I can't imagine having good hunger signals if you are nauseous from the Metformin. Bonnie has a good suggestion.

I hate to say this because your menu sounds like a very good LC plan and you certainly don't overeat, but you may not actually be "Keto" on some days. When someone is very insulin resistant, not only should you stay under 20g Total Carbs, but maybe even lower. That really doesn't leave room for fruit or nuts, rare treat that it is for you. Since you asked for suggestions, one would be to try the Duke Lifestyle diet, also used at HealClinic. A version is here: http://www.kostdoktorn.se/wp-conten...starch_diet.pdf. (minor print error, the cream and mayo limits should actually be 2T not 4T) No nuts, no fruit.

At the same time test the foods you do eat for what Dr Davis calls "The No-Change Rule". Take your baseline BG before eating, in 30-60 minutes after, there should be no change. Maybe try adding Apple Cider Vinegar before meals? http://www.tuitnutrition.com/2014/1...of-vinegar.html
Along those lines, Dr Davis also considers restoring "bowel flora" aka gut bugs important to improving IR. Add some prebiotic fibers and probiotics by supplements, or fermented vegetables. http://www.wheatbellyblog.com/2015/...ed-bowel-flora/ And as tough as it is from how you described your job, manage stress and get enough sleep.

And I know you won't believe me about this, but you can forego meals while working. If approached slowly and with support, IF is not a mental or physical challenge. Some LC doctors now advise Intermittent Fasting to help reduce insulin levels for T2. https://www.dietdoctor.com/perfect-...tes-weight-loss

It takes most everyone some time to get use to fasting, maybe slowly pushing off breakfast by an hour or adding CO and butter to coffee. I know I am really in ketosis, when I have an extra boost of energy, buzz around the house, even have a hard time sleeping because I am too revved up. As weird as it seems, you do not get weak and unable to meet physical demands, but have Extra energy. One of many great explanations about how this happens by Dr Fung: https://intensivedietarymanagement....ise-fasting-23/

Again suggest reading all the links in my previous post, and then ease into it. I started a more structured IF three years ago now and it took me a long time to accept all its benefits for lowering BG and other therapeutic uses. I seek its autophagy benefits for the potential of cancer recurrence prevention. You have to hear Dr Fung say this word in his intro video, and you may think fasting is Crazzzzzy, but done correctly, it makes more sense than treating diabetes by telling patients to eat six meals a day!