Fatigue, or extreme tiredness, is a common symptom of diabetes. It can result from high blood sugar levels and other diabetes complications, or be due to medication side effects.

Fatigue and tiredness are not the same. When a person is tired, they usually feel better after resting. When a person has persistent fatigue, rest may not relieve feelings of exhaustion and lethargy.

Fatigue is a common symptom of type 1 and 2 diabetes and can profoundly impact a person’s quality of life.

In this article, we look at the links between diabetes and fatigue. We also provide advice on how to manage this potentially disruptive symptom.

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There are many reasons why diabetes can cause fatigue, including:

  • changes in blood sugar levels
  • other diabetes symptoms and complications
  • medication side effects
  • mental and emotional issues 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. Cells use insulin to absorb glucose from the blood and can then use this for energy.

In people with diabetes, the pancreas does not produce enough insulin, or the body does not use insulin effectively. This causes excess glucose in the blood.

Fatigue and weakness may 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 have frequent episodes and do not get enough warning that their blood sugar levels are dropping. A person can still feel fatigued even after treatment for low blood sugar.

Learn more about the effects of low blood sugar on the body here.

Other diabetes symptoms

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

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 can have severe mental and physical effects that may lead to the development of fatigue.

Some of the symptoms of diabetes may also disrupt a person’s sleep pattern. For example, a person with the condition can wake up several times every night to use the bathroom or get a drink. People with type 2 diabetes have a higher risk of developing a sleep disorder.

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

Diabetes complications

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

These complications typically develop when blood sugar levels remain too high for a long period.

Possible complications include:

Here, we explain the complications of diabetes.

Adverse effects of diabetes medication

Certain medications that a person can 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 may take corticosteroids to treat the inflammation, pain, and discomfort that develop due to other conditions and diseases. Corticosteroids can cause fatigue with long-term use if a person reduces the dose too quickly or if they affect blood sugar levels.
  • Statins: A doctor may prescribe statins to reduce levels of low-density lipoprotein, 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. Diuretics can cause fatigue through dehydration, and frequent urination can disrupt sleep.
  • Beta-blockers: Doctors recommend beta blockers for people with high blood pressure and anxiety. However, their slowing effect on a person’s heart rate can lead to chronic fatigue as an adverse effect.

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 2–3 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.

Many depression symptoms can cause fatigue, including:

  • diet changes that affect glucose levels
  • changes in sleeping patterns
  • waking too early or being unable to go back to sleep
  • loss of energy

Learn more about the link between diabetes and anxiety here.

Being overweight

The majority of people with type 2 diabetes are overweight or have obesity.

People with obesity may find it more difficult to engage in physical activity, experience sleep disruption, and eat an unbalanced diet. All of these factors can lead to tiredness and fatigue.

Lifestyle changes can help a person manage both diabetes and symptoms of fatigue.

Effective lifestyle adjustments may include:

To reduce fatigue, it is also essential for a person to properly manage their diabetes and any related conditions. Achieving this requires the following measures:

  • regularly monitoring blood sugar levels
  • following a diet that limits refined carbohydrates and simple sugars
  • taking all prescribed diabetes medications and following a doctor’s instructions closely
  • seeking appropriate treatment for any related conditions, such as cardiovascular disease, kidney disease, and depression

A person with diabetes may experience fatigue due to factors outside the condition.

Fatigue can develop for the following reasons:

A person with diabetes should see their doctor regularly to monitor and manage their diabetes.

They may also wish to consult a doctor specializing in treating new or worsening fatigue that interferes with daily life.

People should seek urgent medical attention for fatigue alongside other symptoms, such as fever, chills, or malaise, as these may indicate an infection.

People with diabetes commonly experience persistent fatigue.

Causes of fatigue can include high or low blood sugar levels, depression, being overweight, certain medications, and coinciding medical conditions.

While fatigue can interfere with a person’s daily life, controlling blood sugar levels and lifestyle changes can improve energy levels and reduce tiredness and lethargy.

It can be helpful for a person to connect with people who understand what they are going through. T2D Healthline is a free app that provides support through one-on-one conversations and live group discussions with others living with type 2 diabetes. A person can download the app for iPhone or Android here.

Read this article in Spanish.