Even as far back as 6 years ago one of his previous doctors urged him to switch to insulin because his blood sugar was far too high. He had been taking Farxiga for years and in December he was no longer qualified for it under his insurance and now he has to pay hundreds a month to get that medicine. It had been working well for him all this time but now he can't afford it, and his current doctor is urging him to switch to insulin because of his near-fatal BS levels. He's tried to keep his blood sugar down by dieting but it hasn't worked. Is switching to insulin a good idea? Or is it something he'll later regret?
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Yes, it helped but not enough. Still dangerously high numbers.
But did he do it completely without cheat meals? it won't work unless he goes 100% for months
Check his vitamin D, zinc and vitamin A levels because MANY diabetics are deficient in one or more of these. If these levels are within normal ranges he might want to move to insulin.
Regardless of whether he tries insulin or not, 1) don't let him change his current diet/eating patterns (especially if he does go on insulin because he may [falsely] believe he "no longer has to worry about his BS levels") and 2) have him keep a detailed food and beverage journal of EVERYTHING he eats, drinks and swallows for at least a couple weeks to a month.
"A little this", "a little that", "it's a special occasion", "it's my favorite", "just this once", "this little bit can't/won't hurt", "I can't be rude (and not have any [of something someone made or offered])", and "but I just HAVE to have some", can REALLY, REALLY add up fast. He/You might be surprised how many carbs he (unknowingly and/or unintentionally) ACTUALLY ingests.
Also have him keep track of his activity as well as his BS numbers throughout each day/night.
Review everything after a couple weeks to a month. The results/correlations may be "interesting".
Note: I am not a doctor and the the above suggestions are not to be taken as "medical advice".
Carnivore diet should cure him pronto. No cheating
Are you sure he's being honest with what he's ingesting?
If he has done carnivore and it didn't work, how was his levels so high if he isn't consuming any? Where is the sugar coming from? It has to come from somewhere, and there is no sugar in carnivore.