Managing diabetes can be demanding, with so much to keep track of every day: blood glucose levels, food portion sizes and carbohydrate content, drug and insulin doses, physical activity. Perhaps in part because of this routine — or possibly just due to underlying factors related to diabetes — people with diabetes tend to experience fatigue at a higher rate than the general population. Now, a survey has put a number on this phenomenon: Eighty-five percent of people with diabetes experience fatigue daily that makes it difficult to perform regular activities.
The survey, as reported in an article at UPI.com, was conducted by Diabetica Research Solutions Inc. (DRSI), a company that makes a nutritional supplement aimed at people with diabetes. Since the company did not provide its methodology, the survey can be presumed to be nonscientific. Nevertheless, it can be safely assumed that fatigue is a widespread problem — but what should be done to remedy it? DRSI, not surprisingly, tacitly offers its own suggestion based on another number from its survey: Only 6% of people with diabetes say that they use energy drinks. Most energy drinks contain caffeine, which can of course boost energy levels — but then it often leads to a crash. DRSI offers a supplement without caffeine, but some people may find such a drink less effective than the well-worn allies of coffee, tea, and caffeinated soft drinks.
It is likely, though, that caffeine or energy drinks treat only the symptoms of fatigue, not its root causes. As David Spero notes in a blog post from last year here at DiabetesSelfManagement.com, fatigue may be a direct result of insulin resistance, leading to a lack of adequate fuel in cells throughout the body. But it may also result from inflammation, infection, stress, or poor sleep. In an “Expert Q&A” at CNN.com, the chief medical officer of the American Cancer Association notes that undetected obstructive sleep apnea may result in poor sleep quality, while other causes of fatigue may be muscle weakness, drug side effects, thyroid dysfunction, high blood calcium levels, or adrenal, kidney, or liver problems. With so many potential causes, how should a person with diabetes — or his doctor — begin to respond?
Do you, or did you once, experience fatigue regularly? If so, have you found any way to reduce it and boost your energy level? Have medical professionals been of any help? Do you think it is important to treat the root causes of fatigue, or would you be happy with a solution that simply gives you more energy, regardless of the mechanism by which it works? If your fatigue has not responded well to treatment, have you found a way to adapt to it? Leave a comment below!
If you’re having sleep problems, ask your doctor to schedule a sleep study! My doctor did just that, and while I don’t have OSA, I did have hypopnea, a constriction of the throat while sleeping, in my case during REM sleep. While it wasn’t severe, using a CPAP lets both me and my husband get more rest. It was worth it.
Posted by catgirl | Jul 20, 2011 at 12:25 pmI was diagnosed with sleep apnea about 6 months after being diagnosed with Diabetes Type II. I have a CPAP machine and used it for a while. I still had fatigue.
Posted by Stephanie | Jul 20, 2011 at 12:59 pmI have lost a total of 25 pounds over 2-3 years and have not used the CPAP in a year. The maintanence of my machine is costly.
I am fatigued all the time. I fall asleep at my desk each day about 2pm. It startles me since I don’t realize that I am doing it.
I wish there were another way to get help. I bought my CPAP machine since insurance wasn’t very helpful it was very expensive.
My A1C has come down from above 9 to a consistant low 6.
I wake in the night and am under so much stress. My doctor has prescribed Lexipro and now Cymbalta. Is there another solution?
I FIND I AM CONSTANTLY FATIGUED. YES, I KNOW I AM OVERWEIGHT AND NEED TO SHED THE POUNDS BUT AS MY DIABETES HAS PROGRESSED (I’M IN MY 10TH YEAR NOW)AND I AM NOW ON INSULIN, MY MOTIVATION IS ALMOST NIL. I HAVE NOTICED MORE RECENTLY THAT THIS PROBLEM HAS BECOME MORE PRONOUNCED.
ANY SUGGESTIONS?
Posted by PAMELA | Jul 20, 2011 at 1:03 pmI experience a lot of fatigue and I sometimes forget just how difficult diabetes can be and how much anxiety it can cause. The hardest thing is for me to get on a highway by myself because I’m afraid of having an insulin reaction without being able to take care of myself. Things can change so quickly.
Posted by Lisa Pratt | Jul 20, 2011 at 1:06 pmSee attached, especially the ending.
Posted by G W White | Jul 20, 2011 at 1:08 pmI also suffer daily from fatigue. I often however wake early (wee hours of the morning). Up for an hour or 2 and then back to bed to play catch up? Never seems to work.
Posted by Donna | Jul 20, 2011 at 1:15 pmI would rather see something that works at the root cause than to masque over the problem and cause, w/immediate albeit temporary relief.
