Fatigue

[Carl40]

Hi all,

Diagnosed with diabetes late Jan after a couple of months of constant thirst and all that goes with it.

Due to HbA1c being extremely high (I'm sure they said ~128) and having a high level of ketones in my system they wanted me to go to hospital immediately.

In the end they started me on insulin and a few weeks later, when I was confirmed as type 2, added Metformin (3 x 500mg per day) into the mix.

Recently had a trial of a Libre2, data from that for the full two weeks is shown below and to my amateur mind, looks good, under control with the very occasional spike.

For that same period, the app estimated my a1c at 5.6% (38 mmol/mol).


pic upload


Overall, it seems I have it all relatively well under control BUT I'm suffering from constant fatigue.

Generally sleeping OK although have had a few nights of weird sleeping patterns over the last week but for months I've felt fatigued. Was under the impression that if I brought blood sugars under control this would disappear but it hasn't.

Am considering discussing with GP next week as it's really difficult to function in any meaningful way at present.

Does anyone have any experience with this and/or any views?

Thanks

 

[Goonergal]

Hi @Carl40

I’d definitely speak to the doctor. Ongoing fatigue can be caused by a number of things and is very debilitating. Your numbers look good from that graph, so it doesn’t seem likely to be related to blood sugars.

 

[Carl40]

Hi @Carl40

I’d definitely speak to the doctor. Ongoing fatigue can be caused by a number of things and is very debilitating. Your numbers look good from that graph, so it doesn’t seem likely to be related to blood sugars.

Thanks.. appreciate the confirmation on my thinking!

When I originally saw the nurse and was put on my meds she said that next time I saw her i'd feel like a new person... hasn't happened yet determined to push on and find out what needs to be done to get my energy levels back up.

 

[Daibell]

Hi. Can I ask what your BMI is? You say you are diagnosed as T2 which may well be correct but some of us have suffered mis-diagnosis where the correct diagnosis is T1. So if you have some excess weight then T2 is likely if you are slim then T1 is more likely; there are tests for that. I agree with the nurse that once on insulin you would have expected to return to 'normal'. There may be other causes of the fatigue so see the GP if the problem remains

 

[Carl40]

Hi. Can I ask what your BMI is? You say you are diagnosed as T2 which may well be correct but some of us have suffered mis-diagnosis where the correct diagnosis is T1. So if you have some excess weight then T2 is likely if you are slim then T1 is more likely; there are tests for that. I agree with the nurse that once on insulin you would have expected to return to 'normal'. There may be other causes of the fatigue so see the GP if the problem remains

Thanks... yeah so I'm technically in the overweight category and the NHS recommends i lose 11lb which I will do over the year but having been far more overweight in the past it would be surprising to me if the weight on its own was the underlying cause - I was once a fair few stone heavier and felt a lot better than I do now! Mind you, I'm older now so couldn't rule it out!

It's a fair point about the diagnosis - I had a peptide test in Feb and whilst I didn't get the actual results I was told it was T2,

I'm going to see if I can get some facetime with the GP on Tuesday to go through it all and see what they think.

 

[Hotpepper20000]

People with Diabetes also can have other conditions. Sometimes doctors just dismiss it.
Make sure you insist on investigating what exactly is going on.

 

[Carl40]

People with Diabetes also can have other conditions. Sometimes doctors just dismiss it.
Make sure you insist on investigating what exactly is going on.

Thanks I will.

Going to see if I can get in to see the GP who is most experienced on diabetes tomorrow. Even today, slept for a long time last night.. been up a couple of hours and feeling zonked already. Not tired as in ready to go to bed just drained.

Had glandular fever years ago and it reminds me of the aftermath but not any viruses (including covid - which I'm fully immunised against now) for a long time.

 

[searley]

One thing that concerns me is the presence of keytones to the point they wanted hospitalisation

It’s unusual for t2 to have keytones because t2’s still produce insulin so the body still gets nutrition.. however on the flip side untreated t1’s typically lose weight

There is a possibility of LADA… not knowing the tests done I’d suggest keeping an eye on things

However none of this has a bearing on the tiredness which looking at the libre graph which is good..

I don’t know how long you numbers have been good like that but it did take about a month for me to start to feel better

And have to mention.. being male and 40 it’s possible your testosterone is low and low testosterone can cause extreme tiredness and again in another endocrine deficiency and sometimes comes hand in hand with diabetes..

When my test is low I can sleep all day so it’s another thing to look at, which is often overlooked

 

[Carl40]

One thing that concerns me is the presence of keytones to the point they wanted hospitalisation

It’s unusual for t2 to have keytones because t2’s still produce insulin so the body still gets nutrition.. however on the flip side untreated t1’s typically lose weight

There is a possibility of LADA… not knowing the tests done I’d suggest keeping an eye on things

However none of this has a bearing on the tiredness which looking at the libre graph which is good..

I don’t know how long you numbers have been good like that but it did take about a month for me to start to feel better

And have to mention.. being male and 40 it’s possible your testosterone is low and low testosterone can cause extreme tiredness and again in another endocrine deficiency and sometimes comes hand in hand with diabetes..

