Fatigue in Type 1 Diabetes - Not related to hyperglycemia

I complained of constant fatigue since taking insulin to my specialist, who completed blood tests and discovered I was anaemic.

Diagnosed 3 years now and its definitely affected my energy levels. I get tired quickly and i can't do the same level of physical activity that I used to - it's frustrating.

My consultant also said I should be fine given my BG levels but I found some research suggesting chronic fatigue is more common amongst T1ds despite good BG control. Another consultant said they wouldn't be surprised because our body is a complicated system and injectable insulin really is quite a blunt tool to keep us alive!

Having T1 means that the body can no longer regulate metabolism of glucose. So if glucose is a major source of energy supply/demand mismatches are part of the condition and fatigue can be expected even if blood glucose control is satisfactory. The solution is to eat ketogenically and become fat adapted. Glucose is no longer the main source of energy.

Hi, I have not noticed your symptoms day to day, but when I have been particularly active (above usual activity levels) and not sufficiently increased total carbs in my diet, meaning I haven't therefore injected more insulin, I have noticed heightened fatigue. I carbohydrate count and am on MDI for background. I have only noticed it a few times, like the week of a dance show where I have had rehersals and 6 shows that week for example. Sometimes I have had this in the summer too, where I have naturally wanted to eat lighter meals while it has been hotter weather, and realised I have barely had to bolus at all for a day or so and felt 'weak' (not drastically) and fatigued. Not sure if that helps, but I would maybe keep a food/activity/anything noticeable diary so you can see if there are any patterns?

I have been Type 1 for 20 years now since I was 11. I didn't suffer fatigue growing up but over the past few years I have been diagnosed with an under active thyroid and coeliacs and I feel exhausted. Sometimes I feel so embarrassed that, although I am a slim woman, I struggle to do any form of exercise without feeling so weak and worn out really quickly. I'm only 31, I eat healthy but I struggle to find the energy to do the housework, I dread to think what the future will be like!

Bluemarinejosephine said:

Hello everyone,
I hope that you are all very well, safe and healthy.

Please, I would like to ask you regarding our Type 1 Diabetes and our energy levels.
My below question refers to us who have well controlled diabetes and BG levels within range.

According to the feedback that I have received from medical advisors, when our BG levels are within range and we don’t have frequent hyperglycemic incidences (except from the odd high reading which will occur every now and then) we should not observe a feeling of fatigue because of diabetes.

However, I have noticed with myself that, I regularly feel more tired after a long day at work or after exercise (for example, running or dancing) than what I normally did before my diagnosis.

For example, before diabetes, I would join a gym class or run my usual distance and I would feel a certain “normal” tiredness. Post diabetes, I do the exact same exercise but, I feel like I want to go to sleep for 2 hours (and sometimes, I do… because I feel I really need to lie down).

Similarly, with work, I would have long days at the office, and I would feel tired – or whatever would be described as “normal” tiredness from work. Post-diabetes, I am really feeling the lack of energy and, regularly, I return home feeling exhausted.

I have, also, noticed that it takes me longer to recover from feeling tired. Post-diabetes, a good night sleep is often not enough and I find myself waking up, still, a little tired on the next day.

I was discussing this with a friend who is also a Type 1 and she told me that “we need twice the amount of energy than non-diabetics”. Do you find this to be true/accurate?

Have you observed anything similar?

Also, I am referring to a (possible) connection between BG and fatigue levels only. I am not referring to other parameters that could affect energy levels such as hyperglycemia, malnutrition or deficiencies, hypo/hyperthyroidism etc)

Looking forward to receiving your replies.
Thank you.

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hi Bluemarine,
I am type I (over 55years now) and I do find diabetes does certainly zap you energy levels..especially when you exert yourself. Having had it so long I have become used to continually being tired, it is the norm for me.

If I have a hypo, then I feel extremely tired afterwards. Totally exhausted.

It will probably become the norm for you, if you are finding you are getting tired more often .

Sorry but I think it is just one extra result of diabetes.

just take time to sit down and chill from time to tkme. It helps.

Just to confirm, I do not have a y problems with my thyroid.

Hi @Bluemarinejosephine

Thanks for posting the above. I completely sympathise- i have diabetes 22 yrs and constantly have this issue. I tell my consultants and GP all the time. While my BG levels are very good in general, i am constantly tired, and nearly feel like I need a sleep after every time i eat. I carb count and as i say very good levels of control in general. Am always asked how i am doing and my reply is the same great apart from the tiredness. The odd time my Vitamin D or Iron may be low but in general i am very healthy. I feel like the Doctors think its in my head. They mention ME or chronic fatigue but i know its not that as i get up go to work and get on with my day but my energy levels sometimes are through the floor. I am in my 40s but i know its not age as I have felt this way in 30s and 20s too. I have a busy and on occassions stressful job and by the end of the week am fit for very little. I try to do exercise in terms of swimming (which i can't do due to Covid) but sometimes its impossible to get out of bed earlier to do.

