What Causes Diabetes Fatigue?

Fatigue is one of the commonest and most disabling diabetes symptoms. Exhaustion can disrupt and interfere with all aspects of daily living.

What causes diabetes fatigue, and why is it so common?


We’ve written about fatigue before here and here and received tons of great comments on those posts. But this time let’s go deeper and find the whole range of causes and solutions, even if it takes a few weeks. Hopefully, everyone will find something that might help them, because this is a serious problem.

For example, Melanie wrote, “[Fatigue] really takes a toll on my family and things we can do. I just want to have the energy to play with my son and to do things around the house or with friends…I can’t drive more than 30 minutes because my husband is afraid I will fall asleep…and wreck [the car]. (I have dozed while driving before.)”

Maria commented, “Fatigue is a constant and I have had to learn to do only what I can. I don’t push myself anymore as I pay for it dearly. I get tired of explaining why I don’t feel good, don’t want to do anything. Some understand and some don’t.” And Jan wrote, “I sleep from midnight to noon each day. Then I get depressed because I wasted half a day.”

Because of my multiple sclerosis (MS,) I live with fatigue sometimes, and I know how limiting it is. I know how difficult it can be to manage. There are more than 15 known causes for fatigue. It helps to figure out what is causing yours, so you can address it. Here are some possibilities.

First, diabetes can directly cause fatigue with high or low blood sugar levels.

• High blood glucose makes your blood “sludgy,” slowing circulation so cells can’t get the oxygen and nutrients they need. Margaret commented, “I can tell if my sugars are high in the morning, because ‘groggy’ doesn’t begin to describe it. ‘Drugged’ is how it feels.”

• Low sugars levels also cause fatigue, because when blood sugar is low, there is not enough fuel for the cells to work well.

• In addition, high blood glucose can cause fatigue through inflammation. Blood vessels get inflamed by the sugar. When this happens, according to new research, immune cells called monocytes come into the brain, causing fatigue.

But your fatigue may not be caused by diabetes at all. Other medical conditions causing fatigue include:

Anemia, or low red blood cell counts. It’s easy to be tested for anemia. If you’ve got it, it’s usually due to deficiency of iron, folic acid, or vitamin B-12, or to heavy menstrual bleeding in women (which results in iron deficiency).

• Low thyroid (“hypothyroidism”) — people with diabetes are more likely than others to have thyroid problems. If your thyroid level is low, you are likely to feel tired, sleepy, and depressed.

• Low testosterone levels, especially in men. Men with diabetes are much more likely to have low testosterone.

• Infections: People with diabetes often have infections they don’t know about. Infections take energy to fight, which can cause fatigue and raise blood sugar levels. A common source is urinary tract or “bladder” infections. They often hurt, but sometimes have no symptoms, except for the fatigue. Silent dental infections and vaginal infections are also common and fatiguing.

• Undiagnosed heart disease: If you get tired after tasks that you used to sail through, it could be time to for a heart check-up.

• Conditions like chronic fatigue and fibromyalgia. These are much more common in women, but men get them too. Fatigue is the main symptom. Many other diseases cause fatigue — you can see the government’s list here.

Medication side effects: Many drugs for diabetes, blood pressure, depression, pain, and other issues can cause fatigue. Read labels, ask your doctor or pharmacist.

Then there are causes that aren’t entirely medical:

• Lack of sleep or poor sleep — Some people are too wound up or too busy to sleep. Or they’re up to use the bathroom all night, or they have obstructive sleep apnea (OSA), which can wake them up many times an hour. If that is happening to you, you are likely to be fatigued during the day.

Shift work — rotating shifts or working nights — can cause fatigue directly by messing with your body clock or indirectly by disrupting sleep.

• Depression is very common with diabetes. Most depressed people feel fatigued, even if they don’t feel sad. Even at low levels, depression can sap your motivation. Why get up? You can take a free test to see if you are depressed here.

• Doing too much: If you’re ripping and running all day, not taking breaks or even stopping to breathe much, you are courting fatigue. Patti wrote, “I think that forcing myself to do everything is just causing the fatigue to worsen.” She’s probably right.

• Stress: In small doses, psychological or physical stress can give you energy, but if it goes on too long, it will wear you out.

• Diet: Too much carbohydrate — especially refined carbs — can make anyone tired, especially with diabetes. Kat wrote, “now that I am eating a higher protein/fat, lower-carbohydrate diet, I have shaken off that really sleepy/extreme fatigue that I used to have every day.”

• According to WebMD, too much caffeine can cause fatigue through a rebound effect. They also say that dehydration, or not drinking enough liquid, is a major cause of fatigue.

• Being out of shape or having weak muscles: Not moving our bodies contributes to fatigue. Of course, it’s hard to exercise when you’re fatigued. We’ll discuss that next week.

