low carb diet of under 130 carbs a day which you can adjust downwards if you like. This gives you a little more freedom and if you check your glucose levels you may see great results.
You need to eat well though as I note you are underweight I think you said, just to mention I was diagnosed as 'pre diabetic' in my early 50s, I did not fit the so called profile of type 2 other than age...slip forward 3 years and I was in hospital with DKA and was actually found to be type 1. I say this not to alarm you further but to just bear it in mind if you see your numbers creeping up.