Your A1C is well managed but understand you want to get it even lower.

Keto "may" allow you to do that but if you did make any gains you would have to stay on that diet for the rest of your life - awfully restrictive if you have many years in front of you.

If you like nuts you could avoid the meats. Pistachios, walnuts, cashews and even peanuts are loaded with "good fats" and protien so could replace meat in your diet, plus they are high in fiber.

Dairy products are also not the "big scary monster" that they have been portrayed to be. The saturated fats in dairy have actually been shown to reduce cardiac/cancer risks - something to do with the chain length of the fat molecules (beyond my understanding but trust the studies). So cheese (and fuller fat dairy - I use 5% or 10% cream in my cereal and replace water in recipes with 35% cream) which is high in good fats and protein can likewise take the place of meats unless you want a "vegan" diet.

I tend to agree with what you are saying and absolutely agree that you should have a good and respectful (both ways) interaction with your doctor.

And yes, 5.8 is a "well managed" A1C. But what we don't know is if the doctor has determined that, that A1C level has been achieved "at least partly" because of the meds and is concerned about returning to an "uncontrolled state" without them.

So perhaps the first step, before ditching a doctor, is to ask plain and simply "why" they are resistant to taking you off meds. Maybe they will make a reasonable arguement that actually makes sense.

Maybe just because I'm not (shy) but I question everything that my doctor suggests. And I don't mean that I'm confrontational, but I ask why or what's the benefit or is there another option, or can we try something different first. But if either of my Doc's make a reasonable arguement - explain "why" they think it's the best course, and I agree based on that extra information, then I won't be contrary just because I believe they have been bought off by Big Pharma or the Easter Bunny or anyone.

I don't think that most doctors are inherently pill pushers, but do agree that many don't take even a minute to explain "why", unless you really ask them to. And if an A1C is 5.8 is achieved through diet AND Max or close to max oral meds then it actually may not be wise to discontinue med completely.

So maybe ask for a reason "first"...

This is only my opinion!! and I know I will get a lot of haters! I think you need a new Doctor who will work with you to get off of the meds. Some Doctors seem to always want you on Meds. Good Luck with everything!! An A1C of 5.8 is incredible and a great Doctor will slowly decrease your meds in a controlled situation. You will need to get "weaned off of the meds.; but, you should be able to eventually cut your meds down drastically or maybe even completely.