For the most part I try to get on with it but it does get to me, I am so sick of feeling tired and low energy levels. I've spoken to a few people who wreckon this goes hand in glove with a immuno condition.

Its good to hear am not the only one though

Also no problems with my thyroid either-have been tested for everything including Coealic disease!

I’ve definitely noticed this. There are some days that I feel fine, others that I feel as if I’m dragging my body through the day. It doesn’t always feel as if I’m sleepy, just that I need to summon vast amounts of resource to do something fairly simple. I see people who are filling their lives to the brim and it’s tiring just thinking about everything they cram in!

It’s perhaps to be expected when we consider what our bodies are going through and the extra amount of thinking we have to do on a daily basis to manage diabetes. I could probably make improvements to my diet, do more exercise and try and rest, but it isn’t appreciated how difficult that is to achieve when you have family and work commitments.

I get tired easily now, but I know that if I have more exercise and sugars are mostly within range then I have more energy. I did get exhausted with anaemia once, and I used to crash after long periods of heightened work activity. I remember I always used to have at least one recovery day about every three months before I retired. I used to spend it doing nothing, at home, and trying not to feel guilty.
I do sometimes wonder what kind of energy levels I’d have had if I hadn’t been blessed with T1.

Fairygodmother said:

I get tired easily now, but I know that if I have more exercise and sugars are mostly within range then I have more energy. I did get exhausted with anaemia once, and I used to crash after long periods of heightened work activity. I remember I always used to have at least one recovery day about every three months before I retired. I used to spend it doing nothing, at home, and trying not to feel guilty.
I do sometimes wonder what kind of energy levels I’d have had if I hadn’t been blessed with T1.

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I agree about exercise giving energy but my issue is sometimes that I am soooooo exhausted that even getting up off the couch or driving to the pool is more energy than I can muster (and I am not a lazy person). I am not naturally a sporty person but I do intellectually understand the benefits of exercise but sometimes the tiredness is such a barrier. Perhaps I should stop saying to myself that 'I am sooo tired' and just get on with it.

JossB said:

I’ve definitely noticed this. There are some days that I feel fine, others that I feel as if I’m dragging my body through the day. It doesn’t always feel as if I’m sleepy, just that I need to summon vast amounts of resource to do something fairly simple. I see people who are filling their lives to the brim and it’s tiring just thinking about everything they cram in!

It’s perhaps to be expected when we consider what our bodies are going through and the extra amount of thinking we have to do on a daily basis to manage diabetes. I could probably make improvements to my diet, do more exercise and try and rest, but it isn’t appreciated how difficult that is to achieve when you have family and work commitments.

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You have absolutely hit the nail on the head! Everything you have said is exactly the same for me.

It’s most definitely not appreciated how difficult it is!

It’s a comfort to me to know others feel the same

Tiredness can be caused by many things. Don't assume it's down to the diabetes. I was always tired then camE the pain. When I went to the drs Over 9 months they took 28 vials of blood and 6 xrays. Thyroid, iron and B12 levels were all checked tested for Lupus and a muscle wasting disease. All cam back negative they put it down to Fibromyalgia.

I have been Type 1 for over 50 years, and did not suffer from fatigue until 2002 when I had radiation for breast cancer. After that I never recovered and was diagnosed with M.E./Chronic Fatigue Syndrome. eventually they reckoned it was caused by my immune system over-reacting, and a light went on; another autoimmune condition ! Didn't help the fatigue though. But I don't think it was down to the diabetes as I had had that so long before experiencing the extreme fatigue.. I think it would be worthwhile thinking about this; it's not something picked up by tests.

Bluemarinejosephine said:

Hello everyone,
I hope that you are all very well, safe, and healthy.

Please, I would like to ask you regarding our Type 1 Diabetes and our energy levels.
My below question refers to us who have well-controlled diabetes and BG levels within range.

According to the feedback that I have received from medical advisors when our BG levels are within range and we don’t have frequent hyperglycemic incidences (except the odd high reading which will occur now and then) we should not observe a feeling of fatigue because of diabetes.

However, I have noticed with myself that, I regularly feel more tired after a long day at work or after exercise (for example, running or dancing) than what I normally did before my diagnosis.

For example, before diabetes, I would join a gym class or run my usual distance and I would feel a certain “normal” tiredness. Post diabetes, I do the same exercise but, I feel like I want to go to sleep for 2 hours (and sometimes, I do… because I feel I need to lie down).

Similarly, with work, I would have long days at the office, and I would feel tired – or whatever would be described as “normal” tiredness from work. Post-diabetes, I am feeling the lack of energy and, regularly, I return home feeling exhausted.