When my test is low I can sleep all day so it’s another thing to look at, which is often overlooked

Thanks for this. Was helpful for my discussion with the Doctor today. He's going to run some further blood tests to see if they can identify the cause. Think I'll get them to test ketones next time I'm in just to see how things have changed.

What I'm finding interesting is, somewhat unrelated to the fatigue I suspect is -

I had a libre2 trial a few weeks ago and it came up with an average of 5.6% (38mmol/mol) for my estimated hba1c.

Just plugged in data from the last few days into the mysugr app (I use the Accu-check Performa system and this is their app) and it has came out with the exact same estimate.

Given what I've read, and considering I was diagnosed at the end of January with a reading of 128 I'm thinking the meds and diet changes (going from white bread to wholemeal, eating more eggs and let potatoes etc) are doing the world of good.

Doctor was really pleased when I told him my average - having two separate datasets confirming the same thing bodes well, I feel.

 

[1970clea]

Just a thought, about 2 years after my Type 2 diagnosis my thyroid gave up and I felt awful, no energy, tired all the time, very miserable. I had no idea as my BGS were good at the time. So I hope they are testing for that too.

 

[Carl40]

Just a thought, about 2 years after my Type 2 diagnosis my thyroid gave up and I felt awful, no energy, tried all the time, very miserable. I had no idea as my BGS were good at the time. So I hope they are testing for that too.

Thanks.. yeah that's something the GP mentioned. Said they'd checked it when they did the blood screening at the time of the diabetes diagnosis but is going to do it again to be sure.

Wife had her thyroid out a few years back and I've seen what happens to her if she forgets her meds and its very similar - except for me it doesn't go away.. if it is the thyroid that makes sense!

Hope you are doing ok - I know it isn't fun and a lifelong problem.

 

[1970clea]

@Carl40 once the medication got to the right dose I was fine and remain so to this day. Thankfully, as it was not a pleasant experience - I remember my doctor telling me that she didn't understand how I was continuing to function at the time!!

 

[Carl40]

@Carl40 once the medication got to the right dose I was fine and remain so to this day. Thankfully, as it was not a pleasant experience - I remember my doctor telling me that she didn't understand how I was continuing to function at the time!!

I can imagine, it is not pleasant.. having diabetes as well can't be fun!

 

[Carl40]

Meant to update this. Blood results came back and it was low bit D. Have been prescribed 20,000 unit capsules - two a week for the next six to eight weeks.

All being well should feel more like my old self in that time.

 

[Hopeful34]

Glad they checked your vit D, as it can often be something they're reluctant to test for at my surgery anyway, and I feel very tired when mine goes low. A few years in, and I know to up my maintenance dose myself when that happens now. Hope you feel better soon. Take care.

 

[Carl40]

Glad they checked your vit D, as it can often be something they're reluctant to test for at my surgery anyway, and I feel very tired when mine goes low. A few years in, and I know to up my maintenance dose myself when that happens now. Hope you feel better soon. Take care.

Thanks.. I think I can feel a small positive effect of the first weekly dose already but its minimal and fleeting. Hoping that once I'm up to a normal level I can pick up some supplements to keep it topped up.

Was taking ginseng with multi vits prior to diagnosis and felt a lot better. Put that down to the ginseng but wonder now if it was the vitamin d in the mixture. Stopped taking them as I couldn't establish whether there would be any risk of interaction with the meds I'm on now.

Do you feel "normal" if you maintain your levels?

Thanks

 

[Dr Snoddy]

And get your Vit B12 levels checked. You might be one of the people for whom Metformin decimates this vitamin and this can lead to fatigue. This should be tested for anyone prescribed Metformin but often doesn't happen. B12 can be supplemented and I found that an oral spray worked best for me.

 

[Carl40]

And get your Vit B12 levels checked. You might be one of the people for whom Metformin decimates this vitamin and this can lead to fatigue. This should be tested for anyone prescribed Metformin but often doesn't happen. B12 can be supplemented and I found that an oral spray worked best for me.

Thanks, will do. I'm likely to speaking with a GP tomorrow so I'll ask if that was checked - they did a full blood screening apparently so I hope so but will double check to make sure.

Need to get my mojo back

 

[Dr Snoddy]

Hi, if they did a full blood count then ask about ferritin and haemocrit values. They will give you some idea about iron levels. Low levels could be causing anaemia which would also lead to tiredness. And just having to deal with a diabetes diagnosis can be knackering! You have done spectacularly well in reducing your HbA1c in a short period of time and this could be a temporary response while your body adjusts. Good luck with your doctor's appointment.

 

[Carl40]

Hi, if they did a full blood count then ask about ferritin and haemocrit values. They will give you some idea about iron levels. Low levels could be causing anaemia which would also lead to tiredness. And just having to deal with a diabetes diagnosis can be knackering! You have done spectacularly well in reducing your HbA1c in a short period of time and this could be a temporary response while your body adjusts. Good luck with your doctor's appointment.

Thank you... didn't see this until now but am expecting another call later this week so will keep that in mind for that discussion!

Appreciate the comment about how well I've done reducing this and what you say makes good sense. Was all a big surprise considering I was expecting the diagnosis and being given a few pills and sent on my way (shows how little I knew at the time ).