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By increasing and prolonging active incretin levels, sitagliptin increases insulin release and decreases glucagon levels in the circulation in a glucose-dependent manner

Your calorie needs vary based on your body, activity, and any medication use this as a starting framework and check with your provider or dietitian before making big changes

Persistent fatigue and weakness are often the first indicators that calorie intake is insufficient

A reasonable transition approach is to move from strict keto (under 25 grams net carbs) to a low-carbohydrate diet (50 to 100 grams net carbs) that is less restrictive but still meaningfully below the carbohydrate intake that drove the original weight gain

Every 3-6 months ongoing: Regular monitoring to ensure benefits are maintained and adjust other medications as needed