Does diabetes cause tiredness?

Fatigue (low energy) is feeling constant physical or mental exhaustion that sleep cannot relieve. Fatigue and persistent tiredness are common symptoms of diabetes, both type 1 and type 2. It is not just the result of blood sugar levels and can continue even when your blood sugar is being managed.

If you have diabetes and feel constantly tired, it can affect your quality of life. Knowing more about the link between diabetes and fatigue — and what treatments are available — can help you manage it more effectively.

Diabetes and tiredness

There are many different possible causes for fatigue in someone with diabetes. The first reason you may think of is blood sugar fluctuation. Both type 1 and type 2 diabetes can cause too much glucose in your bloodstream, either from resistance to insulin or an inability to produce it.

Even if you manage your diabetes well, there is still a strong likelihood that you will experience high blood glucose (hyperglycemia). Hyperglycemia may cause fatigue and lethargy.

But researchers from a study in 2015 suggest that blood glucose levels are mostly an indirect cause of fatigue in people with type 2 diabetes. The findings indicate that other symptoms of diabetes are more likely to cause fatigue, particularly if you manage your blood glucose levels well.

Other factors that can cause fatigue in people with diabetes include:

Chronic stress

Diabetes is a condition that needs constant attention and treatment, and many people can find the demands of the condition difficult. This can cause low level and constant stress, which often leads to mental exhaustion and fatigue.

This can further hinder your ability to manage blood sugars well, creating a vicious cycle of hyperglycemia and stress.

Lack of sleep

According to the Sleep Foundation, 50% of people with type 2 diabetes have difficulty sleeping due to diabetes–related symptoms. Feelings of depression and stress can also lead to insomnia. If this is short term, it may just be acute fatigue. But if it is a long-term issue, it may become chronic fatigue.

Hypothyroidism

Thyroid dysfunction and diabetes have close links. According to a review from 2019, between 17% and 30% of adults with type 1 diabetes have a type of thyroid dysfunction that is the result of autoimmunity.

Hypothyroidism happens when your thyroid gland doesn’t produce enough hormones. These hormones are responsible for regulating your metabolism, so too little of them can cause fatigue among other symptoms.

Other possible causes of fatigue in people with diabetes include:

• poor nutrition
• depression
• lack of physical activity
• side effects from other medications
• general inflammation

Other symptoms

Other symptoms that you may experience if you have type 1 or 2 diabetes can include:

• unquenchable thirst
• frequent urination
• unexplainable and rapid weight loss
• constant hunger
• blurry vision
• slow healing of skin wounds

Symptoms of type 1 diabetes will develop quickly. It is important to seek medical help as soon as you notice any symptoms, particularly weight loss, thirst, and frequent urination. Receiving treatment quickly is essential if you suspect type 1 diabetes.

Type 2 diabetes develops more slowly. If you have type 2 diabetes, you may notice these symptoms only when they get more severe. Some people may never notice symptoms until they experience another health concern like heart disease.

Managing fatigue

When managing symptoms of fatigue with diabetes, it can be beneficial to treat the two conditions as one. Lifestyle measures and mental health support can help treat fatigue, as well as improve your ability to manage diabetes.

Things to focus on when trying to manage symptoms of fatigue from diabetes include:

• Lifestyle measures: Regularly exercising and consuming a healthy and balanced diet can help boost your energy levels in the long run. Exercise can also be a useful tool for managing your blood glucose levels. The American Diabetes Association recommends 2.5 hours of exercise per week.

• Mental health support: Diabetes can be tough to cope with long term. It can lead to other health conditions like depression, which can further affect your ability to sleep. Exercise can help relieve stress, but seeking help from a therapist or group counseling may also help.

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Diabetes treatment

The medical treatments that a doctor will recommend to treat diabetes will depend on the type you have. The aim of both is to maintain a safe blood glucose level. This is important for protecting your body against harmful complications like nerve damage.

Type 1 diabetes typically requires the medication insulin. Some types of insulin for type 1 diabetes include:

• Short-acting insulin: These medications help quickly correct high blood glucose levels, typically for use 25 minutes before a meal, and include Humulin R and Velosulin R.

• Rapid-acting insulin: This works faster than short-acting, and can work within 15 minutes. These include insulin aspart and insulin lispro.

• Long-acting insulin: These work over longer periods and can last up to 48 hours, depending on the type you take. It can help establish a baseline blood glucose level and currently includes four different types of insulin, including insulin detemir (Levemir), insulin glargine (Lantus), and insulin degludec (Tresiba).

Type 2 diabetes medications aim to help your body manage the insulin it produces. Not everyone with type 2 diabetes will need medication.  

If you do, the medications a doctor will prescribe may be injectable or oral tablets, including:

• metformin (Riomet), the most common type 2 diabetes medication
• SGLt-2 inhibitors like bexagliflozin (Brenzavvy)
• GLP-1 agonists like dulaglutide (Trulicity)
• sulfonylureas like glyburide (Glynase)

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Some people with type 2 diabetes may also need insulin, for example, if diabetes medications stop working. It is important to follow the instructions a doctor gives you.

Summary

If you have diabetes, you may experience fatigue alongside it. The causes of diabetes-related fatigue vary, from regular hyperglycemia to mental exhaustion from constantly managing your blood glucose levels.

Lifestyle measures and therapies can help boost your energy, as well as give you the tools to manage diabetes in the future.

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