Can diabetes make you tired all the time

Why does diabetes cause fatigue?

Share on PinterestFatigue is a common symptom of diabetes.

Fatigue is a common symptom of diabetes. There are many reasons why diabetes can cause fatigue, including:

  • changes in blood sugar levels
  • other diabetes symptoms
  • complications of diabetes
  • mental and emotional issues resulting from diabetes
  • being overweight

Changes in blood sugar levels

Diabetes affects the way the body regulates and uses blood sugar.

When a person eats, the body breaks down food into simple sugars, or glucose. In people with diabetes, the pancreas does not produce enough insulin, or the body does not use insulin effectively. Cells need insulin to absorb glucose from the blood.

If the cells do not take in enough glucose, it can build up in the blood. The cells need glucose to provide energy.

Fatigue and weakness might result when the cells do not get enough glucose. Diabetes medications, such as insulin or metformin, help more of this sugar to move into the cells and prevent it from building to harmful levels in the blood.

A potential side effect of diabetes medications is low blood sugar, or hypoglycemia.

Low blood sugar can also cause fatigue, especially in people who do not get enough warning that their blood sugars levels are dropping. A person can also feel fatigued after treatment of low blood sugar.

Other diabetes symptoms

Other symptoms of diabetes can also contribute to a person experiencing fatigue, including:

  • frequent urination
  • excessive thirst
  • extreme hunger despite eating
  • unexplained weight loss
  • blurred vision

While not all of those symptoms account for feelings of fatigue directly, many of them may contribute to an overall feeling of being unwell. These persistent and uncomfortable sensations may have severe mental and physical effects that can lead to the development of fatigue.

Some of the symptoms of diabetes might also disrupt a person’s sleep pattern. For example, a person with the condition may find themselves waking up several times every night to use the bathroom or get a drink.

Similarly, discomfort in the limbs, hands, and feet may make it difficult for a person with diabetes to fall asleep and stay asleep.

This disruption to a person’s sleep cycle can lead to them feeling increasing fatigue.

Diabetes complications

Share on PinterestManaging diabetes can help prevent complications, such as heart disease.

People with diabetes might develop complications that contribute to feelings of fatigue.

These complications typically develop in a person who has the condition when their blood sugar levels remain too high.

Possible complications include:

  • kidney problems, including kidney failure
  • frequent infections
  • heart disease
  • nerve damage, also known as diabetic neuropathy

Here, we explain the complications of diabetes.

Adverse effects of diabetes medication

Certain medications that a person might use to treat the complications of diabetes and other health problems may also cause adverse effects that contribute to fatigue.

Medications that can lead to fatigue include the following:

Corticosteroids: A person with diabetes might need to take corticosteroids, such as prednisone, to treat the inflammation, pain, and discomfort that develop due to other conditions and diseases.

  • Statins: A doctor might prescribe statins to reduce levels of low-density lipoprotein (LDL), or “bad” cholesterol, in the blood.
  • Diuretics: People mainly use diuretics to treat high blood pressure. These lead people to pass more urine than they normally would.
  • Diabetes sometimes increases urinary frequency, so this side effect can be particularly potent for people who have the condition.
  • Beta blockers: Doctors recommend beta blockers for people who have high blood pressure and anxiety. However, their slowing effect on a person’s heart rate might lead to chronic fatigue as an adverse effect.

Alongside the diabetes symptoms that contribute to fatigue, beta blockers can have particularly potent side effects in people who have diabetes.

Learn more about the relationship between steroids and diabetes here.

Mental and emotional health

Living with diabetes can often impact a person’s mental and emotional health.

According to a 2016 study of 90,686 participants, people with diabetes may be around two to three times more likely to experience depression than people who do not have the condition.

The same study found that anxiety was more prevalent in people who were aware they had diabetes due to their health concerns.

Both depression and anxiety can also cause increased feelings of fatigue due to sleep disruption.

Depression can also adversely affect blood sugar control, which may increase the risk of fatigue.

In fact, many of the symptoms of depression relate directly to fatigue, including:

  • changes in sleeping patterns
  • waking too early or being unable to go back to sleep
  • loss of energy

Learn more about the effect diabetes can have on relationships.

Being overweight

Many people with diabetes, especially those with type 2 diabetes, are overweight or obese. Excess body weight might also contribute to fatigue.

