hi thanks for posting in HCM I have understand your concern probabilities of your symptoms are 1.metformin induced because it is known to cause those symptoms 2.non ulcer dyspepsia 3.IBS in IBS other symptoms also should be there like abdominal pain and altered bowel habits, so in your case it is least probably. I feel it is mostly because of metformin although metformin is a very good drug to reduce insulin resistance and I can suggest you to stop it and continue with insulin. hope this helps you any further questions please let me know thanks