• Aging: It is normal to have less energy as we age, but this slowing down should not be dramatic. If loss of energy is rapid or severe, there is something else going on.

This list is getting ridiculously long, and it’s not complete. If you’re dealing with fatigue, perhaps start by evaluating yourself for these possibilities. In the coming weeks, we’ll get into solutions professionals and our readers have found.

  • Guido

    When my BG is high for a period of time my motivation to physical activity drops, when this drops I get more fatigue and my BGs are getting even higher……end so on. I found out magnesium depletion was one of the reasons in my case. I decided to find more info about magnesium and wrote this in my article at http://WWW.challengediabetes.org.

    Kind regards

  • sh

    I find organizing my personal errands (groceries, library, banking) at least several during the work week immediately after work helps keep me focused on the weekends. Then I’m not exhausted trying to accomplish all the external tasks but inside my home also.

    Spread out those domestic chores too! Killing yourself to have laundry caught up, home cleaned is way too much stress! At least for me! I take one day of the weekend and set aside at least 4 hours for me! Soak in the bathtub, read and simply relax and recharge my batteries

  • Marilyn Hodge

    I just discovered I have diabetes by one doctor and yet another told me I was border line. So I have to watch what I eat. I know nothing about diabetes. How many carbs can you have a meal ? And I know suger testing should not be over 100 mine is always 99 to 143 So can you tell me am I a diabetic or not ? I have been as high as 187
    Thanking you in advance for an answer.

  • Robert

    I was tired all the time, falling asleep at my desk and behind the wheel. My doctor told me I wasn’t sleeping at night and wasn’t aware of it. He prescribed sleeping pills. Problem solved.

  • Joe

    I have severe anemia (low iron, low RBC, undersized red cells, misshapen red cells) but my doctors can’t find a cause. They were sure it was due to bleeding in my gut, but endoscopy and colonoscopy revealed none. It responds to megadoses of iron, but returns if the iron suplementation stops. Any other ideas what could cause this level of anemia in a 50 year old male?

  • David Spero RN


    You need more information than I can give. I know almost nothing about anemia, except that it’s probably not diabetes-related.


    It doesn’t really matter whether you officially “have diabetes” or not. You’re moving in that direction, and you need to learn more about it. People have written about prediabetes many times on this site — http://www.diabetesselfmanagement.com/articles/diabetes-definitions/prediabetes/2/ And a search for “prediabetes” on the Web will get you all the info you can handle. It would be great to make a list of all your questions and ask your doctor or a diabetes educator.


  • PAT

    Altough I’ve been diabetic for 12 years i just starting taking a meds that causes lows…thanks for explaining this to me also for the highs too.

  • Kathleen

    i have been fatigued all my life. I have done many different things for it. After learning that I have diabetes about 10 years ago and reading up on it I realized that I have had blood sugar issues almost all my life. I was glad to read about the 1.5 type of diabetes asit helps to know that there may be other blood sugar problems.
    I have been diagosed with post tramatic stress syndrome and I know that I have to take very good care of myself. Eating right (which is always hard to know as it changes) sleeping enough being kind to myself for not being a human doing instead of a human being and walking. Thank you very much for all of your writing. I do not have a support group in my area and this is so helpful for me.

  • Tom S

    I’m 74 and have a few health problems including diabetes.

    I had surgery on my right leg that went bad so I was really slowed down and housebound. After I should have been able to be more active I didn’t have the energy.

    I was diagnosed as being anemic, so my Dr. prescribed a high dose of iron. After several weeks of taking so much iron I started checking for rust I still didn’t have any oomph.

    My Dr. then checked my Vitamin D and discovered it was way down in the basement. After several weeks of a very high dose of D3 I’m back to my normal perky self.

    Talk to your doctor, don’t experiment, you may not have the same problem I had.

  • riva greenberg

    I think one cause that’s obvious, and yet you seem to have left off the list, is just being tired of dealing with a chronic illness every day. It takes relentless attention, decision-making and mental and emotional energy.

  • calgarydiabetic

    Diabetes is a serious disruption of our basic energy system not surprising it causes fatigue

  • Kaye

    My diabetes was diagnosed 15 years ago. My fatigue started 10 years ago with depression. I started taking an antidepressant which made me sleep ALL the time. I was also diagnosed as anemic, so started taking mega iron pills. Then I found out that I had sleep apnea. I got a CPAP and that problem was solved. Now I find out that my thyroid is low so have been taking pills for that for 6 weeks now and guess what?? My energy is returning little by little. Who would have thought! My fatigue was caused by a mixture of all those things and the pills prescribed for them. I am constantly working on keeping my sugar level low, but that is a lifetime battle. My advice is just don’t give up and say it’s the diabetes that’s making you tired. You must be your own research assistant and find out the real root of your fatigue.