Reasons for the association between being overweight and fatigue may include:

  • Lifestyle choices that may lead to weight gains, such as lack of exercise or a diet that contains too much processed or junk food.
  • The increased energy a person uses up when moving the extra body weight.
  • Sleep disruption from some complications of being overweight, such as sleep apnea.

Why Is My Diabetes Making Me So Tired?

Treating both diabetes and fatigue is most successful when regarded as whole, rather than separate, conditions. Healthy lifestyle habits, social support, and mental health therapies can positively impact diabetes and fatigue at the same time. Read one woman’s tips for coping with CFS.

Lifestyle changes

Healthy lifestyle habits are at the heart of good health. These include regular exercise, nutrition, and weight control. All these can help boost energy while also controlling your blood sugar. According to a 2012 study, there was a strong correlation to a high body mass index (BMI) score and fatigue in women with type 2 diabetes.

Regular exercise may decrease the risk for developing type 2 diabetes in the first place. But the American Diabetes Association (ADA) says that exercise can help blood glucose even if you already have diabetes. The ADA recommends a minimum of 2.5 hours of exercise per week without taking more than two days off in a row. You can try a combination of aerobics and resistance training, as well as balance and flexibility routines, such as yoga. Check out more on how diet and exercise can help you if you have diabetes.

Social support

Social support is another area of research being investigated. A 2013 study of 1,657 adults with type 2 diabetes found significant correlations between social support and diabetes fatigue. Researchers found that support from family and other resources decreased fatigue related to diabetes.

Talk with your family to make sure they’re supportive of your diabetes management and care. Make it a point to go out with friends when you can, and engage in your favorite hobbies when you have the energy to do so.

Mental health

Depression runs high in diabetes. According to the journal Current Diabetes Reports, people with diabetes are twice as likely to have depression. This can be caused by biological changes, or by long-term psychological changes.

If you’re already being treated for depression, your antidepressant might be disrupting your sleep at night. You can talk to your doctor about possibly switching medications to see if your sleep improves.

Exercise can also help depression by increasing serotonin levels. You may also benefit from group or one-on-one counseling with a therapist.

8 Ways to Beat Fatigue

If you’re napping more often, constantly dragging, and feel like a productive life is passing you by, take these steps to reduce physical and mental fatigue and improve the quality of your life. Written by Susan McQuillan, MS, RDN, CDN

Feeling tired all the time? It might be time to take some steps to increase your energy level.

Fatigue is a common complaint from people with diabetes, especially those with type 2 diabetes. Sure, some of it has to do with your disease, but making better lifestyle choices could greatly improve the way you feel. By routinely monitoring your blood sugar, eating well, getting enough of the right type of exercise, taking steps to reduce stress and maintain good mental health, staying hydrated, controlling inflammation in your body, and getting enough sleep, you can boost your energy levels much closer to normal.

#1. Manage Your Blood Sugar

High blood glucose levels interfere with circulation, and prevent your body from moving glucose out of your blood and into energy-making cells, resulting in fatigue. Low blood glucose levels also cause fatigue because you simply don’t have enough fuel for cells to use to make energy. Monitor your blood levels and always eat balanced meals that contain vegetables or fruit, whole grains and protein, to avoid extreme highs and lows.

#2. Cut Out Refined Carbs

Nothing sends your blood sugar skyrocketing like a piece of cake, a pastry or a candy bar. Avoid processed foods and junk foods that are pure sugar or mostly sugar. Instead, satisfy your sweet tooth with natural sources of sugar, like apples, oranges and other fresh fruit, which also contain vitamins, minerals and fiber. Choose whole-grain muffins and other baked goods that are also high in fiber. The fiber in whole foods helps slow down digestion and absorption of sugar into your bloodstream.

#3. Drink Water

Dehydration is a major cause of fatigue, even for those who don’t have diabetes. Every cell in your body is made up of water that constantly needs to be replenished. Make sure you drink enough fluids, especially water, throughout the day. The best way to tell is to check your urine: if you’re getting enough fluids, it will be clear or very pale yellow. Avoid sweetened beverages that not only wreak havoc with your blood sugar but add excess calories to your diet. Watery foods, like unsweetened yogurt, soups, and fresh fruit also contribute fluids to your diet.