I have, also, noticed that it takes me longer to recover from feeling tired. Post-diabetes, a good night's sleep is often not enough and I find myself waking up, still, a little tired the next day.

I was discussing this with a friend who is also a Type 1 and she told me that “we need twice the amount of energy than non-diabetics”. Do you find this to be true/accurate?

Have you observed anything similar?

Also, I am referring to a (possible) connection between BG and fatigue levels only. I am not referring to other parameters that could affect energy levels such as hyperglycemia, malnutrition or deficiencies, hypo/hyperthyroidism, etc)

Looking forward to receiving your reply.
Thank you.

Click to expand...

Hello

Since you have done every test possible, listen to this.

I am Also Type-1 but only found this out 4 years ago... Before that, for years, I was continuously dragging myself with fatigue and by 11 a.m. I was nodding asleep on my work station ..This continued for many months until I was given a telling by my boss at work, but I still was not able to overcome the tiredness, sleepy eyes, and fatigue. I am overweight so I'm sure this has something to do with it and with my Type-1, but when my GP refer me to a neurologist specializing in sleep studies and ailment, the Consultant kept me under observation and monitoring for 48 hours using cutting edge instruments and monitoring devices(Sleep Clinic-Kingston Hospital)...

He discovered I had sleep "APNEA", meaning that when I fall asleep, my breath repeatedly stops (sometimes 30 times a minute), and hence I never really have comfortable fully-fledged sleep, never. This is a very dangerous illness which no medical remedy in existence for, but if uncontrolled, it could lead to stroke or heart attack ...I was very lucky with the Consultant and could never forgive all the GPs that failed me throughout the years in not diagnosing the syndrome early.

So for the past 4 or 5 years, I wear a special face mask connected to an air pump or respirator (with a slot for a memory card to record my sleep pattern), that detects when I stop breathing, it provides positive air pressure to open my airways and stop the phenomena. I wear the mask throughout the night, every night...and when I forget to put it on after having few pints, the next day I am a wreck.

You cannot imagine the difference it made, literally the next day following the use of the respirator, I was fresh and active full of energy able to walk for 3-4 hours without being tired, The respirator cost around £500 with appendages maybe 600, but if diagnosed, it's freely issued by the NHS.

So, perhaps, maybe perhaps, that you should ask your GP to consider this option and refer you to a sleep clinic...

Nothing to lose but much to gain...Be careful these machines are costly, not many off and rare and in the age of COVID-19, they are sought after.

I wish you the best.

Bluemarinejosephine said:

Hello everyone,
I hope that you are all very well, safe and healthy.

Please, I would like to ask you regarding our Type 1 Diabetes and our energy levels.
My below question refers to us who have well controlled diabetes and BG levels within range.

According to the feedback that I have received from medical advisors, when our BG levels are within range and we don’t have frequent hyperglycemic incidences (except from the odd high reading which will occur every now and then) we should not observe a feeling of fatigue because of diabetes.

However, I have noticed with myself that, I regularly feel more tired after a long day at work or after exercise (for example, running or dancing) than what I normally did before my diagnosis.

For example, before diabetes, I would join a gym class or run my usual distance and I would feel a certain “normal” tiredness. Post diabetes, I do the exact same exercise but, I feel like I want to go to sleep for 2 hours (and sometimes, I do… because I feel I really need to lie down).

Similarly, with work, I would have long days at the office, and I would feel tired – or whatever would be described as “normal” tiredness from work. Post-diabetes, I am really feeling the lack of energy and, regularly, I return home feeling exhausted.

I have, also, noticed that it takes me longer to recover from feeling tired. Post-diabetes, a good night sleep is often not enough and I find myself waking up, still, a little tired on the next day.

I was discussing this with a friend who is also a Type 1 and she told me that “we need twice the amount of energy than non-diabetics”. Do you find this to be true/accurate?

Have you observed anything similar?

Also, I am referring to a (possible) connection between BG and fatigue levels only. I am not referring to other parameters that could affect energy levels such as hyperglycemia, malnutrition or deficiencies, hypo/hyperthyroidism etc)

Looking forward to receiving your replies.
Thank you.

Click to expand...

Hi yes I am the sort of person who has to see the task at hand through to the end but my energy levels will not allow it, doing housework clean bathroom Hoover upstairs and make bed rest Hoover dust downstairs rest start next job, I can no longer do all the housework in one go and only stop for lunch, as you say a long walk is enough or even just doing the weekly shop is enough

Hi i a type 2 diabetes and I also fibromyalgia like you.Which means I am tired all the time plus i have arthritis in both knees and pain syndrome in hands and few other others swell and takes about 10 meds a day.I was told about a year ago and by bloods are still not right.but is it any wonder with all the conductors they keep find ing out i have.but hospital app are being canuaced due to covirn19 .so is this why my sugars are not going up,as sort is going down.can't services due fibr o and psin.any ideas?