Brief Answer:
Insulin resistance

Detailed Answer:
Good day,
Noted your concern. People with insulin resistance often produce excess insulin after they take a meal and that cause the sugar levels to go down 2-3 hours after eating, especially after a carb rich meal. This is called as "Reactive Hypoglycemia". This often happens in obese individuals. Since you have symptoms even in the middle of the meal, this is highly unlikely.

Do these symptoms occur while you are relaxed and eating out with good friends or while on a vacation?

I did see your reports and all are normal except the fasting insulin slightly on the higher side. From your previous question, I realize that you have PCOS and irregular periods which has a link with high insulin levels. Weight loss would certainly improve insulin sensitivity.

I am afraid that I will have to agree with your doctor that you probably are stressed. Mitral valve prolapse is seen in up to 2% of population and people with MVP tend to have some anxiety and stress.

Stress have 2 way reaction to Insulin levels. During acute stress, counter regulatory hormones increase and insulin level reduces. This cause the blood sugar to go high. However, due to high sugars, Insulin levels increase later on. Hence Stress cause low insulin initially and indirectly cause high insulin levels later.

There are many methods to establish Insulin resistance. I used to do research on Insulin resistance in PCOS . HOMA-IR is such an index to calculate Insulin Resistance. Your estimated HOMA-IR ( based on the insulin value of 21 and blood glucose value of 92) is 4.8. This is high and may indicate insulin resistance.

You may access a HOMA-IR calculator from "http://www.thebloodcode.com/homa-ir-calculator/". This have many limitations and ideally Insulin and glucose have to be measured on the same fasting blood sample. Please do not worry even if this is high. It can improve with weight loss and exercise. I have seen many young women with high insulin resistance with PCOS and vast majority improves with weight reduction and exercise. You should aim to lose atleast 5% of your current weight
Regards
Binu

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Brief Answer:
Not to worry. Doersnt seems to be related to IR

Detailed Answer:
No, then it is highly unlikely to be related to insulin resistance.

However, we may have to do special tests like " extended GTT" or a prolonged fasting test to rule out rare disorders associated with high insulin levels. These are bit uncomfortable tests. Your symptoms are not prompting me to recommend these uncomfortable tests.

My recommendation would be to do exercise and try meditation/yoga. Do stretch exercises. Avoid sweets and sugary stuff as much as possible. Sugar increases weight and worsens insulin resistance.

Avoid smoking and limit alcohol as much as possible. Alcohol is packed with calories which will cause you to gain weight. Reduce or avoid junk food as much as possible. Go for an early, light dinner consists of complex carbohydrates and fiber. Please meet a dietician attached to an endocrine unit in a hospital. They are of great help than doctors when it comes to insulin resistance.

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