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What to do for insulin resistance and high prolactin levels in a 30-year-old woman with a family history of diabetes?
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General Health
Question #30617
7 hours ago
12

What to do for insulin resistance and high prolactin levels in a 30-year-old woman with a family history of diabetes? - #30617

Client_fe6005

Hello Doctor, I am a 30-year-old woman from Tajikistan and cannot afford expensive consultations or repeated tests. I would appreciate your advice based on my current results. Height: 172 cm Weight: 81 kg I exercise regularly but have difficulty losing weight, especially abdominal fat. Family history: * Mother has diabetes. * Father has diabetes. * Paternal grandfather had diabetes. My menstrual cycles are regular. The blood tests were taken one day before my period started. I was fasting. I have no excess facial/body hair, no hair loss, no nipple discharge, and no severe acne. Symptoms: * Difficulty falling asleep. * Wake up 3–5 times at night to urinate. * Currently taking Furagin for frequent urination. Lab results: * TSH: 1.23 mIU/L * Testosterone: 1.91 nmol/L * Prolactin: 716 mIU/L * Cortisol: 291 nmol/L * Vitamin D: 15.7 ng/mL * Insulin: 20.1 μIU/mL * Fasting glucose: 5.1 mmol/L * HOMA-IR: 4.55 Could you please advise: 1. Do I have insulin resistance? 2. Would metformin be appropriate given my strong family history of diabetes? 3. Could prolactin and testosterone be elevated because the tests were done one day before menstruation? 4. Do I need treatment for prolactin or testosterone? 5. What vitamin D dose would you recommend? Thank you very much.

How long have you been experiencing difficulty falling asleep?:

- More than 6 months

How would you describe your energy levels throughout the day?:

- Low energy

Have you made any dietary changes recently?:

- Yes, but only minor changes

Have you experienced any other symptoms related to your menstrual cycle?:

- No, everything is normal

How often do you exercise and what type of exercise do you do?:

- Rarely or never

What is your current diet like?:

- High in fats

Have you discussed your symptoms and lab results with a healthcare provider before?:

- Yes, but no clear plan was given
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Doctors' responses

Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
5 hours ago
5

Hello dear See as per clinical history Following findings are there hyperglycemia Chances of diabetes ( genetic background) Weaknesses and confusion Insulin resistance Iam suggesting some tests for confirmation Please share the result with diabetologist or concerned physician only for better clarity Please donot stop it take any medication without consulting the concerned physician HbA1c Serum ferritin Serum insulin Rft Lft Serum rbs Ott Hopefully you recover soon Regards

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