  • Yvonne

    I am a type 2 diabetic. Yesterday I forgot to eat lunch. By 4 I was going into diabetic shock. Paramedics got my blood sugar back up . I ate. Felt better. I feel more fatigued than I did yesterday. Why? My levels are back to my normal. Why do I feel so week?

  • ej

    What you are describing seems similar to what my mother was/is going through. Hemoglobin levels were low. Iron helped only temporarily. She began to see a hemotologist/oncologist who first prescribed procrit (shots.) My mother had/has her blood checked weekly; if her hemoglobin fell below 10, her doctor gave her a procrit shot. The number 10 as the cutoff was decided upon because 1. Medicare won’t cover the procrit if levels are above 10 and 2. there are significant side effects associated with procrit.
    That said, after months on the procrit, and many transfusions, her doctor sent her to her (meaning, her doctor’s) mentor who diagnosed my mother with mylofibrosis. She is now taking Revlimid (oral chemotherapy) in cycles of three weeks on and one week off. We’re hopeful.
    Note: for her condition Revlimid is considered off-label. Initially her insurance refused to cover the $7,000 monthly cost but after letters from her doctors and much perseverance, her insurance agreed to cover the cost.
    Also, a friend mentioned to me that the FDA recently approved a drug associated with mylofibrosis One MDs name mentioned in the article was Mascharenas (I may be off on the spelling)– you might want to do a web search and pass the information to your doctor(s.)

    Best of luck,

  • Katie Hooks

    This website has help me to understand what is going on with my body.I am diabetic of 12 years,and I am suffering from fatigue.The info was very helpful.Those are alot of things in this article I found out that i am not alone in this. I will keep checking for new info

    thank you

    katie hooks

    from vandergrift pa

  • jim snell

    Katie Hooks:

    Amen to your comments. I couldn’t agree more.

    Best wishes and good luck working your diabetes.

  • Glenn

    I have a weight-loss endocrinologist and a GP. Which doctor is best to review the fatigue issue?
    Type 2 diabetic, experiencing fatigue and depression.

  • David Spero RN


    Self-management approaches are probably the most important. But between the docs, I would choose the GP. Others might disagree.

  • ronald

    I have had very low testosterone levels for the past month and manage my diabetes through oral medications. Previously even with diabetes I had high testosterone levels. How can I raise my testosterone level so that I am interested in my girlfriend?

  • Rod Roddy

    Having my testosterone checked helped me in the exhaustion department. Low T was a major contributor to my exhaustion. Hormone Replacement Therapy is helping. I’m sure it’s not the answer for everyone but it may help some.

  • james lujack

    I have depression,diabetes(somewhat controlled with medication),and end up taking medication that causes tiredness.I am 61 years old which probably means I have plunging testosterone and am overweight. No wondewr why I steel away to the bedroom and sleep. I do not have top hear wife saying’you in bed again?’ Thanks for the article explaining these thingas to me.At least I know I am not crazier than I think I am…..

  • leopold steiner

    What I find exhausting is taking a bolus of rapidly acting insulin to treat hyperglycemia. I quickly become so tired I can hardly move, and I often fall straight to sleep, even if I wasn’t tired prior to the bolus. Interestingly, this never happened when I was using the older, animal-source insulins, so no doubt this effect has to do with the unnaturalness of the new insulin types. The idiots who designed them decided to omit everything which did not directly have to do with reducing blood sugar levels, so the entire biochemical complex of the insulin molecule, designed by a million years of evolution, was trashed for its few ‘required features.’ This no doubt unbalanced the wisdom of nature’s subtlety, so now we patients suffer.

  • Al

    I have hi blood sugar and feel fatigued. Would Atos contribute to my fatigue

  • Rob Baldwin

    This is a concern for me about my mother, she is 63 diagnosed with diabetes (not on insulin shots) with medication, she is overweight, depressed (though she does not see a psychiatrist her primary care doctor gives her anti depressants) she has a self mutilation habit (she has sores on her legs that last year required hospitalization and they are back to almost the same again). She works 20 hours a week, and is awake beyond that for maybe another 25 hours a week, she sleeps constantly, either in her lounge chair in front of the t.v. or in her bed. She complains about her hips and back hurting as to why she can not do much as far as movement. I am concerned, what is causing this much fatigue, her mother died at the age of 68 due to diabetes, and I am worried she may not even make 68. I have to assume its a combination of her habits, including diabetes, her infections in her legs, her lack of movement, and her poor diet (she eats all the time just little amounts but she has to have something to eat all the time) she has lost 8 pounds since the beginning of the year, but i think that has more to do with her sleeping more and more than an actual diet.

    Thanks for advice,

  • David Spero RN

    Hi Rob,

    You are right that your mother is in a bad situation. It sounds like her diabetes may be out of control, plus she’s depressed. IF she wants to continue living (a big if), it would help to see a psychotherapist (not a psychiatrist.) She needs more support and more reasons to live.

