Congratulations on the 45 lbs weight loss. Did you have trouble controlling your appetite on that small amount of food?
I have recently been diagnosed with pre-diabetes, which could turn into full blown type II diabetes. I'm on a mission to lose about 23 lbs and so far, it's not going very well.
You have to maintain your diet, in order to keep the weight off and to maintain your blood sugar levels.
Carbs under 40 sounds extremely restrictive. I agree that eating white rice, potatoes, bread, and things with refined sugar is "off limits"; however, it seems that your dietician isn't taking into consideration that there are 2 types of carbs........ the simple carbs such as the "white" things which we should all avoid and the complex carbs, such as those found in vegetables, whole grains, fruit, etc. Those are the carbs that provide dietary fiber, which is necessary for good digestive health. They aren't digested as quickly as the white versions, so they won't spike your blood sugar. Do watch portion sizes, though.
Try switching to brown rice, whole grain pasta and bread, etc. Limit fruits to one or two serving/day, because of the sugar content and opt for whole fruit over juice, because whole fruit has the needed fiber.
I've been allowed 108 grams of carb and am supposed to intake at least that much protein, because I have low protein levels. The carbs are easy; the protein, not so easy.
I'm sure your doctor would want you stay on the medication, in order to help maintain your lower blood sugar levels, especially, with an A1c of 6.4. If it went much lower, you could possibly get off the med, so long as you maintain your diet/blood sugar levels.
Haven't heard any comments since April 2013 on Sweet to Sevelte. Would appreciate hearing about your experiences.
Don't know anybody on the forum right now, who's on Sweet to Svelte; you might try asking in the Weight Loss Alternatives forum, since that's not something we'd, typically, recommend on this forum.