Hyperinsulinaemia

Hi I am new to the forum and am looking for some advice.
I was originally diagnosed type 2 diabetes by GP based upon fasting blood glucose and HbA1C, all results borderline. No treatment, simply advised to loose weight (BMI =37). In March 2015, I was referred to an endocrinologist because of hypothyroidism and fluctuating TSH plus inability to reduce weight despite a strict 12oo calorie diet and supervised exercise plan.. While I was there, he arranged a glucose tolerance test the results of which put my BGL and HbA1C within normal parameters, however my insulin levels were extremely high and C peptide abnormal. The diagnosis was insulin resistance due to obesity and hyperinsulinaemia. I was then commenced on Metformin (lactose free because I am intolerant) 500mg twice a day (off label use), increasing to three times a day within 4 weeks. I continued my low carb, low calorie diet but the weight would not budge despite the usual upset stomach to begin with. In the last 6 weeks I have lost 3.5kg, a steady small reduction. I feel better and my clothes fit better but my abdomen is massive (I am apple form) and not one millimetre has shifted from it. It really is soul destroying, I am trying so hard but no one believes me. Doctors give me encouraging words for my diet and exercise plan then write on their report that I need to eat less and exercise more. I suffer from degenerative spinal disc disease and arthritis therefore the gymnastic class, walking (2 x daily with dog) and swimming when I get the chance is as much as I can physically do and tolerate because of the pain.
I have never had a big appetite so don't need metformin for that, I eat home cooked fresh produce and rarely eat processed foods (only when travelling and options are limited).
In the past, I enjoyed chocolate biscuits by the dozen however, in those days I was thin regardless of what rubbish I ate. In my family there are many apple forms and my siblings (diagnosed 50 yrs old) and grandmother (late onset) type 2 diabetic so probably a genetic link. We all have metabolic syndrome.
Do you think I should continue to take 1500 mg metformin per day if I am no longer within the blood value diagnostic category of diabetes type 2 and it doesn't appear to be helping me to lose weight? The insulin levels have never been measured again so I have no idea whether or not they are reducing. My next endocrinologist appointment in Jan 4rth 2016.

Thank you and well done!
You ask why I would stop Metformin. The objective was to help me to lose weight which I don't see any evidence of. Metformin can be a great help for those trying to optimise blood glucose levels which I am not. There are many side effects to this drug which is why I don't want to continue if there are no real benefits. Only a few studies have demonstrated some success in this area but not enough for this to be called concrete evidence. I guess I am a bit of a Guinea pig I take many other tablets for a whole host of things diagnosed in the past 5 years, so if I can reduce this drug intake, I will.
My HbA1C has ran a similar course to yours starting of at 6.9% in April and now it is 5.4%, BMI almost at 36 but no real progress in this department. In April potatoes and bread were my downfall so I have reduced this intake severely and do not allow my carb intake to go over 100g. I need my toast in the morning and a wee potato other than that I have cut everything else out. I never liked past and rice so that wasn't an issue but I do miss my chocolate biscuits. I am lactose intolerant so don't eat dairy except for a scrapping of butter for my potato. I eat mostly chicken and occasionally a filet steak (150g) but no processed meats and always in small portions. My thyroid function is stable (T3, T4 & TSH) at the moment but that can change very quickly. I suffer from hypertensive heart disease with LVH & HFpEF (no CAD) so my TSH is always checked by the cardiologist every 6 months when he checks my cardiac function. The endocrinologist checks TFT 6 monthly so in effect I know my TSH every 3 months the way my appointments work out.
Sometimes when I feel as though I am making such an effort for nothing, I want to go and buy some biscuits. Thankfully so far I have resisted temptation, my goal funny enough is to be fat ( and healthy-ish), at the moment I am obese and falling to pieces.

Once again an honest story of how an illness can be turned around, thank you, both responses thus far have been truly inspirational.
In April my vit D level was only 9 ( ref : 30-120) after treatment I am now at the lower end of normal with 47. My weekly 20,000 units of suppliment has been reduced to 4,000 maintainence over the winter months. I was amazed at the improvement in my health as the vit D normalised. Metformin can lower B12 and folate, however, I have been deficient in both since I was 28 years old and have 3 monthly injections for PA therfore, it is not really possible to say whether or not the Metformin has any detrimental effect. Magnesium was normal, calcium a wee bit too high and I don't remember seeing B3, chromium or CoQ10 on my blood results. I will ask if they were checked in April if not perhaps if I ask nicely they can get checked in January.
The level of insulin produced in response to the OGTT was much more than the endo expected for insulin resistance so I don't know whether or not something else is going on. I seem to be going from one auto immune disease to another and most of what's wrong with me appears related to hormone deficiency.
I will take your advice and wait until my next endo appointment in January before deciding on the fate of Metformin. Thank you for all the good information and links, you have certainly made me think.

You were right, I am now a confirmed diabetic despite all my efforts and reducing my weight by 6 kg. I do not have my blood results to hand as the Endo only had partial results because more extensive testing was carried out. He could only tell me that I am diabetic and also have adrenal insufficiency. When my local physician gets his report then I will get a copy. A routine urine did not test positive for glucose but did for bilirubin so that has gone for further testing.
My health situation was already complex but the new diagnosis pushes me into a real danger zone, I dread to think of the future.

Indy51 said:

Have you looked into the Wahls Protocol? It's a healing/real food diet for autoimmune diseases, so you might find it helpful.

Have you been tested for Cushings? The expanded abdomen/apple shape and cortisol issues can be symptoms of that. Sounds like you have some very complex endocrine issues going on, so good that you're receiving specialist care

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Thank you, I will order this book, I had never heard of this protocal but the feedback seems very positive. However, I feel so down at the moment, I will eat a big bar of chocolate before starting any other diet. I know that this is not the right thing to do...I just need it.
No I don't have cushings but I do look like a sufferer. My adrenal problems however, are apparently as a result of frequent episodes of inadequately controlled malignant hypertension. My cortisol level was very low but it is slowly coming up although not yet within normal range. This in turn is creating havoc with my thyroid. I was also diagnosed with diabetic kidney disease 3 months before I became diabetic! I do not have much confidence in my endo, he seems to order tests but is not good explaining results. The previous appointnt results and report were not sent to the local GP for over 3 months. Officially, my GP has not been informed of my new diagnosis...I was at endo 4th January.

Andrew Colvin said:

Oh I am so sorry to hear that you could not stem the onset. Such a shame. However, It can be controlled with continued dietary control. I hope your tests come back clear - here is keeping my fingers crossed.

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I just keep being diagnosed with one thing after another, even though no new symptoms are appearing. When the doctors check for one thing in my blood they find another...its soul destroying. I try so hard to watch my diet, and excercise however, my brother and sister (both diabetic) don't really pay attention to diet and/or excercise yet I am the one collecting further diagnosis. no new treatment or advice has been offered, I am left in Limbo.