Fasting insulin of 4ui/l with 80mg/dl but at 60 minutes insulin 43, 6ui/l with also 80mg/dl. fatigue, extreme weight gain. hyperinsulism? ir? why? thanks

Insulin & glucose: If those are Insulin and glucose values fasting, and 60' after a meal or after glu tolerance test, then they look very normal. With vigorous post-meal Insulin secretion, glu does not go up much in many people. It is not a sign of IR or hyperinsulinism.

Insulin levels: testing is very unreliable and generally worthless. If you're obese and on metformin then you most likely are Insulin resistant, but at least your blood sugar is well controlled. Eat less, exercise more and lose weight. Make sure metformin dose is 2000 mg/d if you can tolerate it. Monitor your glucose and f/u with your doctor.