When to begin diabetes treatment

You are in treatment for your diabetic condition. Changing your diet and including exercise is the treatment and at your weight, you should be doing well.
Some people do not need pills to treat their condition. Do you test your blood sugar levels at certain times? You can learn more about keeping the blood sugar from spiking and dropping too low with your eating plan and the timing of your meals and snacks. The more it goes up, the more it can go down.
A gentle modulation of the levels worked best for me in the beginning, and as I age, I need to keep the activity load and/or exercise levels up because my body is slowing down. Bummer! Healthy habits and busy living is more effective and more fun than pills for any condition. I knew a neighbor who ate a bag of potato chips at will and then took insulin shots. That game led to loss of his legs before an early death. A healthy mind and attitude helps as well.
I am no doctor, but I do love learning about nutrition and improving our healthy bodies. It takes a little more than good face cream to hide wrinkles. Dorisena

When first diagnosed with low blood sugar, which was partly due to stress, I found a paperback which described what was happening to my body with low blood sugar. I changed those highs and lows with a different eating plan and exercise, and going to work on the stress.
Pain meds can raise blood sugar as well. I thought I was cured, but never was able to go long periods without food. It felt like my insulin pump would turn on and not be able to turn off, as I described it. In later years, after weight loss and weight gain, I was surprised to find out I was prediabetic. Losing weight and a low carb diet brought me back to normal levels daily if I was strict in my eating habits. I liked it very much and did not miss the sweets, but I missed the baking hobby. Not enough exercise and numerous surgeries have caused the numbers to rise a bit, but the doctors don't think I need any further treatment, and besides, Medicare won't pay if the A1C is below 7.
So I am dismissed from treatment, and my primary doctor renews any needed prescriptions yearly. I am left to treat myself if I want low numbers on my testing. I am trying to lose weight again. I eat too much for my age. My endocrinologist thinks my problem could be genetic but medical world hasn't gotten to that point to say yet. Read for more education. See a nutritionist. Stay active. Be grateful to be keeping the pounds off. Reward your good work with anything but food. I bought earrings for each five pounds lost. We need to get away from thinking pills and shots are the answer to every health issue. We are working on better health. I am not sick. Dorisena

Getting back to my question, I have been exercising and eating primarily veggies with a small portion of protein for years, some days a piece of fruit, but I moved from pre-diabetic to diabetic and my insulin levels are low. My mother was diabetic, as are three of my brothers. To cut out more carbs I will need to fully eliminate fruit and even more veggies. I've already stopped eating carrots, potatoes, beets, squash and tomatoes, years ago. Seriously, I've been working on this for at least 8 years; things are moving in the wrong direction; and I don't know what more to do.

@trieste Have you spoken to a dietician? If not your doctor can refer you to one. Also, for me, I find that going to an endocrinologist beats going to my PCP, particularly if you have any complex concerns, and it sounds as if you do. When my endo moved out of town I did use my PCP for a while but then decided to go back to using the endo, even though he is about an hour away.
For your weight and size I would not think that diabetes would be a concern, but then I guess that even though it is more prevalent when a person is overweight that is not always the case.
JK

Yes, you have done well and need more help from an endocrinologist who can also check your thyroid and other issues. I remember that it was my endo who recommended the Metformin because my primary doctor did not. He said it doesn't do much, and I think it has helped. You may be dealing with genetic causes which complicates matters. Be persistent in seeking more help at this time. Dorisena

Thank you for suggesting an endocrinologist. I will follow up on that for a second opinion.