I am usually sluggish all day long, and work in increments with chores etc.
i am a type one diabetic with low thyroid disease, i have known fatigue very well…i have turned to juicing green leafy vegetables in the morning, with some wheatgrass and wow, what a difference…i also have started eating lots of protein within two hours of waking up and i don’t experience afternoon ‘crashes’ very much anymore…i think a high carbohydrate diet with diabetes is a recipe for disaster, and that flies in the face of every dietitian i have ever consulted with…but now that i am actually eating a higher protein/fat, lower carbohydrate diet i have shaken off that really sleepy/extreme fatigue that i used to have every day…and i am exercising every day, high intensity intraval training one day, weight training the next and i really feel like i have been given a new body…my insulin requirements have gone down…i have lost extra weight i was carrying…diet is key, i have eliminated most grains and most dairy and i feel so much better for it…
i did all of this on my own research, my doctor is of really little value to me except for writing prescriptions for insulin and synthroid and checking my blood with lab work…i was to the point where i really couldn’t get out of bed in the mornings, and i felt like i was struck by lightning most of the time, i felt so exhausted it was unreal…i am now learning that 90 percent of what i was eating was not helping me, food is medicine, heal your body with it, it is quite amazing how well i feel now compared to just a few months ago…
Posted by Kat | Jul 20, 2011 at 1:36 pmI’ve been a type 1 diabetic for almost 32 years and have had fatigue for at least 20 years. I’ve had every test amaginable by many specialists and nothing has helped. I’m retired now and have just learned to live with it.
Posted by Gary Pieper | Jul 20, 2011 at 2:10 pmG. Pieper - Michigan
I had a chemical exposure at my work 6 1/2 yrs ago … the fiasco that ensued after that was extremely upsetting and stressful; lack of employer support, Workers’ Comp insurer who’s only goal was to be rid of me; was out of work for several weeks, returned 1/2-time, but felt like a pariah! Was treated with little respect and frankly, ‘that look’ of a cheater to the system …. when in fact I had over 200 days of accumulated sick leave when the exposure first occurred. Within a few months of that exposure, I experienced fatigue like I’d never known other than the mother of a newborn 25 yrs before! Eventually, my primary care and a specialist suggested I get a sleep study. I’d never had any sleep problems prior. I was dx’d with chronic obstructive sleep apnea … while I still, 6 yrs later, do experience fatigue, the CPAP machine has been WONDERFUL for me! If I try to sleep without it, I have a terrible time. Fast forward from 2004 to 2009 … had some new symptoms that I just sorta blew off to the extreme heat of that summer of 2009 … much thirst, thus many trips to the bathroom … up 1/2 the night; then I had a minor surgery on my hand that wasn’t healing well … that’s when the bells went off! I finally ‘came to’ and realized something was wrong … call to my primary care physician and a visit the next day confirmed diabetes mellitus 2. My initial BS was well into the 500’s; my full blood work up in the February prior was perfectly normal. There is suspicion that the chemical exposure may have lead also to the diabetes, since there is no family history. That really is moot now … I’ve retired, I look after myself, take my Metformin, try to eat sensibly, go to a water exercise class once a week and a zumba class another day of the week … not a pound do I shed, but I keep up with what I need to do. The weight is annoying to me … but it is what it is, it’s not for lack of trying.
Posted by SLA | Jul 20, 2011 at 2:29 pmHAVE ADULT DIABETES,ALSO SLEEP APNEA,ETC.HATED C PAP AND STOPPED USING. LOOSING SOME WEIGHT IN ATTEMPT TO LOOSE SLEEP APNEA.ALSO USE PILLOW TO SLEEP ON SIDE AS THAT SUPPOSEDLY REDUCES SLEEP APNEA, BUT DOES NOT ELIMINATE. FIRST CHOICE IS TO GET AT ROOT CAUSE OF FATIGUE.
Posted by BOB | Jul 20, 2011 at 3:45 pmMy dr. had me on glipizide-metformin combination pill. I started diabetes spiking so he took me off glipzide and now on metformin alone. I found my energy levels improved quite a bit. Also having protein helps energy. I have egg beaters in the morning and cottage cheese before bed. Both have high levels of protein and found my energy level has improved a lot. Also having a protein or nutrition bar for a snack helps to keep energy. I have type 2 diabetes and A1C levels are within the normal range. I go to the gym and have a trainer which also is a great help.
Posted by Richard | Jul 20, 2011 at 4:18 pmi have niticed that there is never any talk of autonomic neuropathy caused by diabetes..is that because people die of other causes without it being diagnosed???
