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Improved blood sugars but increased fatigue

cazz_mm

Newbie
Messages
4
Type of diabetes
Type 1
Hi

I have be T1 for 14 years and been on a pump for 5 1/2 years and have never had great control of my blood sugars. I have so many different basals and ratios programmed into my pump the nurses are amazed, but it is because I react differently to insulin and food at different times of the day!!

Last year I got a new pump and this has given me much better control (last 2 HBA1Cs wer 7.7 and 7.8) and in the past few months I have been using steel canulas (as opposed to teflon) and have had great success in keeping my blood sugars down (as in less swinging from low to high). But I am now exhausted all the time and always cold. I have had blood tests for anemia, thyroid function and even lyme disease, but all came back normal and was wondering if anyone had any idea whether it might actually be related to my blood sugars? Especially if I do let my sugars get a bit high (8-15) by accident I don't feel as cold or tired!

Seems the wrong way round to me, as I thought high sugars gave you fatigue, but I am out of ideas now! Any advice would be greatly appreciated as I can't find any articles explaining these symptoms on the web.

Thanks
C
 
Hi @cazz_mm, having an Hba1C of 7.7% does equate to an average blood glucose of something in the range of 9-10mmol/l, which as an average is still pretty high.

It's possible that your body is so used to running at higher levels that as you move down, you are suffering false hypo feelings, which could equate to the feeling of fatigue. It's also possible that while you are seeing tests in the low range, you are in reality swinging up and down quite a bit, which can also cause fatigue feelings.
 
Ranges for anaemia and thyroid dysfunction are rather wide and quite a few can have severe symptoms even if the blood results are deemed normal. Have you had thyroid antibodies tested? And what were your actual results?
 
You can suffer from false hypo's (as Tim suggests) when you tighten things up but I would expect that this would have disappeared by now, especially as you say you've had 2 HbA1c results of late which have been in the 7's and that HbA1c's tests have be taken 12 weeks apart.

All I would suggest is you ask to speak with your Endo if you haven't done so already as no one should feel exhausted all the time , also if you want to tighten up your bg control further then purchase the book Think Like a Pancreas, it really is a fantastic book and will help you fine tune your basal rates and I:C ratio's. Good luck
 
Thanks for your replies. My HbA1c has come down from being 10-12 in recent years, so although I'd like to get to the bottom end of 7, I am pretty chuffed with it. I test at least 5-6 times a day and I know that my swings between high and low have decreased a lot. Though I am super sensitive to exercise when I have active insulin, which makes life hard (even a 20 minute walk can trigger a hypo if I have taken insulin within 2 hours... but if I didn't exercise, the insulin would have covered the carbs perfectly... I have tested this many times over!!)

I spoke to my GP yesterday and my thyroid function does seem to have dropped. My THS is 2.1 (has been both lower and higher on previous tests) but my FT4 is 9 which has steadily dropped over the last few years from 17 (never fluctuating back up). These figures don't really mean much to me other than the fact I think it is odd that the one has continued to go down. But the GP was adamant that they were in normal range - and if I hadn't forced the point with her she wouldn't have compared back to previous tests.

I have never actually met the Endo consultant (been in this NHS Trust for 3.5 years now!), but am now pushing to see them. I don't think they have tested for Thyroid antibodies...

And I have the book Think Like a Pancreas .... not read it in a while, maybe I should get it back out!
 
cazz_mm said:
And I have the book Think Like a Pancreas .... not read it in a while, maybe I should get it back out!
Click to expand...

Actually @cazz_mm I meant to say the book Pumping Insulin, it has a good chapter on using TBR's for exercise which you will undoubtedly find useful, but that said Think Like a Pancreas is still a great book and contains loads of useful info for pump users.
 
I'd say with FT4 falling from 17 to 9 it's clear your thyroid isn't working properly. Do you know the range?

In normal people FT4 can vary with up to 15%.

There is something called secondary hypothyroidism, it's when the pituitary doesn't produce adequate amounts of TSH. It's very rare though but happens and in those cases TSH is of no value whatsoever. Keep asking for FT4 tests and preferably FT3 too.
 
I second what @Totto says here, it took 18 months before my thyroid tests came back showing a problem that the Dr's took notice off, keep pushing.
 
Me too, I have really bad fatigue every day even though I have quite good control. I think it's like even a small swing in blood sugar makes me tired but it could be something else!
 
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