@hrdlvn welcome back!
Re: gyno or fat… I think it’s fat and water. I’m basing this guess on your photo, the fact that you didn’t mention pain under your nipple, and your sky-high E2:Test ratio. If you had gyno, it would feel like a palpable lump under your nipple. I have a very small bit on my right side from a foolish DBOL cycle years ago. It feels like a small gummy bear under my right nipple.
Re: diabetes…what’s your fasted blood glucose and A1C? You know as we get fatter, our insulin sensitivity worsens. So, as our waist girth trends in the wrong direction, so do our glucose levels. So what I’m trying to say is if your fasting glucose is creeping up, your body is reacting normally, which means it will also react normally as you shed the fat. For reference, every 1 percent my body fat goes up, my fasting glucose goes up 1 point and the reverse when it goes down.
So, if I were you, I’d start every day with a liter of water, a cup of black coffee, and a 2-3 miles walk. And of course, I’d clean diet up. That fasted, LISS cardio is one of the easiest lifestyle changes to put in place, with huge returns in fat loss. Lots of bang for your buck, if you can stick to a clean diet the remainder of each day. I’ll assume you know what a clean diet looks like. I’ve used that strategy in the past to go from 225 to 160. Trust me, give it time. it works. I’m back up to 215 now, but it’s intentional. At present, I’m not too concerned with body fat, just trying to see exactly how strong I can get before I get too far into my 40s. I’d also start an AI until I was leaner. I’d frontload it with a one-time dose of .5mg anastrozole and then take .25mg QOD. This will go a long way to improving your E2:Test ratio, and ensure your efforts walking and dieting aren’t wasted due to high E2. If you get low E2 sides (unlikely) you can always drop the AI. I’d Keep the Test dose at TRT levels. Any bump up over top of range will thwart your efforts to get your SHBG back up.
I’ve traveled the road you’re on. In my life I’ve gone from 155 up to 225, down to 160, back up to 215. During the cutting times, I’ve found nothing more effective than the fasted coffee walking and clean diet combo. And diet is so simple (not easy, simple). If it grew from the earth or ever had a face, eat it. If man processed it in any way, at all, don’t touch it.
Best wishes to you and good luck!