    Is she self-monitoring her blood glucose levels at all? Does she at least get a regular A1C test? Can’t be sure, but I’m really not confident in her PCP’s ability to handle either her diabetes or depression. She might need different meds or fewer meds.

    She can turn this around with self-management, but it will take some effort. See any of our articles on reversing Type 2 diabetes, or on depression, for ideas.

  • Krista

    I am 42 and newly diagnosed lada. I just started Victoza lowest dose and am having extreme fatigue. I can hardly keep my eyes open and feel like I have to get back in bed to rest or sleep. I checked my bg today and it was 83. So not low or high, just perfect. I do not understand the fatigue. Could it be the victoza? I am so new to this and trying to figure all this out. Thanks for any ideas.

  • David Spero RN

    Hi Krista,

    It’s almost certain the Victoza is causing your fatigue, since you weren’t having it before you started the med. Fatigue is one of the main listed side effects. It might wear off with time, or it might not. It’s good about your blood glucose, though. Ask you doctor what to do. He needs to know.

  • Chris Edmonds

    I found i was type 1 diabetic 1 week before i left to work abroad, so i haven’t had a lot of diabetic education, on a trip back home my diabetic diet advisor suggested less or no meat, fish and mainly vegetables, this was to lose weight. since this time i find that after my evening meal all i want to do is sleep. your article on diabetes and fatigue has really helped, has i am working in a third world country with no diabetic advise on hand, thanks for your article.

  • Kim

    I have a friend that has type 2 dietetes and is ever fatigue and his levels are up and down his is not sleeping very well and very upset all the time I just need to know what to do to help him with this he works outside as a pipe fitter and is in heat alday can’t eat that good at work because of the work hours. I think he needs to change his diet but he want eat much at work and then wen his at home off work for a day or two he still won’t eat because he said he’s not working and all the food does is make his levels go up and then his not felling good so what do I do to help him with this.

  • Jason

    I find I suffer constantly with fatigue. It truly is a vicious cycle – I don’t sleep well at night due to stress from work and depression. I wake up feeling “drugged” as someone else has said – even if my blood’s not high (I have rather good control right now). I constantly yawn at my desk at work which embarreses me, which causes more stress which causes me to loose sleep etc… I keep having to go to the toilet – again, even when my bloods are perfect – which causes me stress and embarresment at work (who wants to pee every 30minutes?!). People don’t realise how much of a burden Diabetes can be to people living with it. I mean, I am constantly tired. I constantly want to sleep. My girlfriend gets annoyed at me for it, and even THAT stresses me out. And as we all know, stress can cause high bloods which makes me even more tired and then more stress etc… Horrible, horrible illness. And, on top of all this, I am now being investigated for suspected Psychosis. Life is failing me right now.

    I’ve been diabetic all my life (diagnosed in 1990 at 9months) so it’s all I’ve known. Perhaps I’ve just been used to how it makes me feel, but it’s only in recent months that I’ve been told people are worried about me and that the constant degree of lethargy and fatigue isn’t normal. I can barely focus at work, and I can barely do my job.

    Does anyone else have this? I mean, I’ve been Diabetic for almost 23 years now… I can’t be alone, right?

  • David Spero RN

    Hi Jason,

    I’m sorry that you are going through a hard time. It will get better.

    If your control is good, this can’t all be diabetes’ fault. Not sleeping could cause the fatigue, the depression, and a lot of other things. Please get help. Investigate why you are urinating so often. Get some therapy and/or join a support group.

  • debbie scott

    My 59 yr old husband is 135lbs and 6ft tall. He has diabetes contolled with oral meds…half of ea pill 2X a day as he eats so little and whole pills caused his sugar to plumet. He has a low sex drive andhas always slept long periods of time….before and after diabetes diagnosis. Now hw sleeps almost round the clock and is eating even less saying nothing sounds good. What is going on? Thinking early trip to dr best idea here.

  • David Spero RN

    HI Debbie,

    Yes, get him checked out ASAP. I doubt Type 2 diabetes by itself could account for such severe fatigue and loss of appetite. I also doubt that he is Type 2. Quite possibly, he needs insulin. At least get thyroid, blood count, and testosterone checked.

  • Vimi Gisby

    I have type 2 diabetes but just lately I have been feeling very tired. I normally am up around 06.30 hrs and go for a 45 minute walk, but in the last 10 days its a great effort to do the walk and have missed a few. How can I get back to a normal active life without feeling tired?

