Insulin Resistance and carb craving....(long)

I am in the process of getting insurance approval for VSG.  I have insulin resistance and since the holidays have been on a real carb bender.  Was Dx with PCOS 25 years ago - tx with BC.  Dx with insulin resistance about 12 years ago and tx with Metformin 2000mg/day since.  In addition, have PMDD....I am just a mess. lol  I can feel that my BS is flucutating more lately.  I have not checked it because I really don't want to know what the results are.  It is very hard to explain my extreme carb craving to my hubby....further complicating my decision toward VSG.  He cannot understand my "taking the easy way out" when I conintue to eat sweets.  (his words).  How do I tell him the effect sweets have on me?  The craving, the binging, the "sugar headaches", the anxiousness when my BS and insulin levels are soaring, the drained feeling I have when levels begin to drop, the exhaustion I feel when my BS then gets low at the end of a bender?  This must be a tasts of addiction. (hubby says I am obsessed with sweets).  To begin with, I have not had any follow up labs since DX with insulin resistance years ago.  Currently, my OB/GYN refills my Metformin yearly when I go for my routine exam.  Since the first of the year, my insurance has changed, so my current PCP is now not in network.  I believe I will change MD (I have some leads on good referrals) and make an appointment this week for labs,etc.  I have called my Bariatric surgeon's office and asked for a list of PCP in my area that they work with.  I will start investigating there. Judging by the way I feel, there is no telling what my insulin levels, serotonin levels and glucose levels have been.  Please tell me I am not the only one that carbs have such control over. 

Sorry to hear about your struggles.  I have PCOS also and type 1.5 diabetes for 25 years.  I had RNY in September and am doing very well.  Off a LOT of oral meds for diabetes, but still use metformin (1000 daily vs. 2000 daily before surgery).  I use less insulin now also.  I'm down about 42 pounds.

There are a few things I want to say to you.  First, you need an endocrinologist - like NOW.  You could really benefit from working with someone who understands the dynamics of your disease, cravings, etc.  These things are all colliding in your body and you are not doing yourself any favors by just getting a prescription from your OB/GYN for metformin.  You are likely going to need the consultation and approval of an endocrinologist prior to bariatric surgery.  If that isn't one of the approvals you need, I'd question your surgery team.

I don't know how far you are in the process, but you'll need lots of approvals and screenings to get bariatric surgery.  You'll also need a psychological evaluation.  I am sure you will hear much more from them about your PMDD and carb addiction.  It's not uncommon.

Secondly, and I know this is going to sound harsh, but your denial is killing you.  You need to start testing yourself, keeping records and getting on a medication regime that is actually working for you.  Again, this is where the endocrinologist comes in.  Your carb cravings are completely tied up in your uncontrolled blood sugar.  You do realize that, right?!  The higher your blood sugar goes, the more you are going to crave carbs because your body is dumping sugar like mad.  This is a never-ending cycle if you don't get it managed right away.  I am clearly not a physician, but it sounds to me like you need insulin.

Get aggressive about your own health today. 

I agree with the poster above and also want to recommend investigating getting the RNY instead of the VSG.  It changes the metabolism of some sugars.  If your body is still producing insulin, then the RNY might even cure your diabetes.  If you no longer produce insulin, then the RNY will reduce your need for insulin drastically but won't cure you. Your endocrinologist can do a blood test to determine whether you still produce your own insulin.

I was a Type II diabetic for years and years and finally the medications like metformin stopped working for me. I ate so much sugar and my pancreas produced so much insulin that I basically worked my pancreas to death.  I had the lap band years ago and it didn't help my diabetes or curb my sugar cravings at all.  It slipped (failed) and I had RNY about 5 months ago.  The carb cravings are much better and I use much less insulin than before, but if I eat any carbs, I still need at least a few units.  So I'm not cured but it sure is better. 

Good luck with your journey to the loser's bench!

If I had diabetes, and was choosing a surgery now, I would want a DS. diabetes is resolved, and long term weight loss is great.
Good luck either way.