Posted by marylittle | Jul 20, 2011 at 4:42 pmI was tested by my neurologist years ago and was told I had neuropathy in my feet, believe me you know you have it, my feet burned so bad felt like I had walked on hot coals. Now I get very bad pain in my feet plus I’m losing my balance. There’s no mistaking neuropathy, maybe people just over look their pain ? I dunno but most diabetics I talk to also suffer with neuropathy. Maybe it’s a subject people are afraid to talk about ? I just deal with mine day to day. God Bless Everyone with diabetes . Peace
Posted by Yasmin | Jul 20, 2011 at 5:11 pmI forgot to mention that I am a diabetic I have lived with it for 20 years now, I’m type 2 , however I do 5 insulin shots a day and I do get very fatigued at times, I have good days and low days , my low days I try to not have a lot going on that day. I get angry too about the disease, but I pray & meditate alot it helps. Plus watch my diet and everything. It does , it all gets old sometimes , but if I don’t do it , no one will do it for me so I hang in there . :-)
Posted by Yasmin | Jul 20, 2011 at 5:22 pmI find that more protein serves me better than the leafy greens. Often I will have an egg salad sandwich, a small can of v-8 juice and applesauce with cinnamin for lunch and then I can go the distance until dinner.
Posted by Susan Wagenlander | Jul 20, 2011 at 5:52 pmI do have sleep apena and I am doing well with the machine and head gear every night. The C-Pap machine seems to have done the trick and I’m not so often tired. I believe the combination of more protein and the C-Pap at night really helps me.
I have had diabetes for seven years. I have complained consistently that I have no energy at all. I actually live an existing life even though I am only 64 yes of age. I have had a Cpap machine since 1991 and will not lay down without it. I seriously can’t see a lot of difference during the daytime. I do know that I am somewhat better in the daytime than if I didn’t use it. I also have only one side of my thyroid. I am on Synthyroid (name brand) and seemed to notice a difference when I began taking that about 2 years ago. It’s been a long time since I have had a day when I felt like doing anything. I’m also depressed and taking Prozac which my doctor told me could also cause fatigued. I am overweight but have no ambiion to do anything about it. I read every article I can get my hands on and really enjoy Diabetes Self Management. I feel as if there is not any hope in the future for feeling any better. My A1C is at 7.2. Any suggestions?
Posted by Sharon | Jul 20, 2011 at 7:58 pmInteresting. I was wondering why I didn’t feel any better when I started an exercise program; I still felt like I had no energy even after 4-5 days per week for 10 weeks. The exercise improved my blood sugar levels though. Is anyone else frustrated that the diabetes affects EVERYTHING!
Posted by Carol | Jul 20, 2011 at 8:21 pmI would LOVE to find a solution to the fatigue, but getting to the source would be best.
I agree with those who commented that low carbohydrate and high protein and fat helps. The high carbohydrates act much like a choke on an engine - hard to get it running - bogs down. Its just the opposite for kids who eat too much sugar - they bounce off the walls! Diabetics need to take lower and frequent doses of carbohydrates.
Posted by Bryan | Jul 20, 2011 at 10:27 pmWhat the h— is autonomic neuropothy?
Posted by Steve | Jul 20, 2011 at 11:32 pmAmazing you’re running this article when I have just decided I need to talk to the dr about my extreme fatigue. Although the recent heat wave is contributing to it, the fatigue started long before that. For many months now (maybe even years) I periodically find myself waking from an afternoon sleep — and I wasn’t even aware I was taking a nap!
It’s always important to get at the root of any condition - if treating that doesn’t work, then we go for the other stuff.
I’m not thrilled about the dx of sleep apnea. I think it’s just an excuse to sell us stuff — I think there’s an underlying cause we’re not looking at.
Posted by Tommy P | Jul 20, 2011 at 11:47 pmI was diagnosed with type 1 almost three years ago, at the age of 36 (quite the surprise!). I don’t get enough sleep to begin with, which I’m sure contributes greatly to why I’m tired so often, but I find that the greater the fluctuation in my blood sugar, the more tired I am. When I am high for any extended period of time, I am much more tired, and when I go from high to low often I am also more tired. I know that the answer to this is to eat small meals often and eat foods with a low glycemic index. I am making a concerted effort to do this, but it is hard. When I do manage, I feel much better.
Posted by Chava | Jul 21, 2011 at 2:36 amI have type 2 and working out in a swiming pool every day helps my fatigue . I think I relaxe more in the water. I use a noodle do kicks and streach for half an hour and very seldom actually swim .I sleep better at nite also on the days I work out in the pool. If anyone needs motivation for getting in shape working out in the pool is a great way to start.