#4. Build Up Your Muscles

Exercise strengthens your muscles, boosts your energy levels, improves sleep, and makes further exercise easier. At the same time, lack of exercise weakens muscles, making it even harder to exercise and, eventually, harder to move at all. In addition to moderate aerobic exercise, such as swimming, bicycling or low-impact aerobics, the American Diabetes Association recommends strength training such as weight lifting, resistance bands, or calisthenics (such as push ups, pull ups, and sit ups) twice a week. It also helps to increase everyday activities like walking, gardening, climbing stairs, and taking the dog out.

#5. Slow Down

Fatigue will arise if you are always on the move and don’t take enough time to relax. And given that those with diabetes may be more prone to fatigue, it won’t help your health to overdo it at work or at home or to try to keep up with everyone else. Find ways to disconnect: turn off your phone or computer; practice mindfulness which, in short, means staying focused in the present moment rather than worrying about the past or hurrying toward the future; find a relaxing hobby; and simply do less throughout the day.

#6. Preserve Your Mental Health

Chronic psychological stress and depression not only cause mental fatigue but can contribute to insomnia and other problems that simply wear you out. Both exercise and relaxation therapies such as meditation, yoga, and deep breathing can help. If your stress level is consistently high, or you feel relentless anxiety or sadness, speak with your health care provider; you may benefit from cognitive behavioral therapy or need some form of medical treatment to get these feelings under control.

#7. Fight Inflammation

High blood sugar is linked to inflammation in blood vessels, which in turn has been linked to diabetes-related fatigue. Although the connection is still unclear, researchers have found a link between diet, gut bacteria, inflammation and the development of type 2 diabetes. A low-fat, high-fiber diet rich in prebiotics and probiotics (“good bacteria” that help keep the intestinal tract balanced and healthy) may reduce inflammation and help prevent or lessen symptoms of diabetes, including fatigue. Speak with a registered dietitian or diabetes educator to see if an anti-inflammatory diet could work for you.

#8. Get Some Sleep

Aim for 7 to 8 hours of sleep every night. Make sure your bed is comfortable, your bedroom is dark, and the temperature is on the cool side. Maintain a routine of going to bed and getting up at the same time every day, and avoid stimulating activities just before bedtime. If you still have trouble getting enough sleep, or if you feel tired and weak when you get up in the morning, regardless of how long you sleep, speak to your health care provider to try to get to the root of the problem and find a solution.

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Continue Reading 4 Breathing Exercises for Better Sleep

5th September 2005
Recent research suggests that extreme sleepiness could be a sign of depression or a diabetic, even if a person does not sleep well.
Out of a random sample of 16,500 men and women aged 20 to 100 years old Americans, 8.7 percent experienced extreme day time sleepiness.
Researchers have discovered that extreme daytime sleepiness is highy connected with depression and obesity rather than with sleep-disordered breathing or sleep disruption.
Depression was the key factor for extreme daytime sleepiness because the metabolism slows down.
Those who are being treated for depression are three times as likely to experience extreme sleepiness than others.
There is a strong correlation between extreme daytime sleepiness and diabetes. Individuals with diabetes are two times more likely to report extreme daytime sleepiness than those who are not.
Overweight people are also more likely to experience extreme daytime sleepiness.
Extreme daytime sleepiness is more common in people less than 30 and those aged 75+, suggesting greater medical illness and health problems.

Daytime Snoozing May Tell Risk of Hypoglycemia

This article is a collaboration between MedPage Today and:

Older patients with diabetes who are overly tired during the day may be at a higher risk for hypoglycemia, researchers reported.

In a subgroup analysis from a large observational study, patients who had higher scores on two different scales of daytime sleepiness were significantly more likely to have suffered from severe hypoglycemia (P=0.016 and P=0.024, respectively), Rebecca Reynolds, PhD, of Queen’s Medical Research Institute in Edinburgh in Scotland, and colleagues reported online in Diabetes Care.

“In this large cohort of elderly people with type 2 diabetes, those with increased daytime sleepiness, as measured by two different scoring systems, were more likely to have experienced severe hypoglycemia,” they wrote.

Sleep-disordered breathing and the daytime tiredness that comes with it are common in type 2 diabetes. To determine whether feeling tired during the day had any link to hypoglycemia severity, the researchers looked at 898 patients with type 2 diabetes from the Edinburgh Type 2 Diabetes Study.

