Fatigue is a common symptom of diabetes and can result from high blood sugar levels and other symptoms and complications of the condition. Some lifestyle changes can help a person manage diabetes fatigue.
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.
According to the American Diabetes Association, research shows that 61 percent of people with newly diagnosed type 2 diabetes report fatigue as a symptom. The same study found that fatigue is the second most common symptom in this group.
In this article, we look at the links between diabetes and fatigue. We also provide advice on how to manage this potentially disruptive symptom.
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.
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
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.
Mental and emotional health
Living with diabetes can often impact a person's mental and emotional health.
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
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.
Lifestyle changes can help a person manage both diabetes and symptoms of fatigue.
Effective lifestyle adjustments may include:
- maintaining a healthful weight or losing weight if necessary
- getting regularly exercise
- eating a healthful diet
- practicing good sleep hygiene with regular bedtimes, 7 to 9 hours sleep, and unwinding before bed
- managing and limiting stress
- seeking support from friends and family
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
Some types of medication may cause fatigue as a side effect.
A person with diabetes might have fatigue due to factors outside of the condition.
Fatigue might develop for the following reasons:
- acute illness
- unrelated stress
- arthritis or other chronic conditions that cause inflammation
- hormonal imbalances
- sleep apnea
When to see a doctor
A person with diabetes should see their doctor regularly to monitor and manage their diabetes.
They may also wish to consult a doctor who specializes in treating new or worsening fatigue that interferes with daily life.
People should seek medical attention for fatigue that occurs alongside other symptoms, such as fever, chills, or malaise, as these could 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 putting in place lifestyle changes can improve energy levels and reduce tiredness and lethargy.
How can I tell the difference between tiredness and fatigue?
Fatigue is usually more intense than being tired and is described as unrelenting exhaustion that rest does not relieve.
This chronic feeling may also mean being weary, and it often develops over time. Fatigue, in addition to low energy, can cause additional symptoms such as headache, dizziness, achy muscles, and even irritability.
Conversely, tiredness usually improves after rest.Deborah Weatherspoon, PhD, RN, CRNA Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.