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Diabetes and Fatigue:
Reasons You May Be Feeling Tired

Photo of manFeeling exhausted? if you have diabetes, your weariness may be related to your chronic condition. learn more about some common issues that may cause your restless nights.

You stayed up late to catch your favorite tv show—then set an early alarm to shuttle the kids to swimming practice. Or you tossed and turned as the neighbor’s dog howled. Some days, your sleepiness requires no medical explanation.

But many people with diabetes feel run-down in a way that can’t be cured by a grande cappuccino. One study found 40 percent of people with type 1 diabetes have chronic—or lasting—fatigue, compared with 7 percent of healthy people. And about 60 percent of people newly diagnosed with type 2 diabetes report low energy levels. People with diabetes consider exhaustion a bigger burden than any other symptom. And being overtired can interfere with your daily life and impair your ability to take care of your diabetes, increasing your risk for complications.

Two recent studies in the journals Diabetes Educator and Diabetes Care reveal the most common reasons people with diabetes feel tired. Most, contrary to common medical beliefs, have little to do with blood glucose levels. The good news? You can take steps to address them and regain your energy. Here’s how.

Fatigue Factor 1: Depression

People with diabetes are twice as likely to struggle with depression than people without it. And fatigue or low energy is one of the hallmark signs of this mood disorder.

Doctors aren’t sure why diabetes and depression often go hand in hand. The stress of managing your condition may wear you down and make you feel isolated from family and friends. Frustration over inconsistent blood glucose readings or tension with your doctor can also trigger bouts of sadness.

Recharge: Depression is a serious medical illness that usually requires treatment. Watch for other warning signs, including loss of pleasure, hopelessness, changes in sleep habits or appetite, and feeling sad in the morning. If you spot them, talk with your doctor or a mental health professional. Treatment with medication, counseling, or both can lift your mood.

Fatigue Factor 2: Lack of Exercise

Sure, moving more requires expending some energy. But people who make physical activity a regular part of their lives end up with more energy in the long run. Exercise relieves stress, improves sleep, and strengthens your heart. Plus, it helps your diabetes treatment work better by increasing your cells’ sensitivity to insulin.

Recharge: Make a small, specific goal to increase your activity level. For instance, say, “I will walk four times a week for 15 minutes.” Write it down in a place where you’ll see it frequently. And find a way to exercise when your energy level is typically at its highest. For example, if you’re too tired after work, plan a walk break during lunch or first thing in the morning.

Fatigue Factor 3: Diabetes Symptoms

Over time, diabetes can affect nearly every part of your body. High blood glucose may damage your nerves, eyes, heart, or kidneys. The more of these complications you experience, the more likely you are to feel fatigued. In some cases, a physical link contributes to the exhaustion. For instance, kidney disease often goes hand in hand with anemia. In this condition, your blood doesn’t carry enough oxygen, leaving you low on energy. Other times, the psychological stress of dealing with complications and their treatment zaps your resources.

Recharge: Work closely with your health care team on a self-care plan. Set targets for your blood glucose, blood pressure, and cholesterol— and strategies to reach and maintain them. See your doctor at least twice a year. Together, review your plan and discuss what’s working and what requires adjustment.

Fatigue Factor 4: Extra Weight

Obesity and fatigue can lead to a downward spiral. Extra pounds and exhaustion impair your ability to exercise—which further drains your energy and boosts the number on the scale. Drowsiness can also drain you of the energy you need to prepare fresh, healthy meals. Instead, you may turn to fast food and other convenient options that do further damage to your waistline.

Recharge: Talk with your doctor about whether you need to shed pounds or avoid gaining weight. Exercising more and consuming fewer calories can help you push down the needle on the scale. Start by trimming just 100 to 200 calories a day—try drinking water instead of soda or eating fruit instead of a candy bar. This will help you lose 1 to 2 pounds per month.

Fatigue Factor 5: Trouble Sleeping

Our 24/7 lives often lead us to skimp on snooze time. Many people with diabetes can’t fall asleep or have trouble staying asleep, regardless of when they go to bed. Pain—or medications to treat it—often keeps them awake. Hormones, stimulants like caffeine, and exercising or eating too close to bedtime may also play a role.

Recharge: Studies suggest a good night’s sleep not only helps you feel rested—it also helps control your blood glucose. Help yourself drift off by sticking to the same sleep schedule, even on weekends. Avoid coffee or other sources of caffeine in the late afternoon or evening; its effects can last eight hours. Keep your bedroom cool, quiet, and dark. And see your doctor if your insomnia lasts more than a few days or is accompanied by loud snoring or pauses in breathing at night. You may have sleep apnea, a serious condition that requires treatment.

A Final Word on Fatigue

Dwelling too much on your fatigue can continue the cycle of weariness. Plan to take action against these common causes. Having hope that your energy levels can increase and taking small everyday steps to boost them can go a long way in restoring your vitality. As a result, you’ll be able to stay in good health—and enjoy your life.

By Cindy Kuzma, a feature writer for Vitality. For resources on managing the physical and emotional challenges of diabetes, visit the National Diabetes Education Program at www.ndep.nih.gov and search for “manage diabetes.”

COULD DIABETES EXPLAIN MY EXHAUSTION?

Fatigue is one of the main symptoms of diabetes. If you’re frequently tired and don’t have a diabetes diagnosis, watch for these additional warning signs. If you spot them, ask your doctor about having a blood glucose test for diabetes. Other symptoms include:

  • Blurred vision
  • Severe hunger that doesn’t go away after you eat
  • Increased thirst and urination
  • Slow-healing wounds or sores
  • Weight loss
  • Tingling, pain, or numbness in your hands and feet

Signs often develop quickly in people with type 1 diabetes and more slowly in those with type 2.

Some people with diabetes have no symptoms beyond fatigue—and some have no symptoms at all. Talk with your doctor about screening if you have other risk factors for diabetes, such as a family history, obesity, or a case of gestational diabetes in the past.