  • Ingrid McAdoo

    I was diagnosed with type 2 diabetes in 2011. I am still trying to deal with it. It was the harsh fatigue that led me to know that something was wrong-I was driving and had to pull over. The feeling is so intense I have to lay down at times. There are fatigue related problems such as delay in daily activities and others. I am 50 years of age and take an oral Med for diabetes,
    I take a 30 minute walk in the mornings and upon return I’m tired-not that exertion type, but fatigue-my eyes get heavy and I have to lay down. I have the endomorhic build and am obese-trying to loose weight. I need advise on what to eat before I go walking/exercise, afterwards. Someone once suggested yogurt. However,I became fatigued and nauseated walking. I would appreciate your expertise.

  • Tamera Scheer

    Ingrid, try protein. Protein and high fibre diets are a must for diabetes. I suffer from fatique all the time….but protein gives me energy, makes me full and levels my blood sure. BEfore you go for a walk have some eggs or cottage cheese, a few nuts and an orange. When you come back, you’ll feel like a million bucks. Oh and drink lots of water!

    Everyone on this page needs to up their protein intake balance it with high fibre and green vegies. YOu’ll feel the difference right away.

    All the best.

  • Susan

    I was diagnosed with type 2 in September this year my medication is Glucophage SR 500mg once daily. I am bad tempered and have flare ups of temper and am constantly tired I could sleep all day and then feel guilty that I have wasted my day when there are things I should be doing. I am going in to hospital on January 14th 2014 to have surgery on my cervical spine for a prolapsed disc I am worried how I will cope when I come home with this lethargy.

  • David Spero RN


    I hope you can use some of the ideas in the article and the follow-up pieces to get your energy back. Getting your glucose levels down might be a good place to start.

  • Timm

    I have to eat at certain times to take my medication. However after I eat I find myself at my job nodding and very sluggish even after drinking coffee! I’ve tried going to bed earlier but it doens’t have anything to do with a lack of sleep but it is always after I eat something. Does this have anything to do with the insulin spike that comes after a meal? I eat healthy and light and do train with weights.

  • gwen

    every time I begin to eat healthy I get so tired. I am following my diabetic diet when trying to eat healthy but I always feel like someone sapped all the energy out of me. my dietitian set up my eating plan for me. if I can make it a full month then I feel better but that makes it really hard to eat right

  • Dana McCutchen

    I was diagnosed with type 2 diabetes in Feb. 2014. My numbers are all over the place stilll. I was extremely tired yesterday, but I thought it was my Fibromyalgia. After lying down for about an hour, I woke up feeling shaky. I checked my blood sugar and it had dropped to 60. I drank half a cup of root beer to get the sugar in me. I felt much better. Is it the sugar or the carbs that I need? My Rhematoid Arthritis makes me tired too, which makes it hard to discern what the problem is.

  • Bunnieb

    I think i am beyond help.I was diagnosed with type2 in 2007 after being diabetic for at least 2years before.I am a 57 year old woman and fatigue is the understatement of the year.I sleep 10 hours a day,and spend about 7 hours more in bed reading.I am definately overweight and have suffered from severe depression since 1996. I have mild sleeping tablet and also 30mg or more in tranquilizers a day.Here is why. My husband had Cancer in 1993,my beloved Mum and Dad died after long illnesses around the same time and my husband has been physically and mentally disabled since.Worse,3 years ago he became paranoid and until a psycotic breakdown a year ago swore and mentally abused me daily.Since his breakdown he now has early Alzheimers and i literally have to do everything.i am on a very low dose of tablets daily as my glucose crashes again and again.My worst problem started about 2 weeks ago, getting my glucose levels up and keeping them there is now a daily nightmare.Coca Cola always worked in the past but now it is like i have not drank it. As soon as my levels are good again, 15 minutes of work and another glucose crash.My husband does not have the capability to understand. I am stressed out all the time i am awake. Should i be on insulin. This thought terrifies me as i get so confused.Above is my future which can only get worse. HELP PLEASE.THANKYOU.

  • David Spero RN

    Hi Bunnie,

    Things are really hard for you. It would be great to get some help with your husband, up to and including finding a place for him to be cared for.

    About your sugar crashes, what does your doctor say? This is a fairly unusual symptom of diabetes, and I think your medicines might need to be changed.

    Please get some help and let us know how it goes.

  • Pam

    I started feeling very lethargic, not sleepy, over 3 years ago, about the same time as I had a thyroid cyst (which went away by itself). I got lazy about meals, started eating lots of chocolate. 6 months later I was diagnosed as Type 2 diabetic, diet controlled. Now although my blood sugar is good and thyroid levels ok, I am still very lethargic and am just about managing my life. My Doctors have no answers.
    Any suggestions?

  • carolina

    hey, this might be a really unexpected comment, but i have an assignment for university (i´m studying medicine) which is about the mechanisms of fatigue in diabetes. i´m having difficulty finding information about this topic but your article has helped guide me a bit. i was wondering if you could let me know where i could find good and especially reliable information on this topic. thank you so much.

