Fatigue, or extreme tiredness, is a common symptom of diabetes. It can result from high blood sugar levels and other complications of the disease 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 affect a person’s quality of life.
This article looks at the links between diabetes and fatigue. It also provides advice on how to manage this potentially disruptive symptom.
Diabetes resources
Visit our dedicated hub for more research-backed information and in-depth resources on diabetes.
According to Practical Diabetes, there are
- changes in blood sugar levels
- other diabetes symptoms and complications
- medication side effects
- mental and emotional issues from diabetes
- having overweight
Some healthcare experts may refer to symptoms of fatigue occurring due to diabetes as diabetes fatigue syndrome.
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 use it 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.
Other diabetes symptoms
The American Diabetes Association notes that as well as fatigue, other symptoms of diabetes that can contribute to or exacerbate fatigue include:
- frequent urination
- excessive thirst
- extreme hunger despite eating
- unexplained weight loss
- blurred vision
- slow healing wounds
- numbness in the hands or feet
While not all of those symptoms directly account for feelings of fatigue, many 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 fatigue.
Diabetes UK indicates that some of the symptoms of diabetes may also disrupt a person’s sleep pattern. For example, a person with diabetes might wake 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.
Learn more about diabetes and sleep.
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.
According to the American Heart Association, possible complications
- kidney problems, including kidney failure
- frequent infections
- blindness
- heart disease
- nerve damage, also known as diabetic neuropathy
- higher risk of Alzheimer’s disease and dementia
Learn more about the complications of diabetes.
Adverse effects of diabetes medication
Certain medications that a person uses 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
- Corticosteroids: A person with diabetes may take corticosteroids to treat the inflammation, pain, and discomfort 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 levelsTrusted Source 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 usually 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.
Mental and emotional health
Living with diabetes can often impact a person’s mental and emotional health. Health experts use the term
Feelings of frustration and worry due to living with diabetes can adversely impact a person’s well-being and management behaviors, which can also affect HbA1c levels. This can then increase the risk of diabetes complications due to difficulty managing blood sugar levels.
Evidence notes that those living with diabetes distress may develop depressive or anxious symptoms.
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.
Having overweight
Having overweight or obesity is a
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.
Learn more about overweight and diabetes.
Lifestyle changes can help a person manage both diabetes and symptoms of fatigue.
Effective lifestyle adjustments may include:
- maintaining a moderate weight
- getting regular exercise
- eating a balanced, nutritious diet
- practicing good sleep hygiene with regular bedtimes
- managing and limiting stress
- seeking support from friends and family
- maintaining hydration
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
Learn more about living with and managing diabetes.
A person with diabetes may experience fatigue due to factors outside the condition.
Fatigue can develop for the following reasons:
- acute illness
- unrelated stress
- anemia
- arthritis or other chronic conditions that cause inflammation
- hormonal imbalances
- sleep apnea
Learn more about fatigue and how to treat it.
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, having overweight, certain medications, and other medical conditions.
While fatigue can interfere with a person’s daily life, controlling blood sugar levels and making lifestyle changes can improve energy levels and reduce tiredness and lethargy.