Posted by Maria Huff | Jul 21, 2011 at 6:37 amI have had type 2 for about 5-6 years now. I know I’m over weight and I want to lose about 40 lbs. I am always tired!!!! My extreme tiredness I blamed on being the sole caregiver for my husband for a couple of hard years. (he has Alzheimers and has been in a facility for about 5 months now.) I thought I would feel better as time went on but I don’t, I have a CPAP machine that I use but I don’t sleep well with it (I’m ready to stop using it and let nature take its course!) I wake up as tired as when I went to bed. I want to do do things but don’t seem to have the energy to do them. My blood sugars seem pretty stable now and my A1C is a little high but not much (7.0) It gets very frustrating!!! Not sure what to do next!
Posted by Laeta Smith | Jul 21, 2011 at 11:26 amThank you to everyone who has posted, it really helps to not feel so alone! I experience fatigue on a daily basis, and so far we have not found a solution for me. It gets exhausting pushing through every day tired! And I have found it is MUCH harder to deal with the psychological part of having this disease when one is constantly fatigued.
Tommy P, I have the same experience finding myself waking up from a nap that I didn’t know I was taking!
Thanks again everyone, I just celebrated(?) my first year of diagnosis and I am still learning how to best cope/deal/strategize/maneuver/live with this disease.
Posted by Shelly | Jul 21, 2011 at 5:22 pmI was dxd with sleep apnea before my thyroid malfunctioned and my diabetes kicked in–homerun right! Anyway, the cpap is great. There are other treatments for apnea, but they are more intrusive, complicated and expensive. Besides, they aren’t a sure thing. The cpap works in the majority of cases and doesn’t require surgery. There is definately a direct correlation to apnea and fatigue. But, apnea is more serious than that, it can cause death. Have a sleep study done. Find out how many times you are actually waking up at night because you aren’t breathing. The numbers will shock you. How long do you think your body will go through the abuse of non treated apnea before it just says “to hell with that, I am too tired!” Before dismissing the diagnosis or the cpap because it isn’t always comfortable, think of the alternative.
Posted by Jeanette S | Jul 21, 2011 at 6:01 pmI am type 2 Diabetic. I was very fatigued for about three months. When I went for my labs at my Kidney Doc, I found out that I was anemic, and had to have a couple of iron infusions. I was o.k. for awhile, but now, after getting labs at my Family Doc’s, I find that I’m anemic again. He has put me on iron pills and I’m to go back in a month to see if it helps. But somehow, I still have fatigue and need to nap for about two hours every day.
Posted by Audrey M. | Jul 21, 2011 at 6:57 pm‘ve noticed that a lot of diabetics also need to use a c-pap machine. I had a sleep study and was told I had sleep apnea. I didn’t get a c-pap, but instead I bought an adjustible bed that raises the head up. That has helped me so much. Plus I’ve lost weight and that seems to help, too.
Posted by Audrey M. | Jul 21, 2011 at 7:09 pmIs the reason that so many of us need to use a C-pap because we are overweight? Being diabetic in itself doesn’t actually have anything to do with it, does it? Just curious.
I have submitted to caffeine. It has seemed the most effective for me. I have stage three kidney failure, fibromyalgia, and chronic fatigue syndrome. I also use green tea capsules.
I do have crashes, but in all, the caffeine is the best. I would like to have a solution that actually corrects the problem. Until it shows up, I want my coffee.
Posted by Jeanne | Jul 22, 2011 at 12:40 amThis is interesting reading. And here I thought my fatigue was caused by just getting older. I’ve always been very active and now going on 65, I need a nap every day. I was diagnosed w/Diabetes II four years ago and manage it w/metformin and a low carb and no added sugar diet. I don’t exercise like I should, but I’m not overweight. I have terrible sleeping problems; there again, blamed it on my age, stress, etc. Don’t want to go to sleep apnea clinic; I know they’ll hook me up with CPAP. Don’t want to go there!!! Always felt diabetes is a manageable and not so bad disease compared to cancer, but maybe some stress is related to having to deal with this and don’t realize it.
Posted by Mary Beth | Jul 25, 2011 at 7:17 amHang in there everyone!!
There are some days I am just tired no matter what. It helps to get a get a good nights sleep, but sometimes leg cramp from a herniated disk keep me up and down. I also make sure that I eat a more protein breakfast to avoid that morning ‘power surge’ which tends to set you for the rest of the day. Taking your meds at the appropriate time also helps.