  • Kerri Potvin

    I am type 2 diabetic, low thyroid, anemic, depressed. All are treated with medication. I want to start working out, but am so tired and weak, I simply can’t motivate myself to get out of my chair. Should I not feel better with the medications?

  • tahira shaheen

    all information is very useful and informtive

  • tahira shaheen

    i am diabetic and i feel very much tiredness and feels lethargy by your information i change my diet habbits for the improvement of condition.

  • Timothy J. Martinez

    60 year old male I have had diabetes for approximately 15 to 20 years now I take metformin twice a day, R-Regular & N-Novolin Insulin 3 times per day. I take other medications for complications due to my diabetes such as heart medication, enlarged heart, high blood pressure, tachycardia,tendinitis especially my shoulders, diabetic neuropathy, pretty acute lots of pain, arthritis, degenerative disc disease L-5 problem area, Sleep apnea now on CPAP at night to restore breathing & sleep patterns, pain medication such as Gabapentin, a few others to manage acute pain. I also struggle with panic attacks and acute anxiety. Regularly I feel so tired simple tasks cause me to sweat and feel tired after 5 to 10 minutes of light work, often I sweat profusely, I just had my yearly with labs at the VA Dom or Veteran’s Domiciliary, Veteran’s Health clinic in my home town and all checked out fine. However, at 60 years my dad was a cattle foreman riding horse, working hard he did not have health issues though, my Mother had many of my illnesses and seemed to get more done than I do. I’m 5’9 260 pounds so I know when I was 180 pounds I felt better, losing weight is really hard for me. I have decided to do my tasks until I tire rest a few minutes and try again, often though I feel walking uphill or fishing on my boat too much for me! Any advice is MUCH appreciated! Thanks, Tim

  • David Spero RN

    Hi Tim,

    You have a lot of issues here and I can’t sort them out. Perhaps your doctor can help. Getting your glucose down might help — you could try vinegar or bitter melon for that and/or a low-carb diet.

    In managing your fatigue, you should rest BEFORE you tire. You know when you’re going to get tired, if you pay attention. So rest before that, then start again. You will find you can get much more done with less fatigue.

    Also, taking so many medicines could contribute to fatigue. Next time you see your doctor, ask if any of these meds could be making you tired, and see if any changes can be made.

  • Tammy Garcia

    I am a 51 year ol woman who was diagnosed with type 2 diabetes in 2008. I have lost 47 pounds since then. My AC1 are always about 5.9 and my blood sugars range between 76 and 140. I have multiple problems that might be causing my fatigue including my thyroid, and Neuropathy. I have had the Neuropathy since 2001. I went to the Mayo Clinic and for 3 days they poked, prodded, and stuck me with various instruments, only to come out with the diagnosis as Idiopathic Neuropathy. I am a teacher so I keep pretty busy. I would not say I am too stressed because I am not in a hurry, depressed, anxious, or frazzled. I do have terrible fatigue though. The doctor put me on Amphetimine salts to keep me awake but then i don’t sleep well at night because of the pain so I take pain killers. They cross each other out so I am in a stuck elevator. Not moving up nor down. I read a lot of information about Diabetes and how to keep my sugars down. I will say this, with all the problems I have you would think I was depressed but I am not. I love life and enjoy doing things with my family. Some days are fine but others are bad don’t want to get off the couch because I am so tired. it has even caused me to forget things that happen in the day. Can you Help? Am I missing something?

  • David Spero RN

    Hi Tammy,

    If your heart and lungs are OK and your sugars as well controlled as they seem to be, and the Mayo Clinic has checked you out, you might want to ask your doctor about Provigil (modafanil) or Nuvigil (armodafanil). Or maybe more physical movement might help — like yoga, walking, tai chi, or water exercise.

    David Spero RN

  • sherry

    Hi I am a 63 year old female and have had type 1 diabetes for 30 years. I have the fatigue issues but does anyone feel sl nauseaed in the morning especially if my bs is elevated. My last HA1C was 6.4. thanks just curious

  • Surly Trek

    Hi, I am a 5 ft ‘4’ 13 year old female, and have started feeling very fatigued, and cannot eat. I thought the reason I was tired was lack of sleep because I noticed symptoms when I wasn’t getting enough sleep at night, but later found out even when I do get at least 8 hours of sleep I still feel fatigued i the morning.As for the eating part of my problem I have not felt hungry in a few months and it never effected my eating, I just ate when it was lunch or dinner. Just last month my symptoms got worse and haven’t been able to consume a normal portion in about a month, and it keeps getting worse with time.I can’t even look at food, it makes me sick.I am trying to eat, but I feel to tired and weak to eat, and am almost to weak and tired to get out of bed. I am already a little smaller than I am supposed to be, but just last week I was 93 pounds and today I am 91. Thanks I hope you can help!