These patients, who had a mean age of 67.9 years, completed two questionnaires on sleep-disordered breathing and daytime sleepiness — the Epworth Sleepiness Scale and the Berlin Questionnaire — and they were also asked about severe hypoglycemia.

Overall, the investigators found that patients who scored highly on the Epworth Sleepiness Scale were significantly more likely to have suffered from severe hypoglycemia than those with low scores (15.6% versus 9%, P=0.016).

A positive score in the “sleepiness” category of the Berlin Questionnaire was also associated with a history of previous severe hypoglycemia compared with a negative score (13% versus 8%, P=0.024), they reported.

The overall Berlin score, however, wasn’t related to severe hypoglycemia — and in regression analyses controlling for several factors including age, sex, duration of diabetes, HbA1c, body mass index, and treatment type, the Berlin sleepiness category was no longer significant.

Epworth Sleepiness Scale score, on the other hand, was still a significant predictor of severe hypoglycemia in those analyses.

“Sleepiness as a symptom, rather than sleep-disordered breathing per se, may be a risk factor for hypoglycemia,” Reynolds and colleagues wrote. ” is a non-specific symptom caused by a range of underlying causes and should be differentiated from sleep-disordered breathing and sleep deficiency.”

The study was limited by its cross-sectional design, and the findings need to be replicated by collecting prospective data on hypoglycemia and other important confounding factors, the researchers wrote.

But if “further evidence of sleepiness contributing to risk of severe hypoglycemia were available,” they concluded, “sleepiness would be another factor to consider in the clinical assessment of hypoglycemia risk.”


The study was supported by the Medical Research Council and the Chief Scientist Office of Scotland, the Wellcome Trust, and Pfizer.

The researchers reported no relevant conflicts of interest.

Primary Source

Diabetes Care

Source Reference: Inkster B, et al “Association between excessive daytime sleepiness and severe hypoglycemia in people with type 2 diabetes” Diabetes Care 2013; DOI: 10.2337/dc13-0863.


The 4 Signs You May Be Diabetic

In case you missed my Sheknows column:

When you hear the word “diabetes” you may think insulin injections, foot problems, and other symptoms that could never happen to you. Unfortunately, many Americans are diabetic or pre-diabetic and may not even know it! Studies show that up to 27% of diabetes cases go undiagnosed. Diabetes is diagnosed when your blood sugar values are elevated above specific parameters. Pre-diabetes, however, can be diagnosed in patients who have only mildly elevated blood sugars, and is becoming increasingly more common. Pre-diabetes is associated with an increased risk of developing diabetes over time. Here are four common symptoms of diabetes and how your doctor can help:

Increased thirst: If you’ve been feeling more thirsty than usual, or constantly trying to keep up with drinking fluids, your blood sugar may be out of control. If your body is having difficulty processing sugar, which happens often in diabetics, the sugar breaks down to glucose in the blood stream and draws water out of the body. Additionally, your kidneys are working overtime to keep up with the increased glucose load. This leads to feelings of increased thirst, and persistently feeling thirsty even after you have had something to drink.

Fatigue After meals: There’s no doubt, we’ve all passed out after a big meal or Thanksgiving turkey and mashed potatoes! But if you are regularly feeling sleepy after meals or find yourself dozing off at your desk after lunch, this could be an indication that your blood sugar is uncontrolled and you may be diabetic. After eating, our pancreas, an organ responsible for generating hormones, pumps out insulin to help regulate the load of glucose that is created from our meal. If you are diabetic, the body is not able to efficiently complete this process, so your blood sugar rises and then may suddenly fall, causes excessive sleepiness, fatigue, and even falling asleep unintentionally.

Hair Loss: If you’re suffering from hair loss, and see multiple strands or clumps of hair in the shower or on your bathroom floor, this could be a sign of insulin resistance. Hair loss is a classic symptom noted by many diabetics. Some studies suggest this is due to the decrease in circulation and blood flow to certain areas with hair follicles, making it harder for the hair to grow.

Numbness or Tingling in the Feet: Diabetes affects multiple systems in the body, from the heart, kidneys, and even nervous system. Nerves are often adversely affected in patients with diabetes, leading to numbness and tingling sensations. These nerve symptoms are most often felt in the feet or toes, but can present as shooting pains, or loss of sensation in the feet, calves, or shins.

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