Posted by AMM | Jul 25, 2011 at 8:06 pmYes, I have type 2 diabetes, sleep apnea, neuropathy, restless leg etc. I have a hard time sleeping with the CPAP. I am always tired, taking naps during the day. Once in a while I have to pull over when driving because I can not keep my eyes open. So I pull into a parking lot and turn off my van and lock the doors and take a nap. then I wake up and go home. I am way over weight, and have no ambition to do anything about it. I have alot of problems trying to walk around the block for excersize. And I have my mother with lung cancer and bone cancer/diabetes etc. and my father has clep palete/sinus cancer inwich they had to remove his nose. surgery was 10hrs for a 76 yr old man. And now 5x a week for 6 weeks we go for radiation. Never mind, any of the other doctors he or my mother need to see. Neither one can drive anymore. sleep is like every 3-4 hrs at a time. A straight 8 hrs of sleep. What was that like again????
Posted by sherrie caskie | Jul 25, 2011 at 10:44 pmwow- This blog has been enlightening- I am a type 2 diagnosed in 2005 had 4cabg ten days later- and have been exhausted every since- the meds metformin just make me gain weight have now put on 50 count them pounds since then 10 pounds a year and i do moderate workouts- but it is a battle- and i do not feel likie i am winning any ideas?
Posted by marcy | Jul 26, 2011 at 1:56 amThat 85% figure seems awfully high, but obviously many people are dealing with fatigue. I encourage everyone to read my article from November 10 on this, which is linked in the 3rd paragraph of Quinn’s article.
In addition to eating better, I suggested anti-inflammatories, checking for signs of infection (especially gum infections,) reducing stress, doing breathing exercises and meditation, improving sleep, taking certain supplements, and evaluating for depression.
People usually don’t think of the inflammation and infection angles. I think the drugged out feeling people with diabetes get is often a sign of inflammation.
Posted by David Spero RN | Jul 29, 2011 at 1:08 pmHello! I’m 32 yrs old and have been a type 1 diabetic since age 10. I am tired all the time, and it’s actually a relief to read this and know I’m not crazy. :)
The positive as I see it is that I know no other way. I’m used to being tired.
What works for me is exercise and moving around, getting sun. The more I allow myself to rest or lay around during the day, the worse off I am.
I do, however, try to take 1-2 days each month to veg on the couch all day and “catch up.”
Posted by Traci Ratzloff | Aug 03, 2011 at 3:14 pmI forgot to mention above, there is an awesome app on the iPhone (and probably other smart phones?) called SLEEPCYCLE. You turn it on and lay it next to you when sleeping. It works as your alarm. If it senses you are about to drift into your “deep” sleep too close to the time your alarm is supposed to wake you, it will wake you. The theory it’s better to wake up early than to be interrupted from your “deep” sleep. It REALLY works good for me!
Posted by Traci Ratzloff | Aug 03, 2011 at 3:20 pmVery interesting as I was just reading August’s Diabetes Forecast magazine in which a reader asks if diabetes causes fatigue and Dr. Robert Gabray responds that both low and high blood sugars can cause fatigue so you should check your readings when tired but oral diabetic medications do not typically cause fatigue. I am Type 2, on metformin and also suffer from severe afternoon fatigue not related to high/low blood sugar. So I guess either none of us knows how to monitor our blood sugars or our doctor’s are not listening to us when we talk to them. Which do you think? I vote for the second choice.
Posted by cindy | Aug 03, 2011 at 8:46 pmI have had Type 1 diabetes for 48 years. I have been on an insulin pump for 10 years. I’ve been experiencing severe fatigue for about 4 years now and no doctor has been able to diagnose a cause. Last year, after a sleep study, I was diagnosed with obstructive sleep apnea and tried using a C-Pap machine but couldn’t tolerate it. I also have a severe chronic cough and have been run through all kinds of tests and even had a surgery called a TIF procedure which also didn’t help. If someone has any suggestions, I would be very grateful! Oh yes, I’m also bothered with diabetic neuropathy with extreme burning of the feet.
Posted by Patricia Thomas | Aug 04, 2011 at 4:20 pmI have found that large doses of b-12 added to chromium picolinate helps alot. Would love to have a great sleep at night, but hubby loves to fall asleep to tv.
Posted by Carol Tilton | Aug 07, 2011 at 12:38 pmI thought my fatigue would slowly vanish after my mom passed. It hasn’t. Have tried various supplements, works for a while, back to being tired. There are some really good suggestion here. I plan to try a few and return to some I previously used. Its also nice to know I am not alone.
Posted by Beverly Kelley | Aug 31, 2011 at 8:53 pm