    • Concerned mom

      This is really not normal at your age. You need to see your doctor!! You seem underweight, and are beginning to experience anxiety which is coming out in being “afraid” of food. Please know you are not alone and that anxiety/depression and fatigue are all linked and easily helped with the proper diagnosis by a real doctor (maybe take an antidepressant??) Good look!

  • Cheryl A.

    Wow!…I am 54, diagnosed type 2 since 4 years ago will be 5 December 7 2009. I had a hysterectomy where they found I had diabetes was a 8 A1c, I left the hospital at 183. I lost 50 down to the lowest of 146, came back up to 150 and stayed there for 2.5 years. Was sent to a dietitian is why I lost and only in 1.5 months. my BS were always under 100, some were 71, but most 80’s. on resting. Then two hours later no more than 130’s. Long story short. quit a job, got stressed, now my sugars are anywhere from 136-403…I was off when I lost, all my blood pressure meds, and the metformin…now I feel all screwed up having been put through a lot of pill changes. I ended up back on High BP med after 5 kinds, which I still swell a lot, had a echo test done to see why, it was normal..I am on double dose of Metformin of 2000mg a day. I too am GREATLY fatigued, I drive a school bus, this is not a good thing to be so tired most the time. I am waiting to have my thyroid blood work done with extended depth of the TH’s a thoro look at it. I too am having a real tough time walking for 30 minutes let a lone 1 hour like I use to. I also have sleep problems, I don’t go to bed when I should, I have to push myself away from the computer FB world has me. But I am on a CPAP as well, and also get insomnia. I did try and do use a recipe to sleep from my dietitian it is hot milk, honey, cinnamon and ginger. It works. Like 6 oz milk, with 1/2 tsp honey, 1/4 tsp of cinnamon, 1 cube of ginger from Wal-Mart in the freezer section, by the fruit they have most stores in by the frozen fruit. But use 1 cube, heat and drink as hot as you can stand not to burn. I do get depressed not as much as I once did when younger with raising my children..but my diet is not as I once did at the best time I was at so I know what I need to do, walk at least 1 hour and good nutrition, I just need motivation. Bless everyone here, yes it is a draining disease, but one we can beat as long as we follow the right menu to succeed. Best to all here who suffer. :)Oh too, my A1c last time was a 9…that is pretty awful when my lowest was 4.9 during my 2.5 years maintaining..:(

  • Alice

    I’ve suffered from insomnia and fatigue which has led to stress for the past couple of months. I read this article which was really helpful to me, thought I’d share: http://www.vivamagonline.com/sleepless-in-canada/

  • eileen parker

    I am type 2 diabetic, insulin and med controlled, or not as it happens, am on steroids for inflametory arthritis, low thyroid, high BP, have had a total colon removal and have a stoma, my bloods are wild, need help here pleases xx

  • Sunny Sebastian

    All the information’s in your site is worth enough. Now I have a new vision about my diabetic and how to deal with that life.

    Thank you.

  • Pat Secrest

    I am a 67 year old female & have had type 1 for over 50 years. My blood sugar control has not been very good. I have had diabetic retinopathy (treated successfully) & circulation problems in my legs (now being treated with meds since the specialist does not feel that I need surgery). My heart seems to be O.K. & I have not had a heart attack or stroke. I know I am lucky & am grateful. My brother, who also had Type 1, died of a heart attack at age 28. I recently decided to try again for better control in order to have a better quality of life. My docs. insist I try for very tight blood sugar control. I have tried this before & have found that it results in more hypoglycemic episodes as well as depression & anger & this is happening now. I understand carb counting & adjusting insulin dosage but have found it does not work as well as they say. It is a frustrating process which I am prepared to deal with but I hate it that it is always my fault if everything does not go perfectly & hypoglycemic episodes do not improve my life. I would find it easier to work with doctors if they would acknowledge that this is not easy, that it is not my fault if it does not work perfectly & that hypoglycemic episodes are dangerous. Besides the obvious dangers of operating a vehicle or of hurting yourself in some other way while hypoglycemic, I recently learned that the Juvenile Diabetes Research Foundation has found that 1 in 20 Type 1 diabetics die of low blood sugar. I guess the trade off is that tight control means fewer diabetic complications & that it might be more jolly to die in your sleep from hypoglycemia than to die of a heart attack. I would find it easier to stay on track if docs. would treat me with respect & acknowledge that blood sugar control is hard. Maybe they don’t know how hard it is or perhaps they think that shaming me will motivate me to do better. It doesn’t.

  • Rick


    I get scared to read diabetic accounts online. I respect everyone, of course, I just find that hearing about everyone’s complications brings me down. If you’re like me, those horror stories don’t have to be you.

