Dana--
I also have hyperinsulinemia aka "prediabetes" aka "metabolic syndrome x" and I know what you are going through. My sugar goes low and high and it is awful. It is hard to maintain by diet alone. Do you have copies of your blood work, especially your liver enzymes? Have they diagnosed you with "fatty liver" aka "Non-alcoholic fatty liver disease" or "diabetic liver"? They can treat your prediabetes, if you find a doctor willing, but they need to check you out. If your liver is affected (they can tell if you have fatty liver from a liver ultrasound, very non-invasive, just lke the pregnancy ultrasound only they look at your liver). Anyway, if your liver is affected, you should have at least one appointment with a liver specialist, called a hepatologist, not just a general GI doc because the hepatologists are really really good at dealing with that kindof problem and have the latest information. Glucophage has saved both me and my father's life. For people with this liver involved type of diabetes, its the liver causing the problem by not metabolizing the sugars properly and not burning fat. A fatty liver diet is different than the regular "heart smart" diabetes foundation recommended diet, which is being attacked vigorously by diabetics because in some cases it does more harm than good. If you do have liver problems, a hepatologist can recommend a proper diet for you specifically, Atkins and South Beach were recommended for me by mine with a moderate fat intake,not low fat. I became ill on a low fat "heartsmart" diet.
But the pills for diabetes were what really straightened out my blood sugar, I am an even 100 now, 120 if I eat bad stuff, and I am extremely sensitive to small swings in my blood sugar numbers either way. If I get under 80 or over 120, I feel it. If you don't have a blood sugar test kit, I strongly urge you to get one. Personally, I think everyone should have one in their first aid kit, especially if you are overweight, on a special diet or are chronically ill. They are cheap now, mine was 18 bucks and if you get a prescription for it, you shoudn't have to pay at all.
Only certain diabetic medications work for the type of liver involved diabetes that I have, metformin(glucophage) and another one I can't remember. Anyway, I was decompensating from liver disease (dying) and getting all kinds of other problems until I started my pills. It literally saved my life and I had to see a fancy hepatologist at a famous gi center to get put on it. Since then,my liver enzymes are low normal, my liver disease progression has halted, the inflammation has stoppped, and my ability to tolerate meds is a little better. All this from metformin. ALso, my high blood pressure went down due to the inflammation of the liver stopping. Its important toknow if you have fatty liver (which has nothing to do with your weight or body fat I was105 when I first got it) because the wrong meds can make you worse.
Clinical trials for metformin for prediabetic fatty liver should be complete, docs have known about it for about twenty years because my dads been on it that long.
The onset of my "genetically inclined" fatty liver/prediabetes was due to autoimmune endocrine (thyroid and others) disease, so keeping this under control helps me alot. Its something that runs along with diabetes. So you may want to get that stuff checked. I may have goten it anyway, but maybe later in life.
I hope this helps.