    I’m 34 years old, have been T1 for 22 years. I’m healthy and fit. But over the past 10 years I’ve been fighting fatigue, along with its associated brain fog. I recently discovered that my vegetarian diet may have been partly responsible, and I’ve since begun to take a closer look at my nutrition. I’m taking a few supplements and multivitamins now (mainly Omega 3’s) that appear to have turned the trick. It turns out my body was starving for some vitamins, almost because my vegetarian, low-fat, diabetic diet was TOO healthy- can’t say that didn’t surprise me. I’m not “as good as new” yet, but the brain fog is clearing up and the fatigue is more controllable than ever. I’ve also added salmon to my diet, along with daily antioxidants (blueberries, kiwi, red-skinned grapes) and I feel a lot more awake and in tune with the world. So it turns out that malady wasn’t entirely diabetes-related for me.

    I do still get some fatigue tied to low and high blood sugars, though. I discovered this by going ape on my glucometer for a few weeks to get a full 24 hour picture of my sugars, at which point I realized that a lot of my fatigue was indeed blood sugar related- it just so happened to occur at a time of day when I had never really tested before (immediately after meals, for example). Specifically, I realized that my fatigue after eating was often due to an incredibly LOW blood sugar (I’m talking 1.6 – 2.5 mmol/L, or 30-45), and that my insulin was working faster than my body was processing the food- effectively knocking me out, which I had always assumed was a harmless “power nap” due to my stomach digesting the meal. It turns out these “naps” (usually lasting 10-15 mins) were very dangerous and in some ways I’m lucky to be alive today to write about them. Needless to say, it scared the crap out of me when I first realized it. I’d never seen readings that low on my meter before, and then thought about all the times when I might have cheated death in the past. Who knows, I’m lucky one of these power naps didn’t leave me “dead in bed.” Yikes. My body was simply metabolizing the insulin a lot faster than anyone had ever warned me, although my endo maintains I’m the exception to the rule. Either way, it’s almost come to the point where I need to eat BEFORE I take my insulin depending on my glucose level… it’s absolutely nuts. If there’s anything to take from this, it’s that YOUR body may be a little different than what your doctors, handlers tell you to expect, and that optimizing your control may require a set of tweaks that are unique to you.

    So in summary, I strongly advise you to check your blood sugar every time you’re feeling tired. It may be that simple. If you’re like me, you may need some juice and it’ll wake you right up lol- it’s kinda comical. Ever since I discovered this, I adjusted my fast-acting insulin dosage accordingly and now keep some sweets nearby in case I need them. I always thought low blood sugars were obvious, but have since learned that your symptoms are a lot different when your stomach is full. And in general, I’ve found that keeping my sugars between 5.0-12.0 mmol/L (90 – 200) keeps my mind clear and focused on a consistent basis. Outside of that range is a gamble, not just physically but “cerebrally” also.

    As an aside, I’ve found that regular exercise is the only way to beat this sucker and live a normal life. You don’t have to go all-out all the time, but you should keep your body active. 30 minutes every day doing something- anything! – is so important for us. You can do it, I promise, you’ll feel better for it and your system will be stronger. Anything you can do is 1000000 times better than nothing. That’s simply the boat that we’re in and we all need to keep rowing.

  • Kay

    Hi, I am 63 years old, had a hip replacement in July 2014. In the last few months i have notice when i do something strenuous i have to keep sitting down, my legs go weak and my heart races, i feel faint. This is so not like me. I have had blood tests for anemia and diabetes, have to wait for results. Have trouble focusing and overheat quickly. Its weird . I eat cereal for breakfast, have a yoghurt,protein, berry drink for lunch and a small main meal. Thats it plus i am gaining weight????????Any thoughts, oh i don,t est much red meat. Have taken a real dislike for the taste of it

    • dscottv

      Try eating low carb and walk 30 minutes per day.

  • Imoigele Longe

    I am 42 and male.I live in Lagos, Nigeria. I have been dealing with infrequent fatigue for over 2 years. I was diagnosed of diabetes just this week and I was placed on medication to manage it. All of a sudden I experience frequent fatigue often dropping off to sleep while at my desk trying to get some work done.

    I retire to bed on the average about 10.30 pm and I am up at 4 am to help my wife with getting the children ready for school daily. We are all out of the house at 5.30 am heading to school and work. I often have to battle to keep awake while driving and when I get to work and sit at my desk I just dose off. This happens intermittently while at work. In fact once this happens I feel totally useless and cannot get very much done.

    I resorted to drinking coffee but it only helps for a short period. When I drink more than 2 cups of coffee a day I become breathless and on the edge. Hence, I have decided to drink a cup of coffee only when necessary.

    When I found out about diabetes I realised why I had been battling with fatigue. I am willing to overcome and live healthy. I know that it is not a death sentence as diabetes runs in my family. For example my father is 81 this year and he has been dealing with the disease. I have begun to read more information about it and I am now aware of how to manage it effectively.