Maxy sez : Tired All the Time? It Could Be Your Diabetes

 Fatigue in people with diabetes is often attributed to blood sugar fluctuations, but stress and emotional concerns can be major contributors. Learn coping strategies that can help boost energy and mood.

By Beth W. Orenstein           Medically Reviewed by Farrokh Sohrabi, MD

If you’re coping with diabetes and feel wiped out all the time – the kind of fatigue that isn’t helped by eating or getting a little extra sleep – your doctor might tell you that your blood sugar levels are to blame. But new research shows that the duo of diabetes and fatigue could have other causes. In a study published in The Diabetes Educator, researchers Cynthia Fritschi, RN, PhD, and Laurie Quinn, RN, PhD, of the University of Illinois College of Nursing, found that stress, depression, body mass index (BMI), and lack of physical activity can all be significant contributors to fatigue in people with diabetes.
The study looked at 83 women ages 40 to 65 with type 2 diabetes. The women completed questionnaires about their health, fatigue levels, diabetes symptoms, depression, emotional distress, physical activity, and how they were managing and coping with diabetes. Some of the women wore a continuous glucose monitor for three days to assess the changes in their glucose (blood sugar) levels.

The researchers found no relationship between the women’s fatigue level and their blood sugar control. Fasting blood sugar, glucose fluctuations over the study period, and A1C, which measures average blood sugar level over the previous two to three months, did not predict how tired the women reported feeling. “It appears that other factors – such as being overweight, getting little physical activity, and having higher levels of distress – could be causing their fatigue,” Fritschi says.

Diabetes and fatigue can set up a Catch-22, Fritschi adds. “One of the key strategies for taking care of diabetes is exercise, yet people with diabetes can be too tired to exercise," she says. If you’re also depressed, you’re even less likely to have the energy to take other steps needed to manage diabetes, such as preparing healthy meals and monitoring your blood sugar. “I think there are definitely quality of life issues that come with diabetes and fatigue,” Fritschi says.

Coping With Diabetes and Fatigue
Take a proactive approach to dealing with fatigue by addressing your symptoms and concerns with your health care providers and support team.

· Give specifics. When talking to your doctor about how you feel, don’t just say, “I’m tired all the time.” Tell your doctor that 'I’m too tired to go for a walk or go grocery shopping,' ” Fritschi says. Let your doctor know that your exhaustion is preventing you from doing activities that are important to keeping you healthy.

· Keep a journal. How many times do you get up at night to go to the bathroom? Are you skipping meals because you’re too tired to stand and prepare them? Make detailed notes on these issues and use your journal to talk to your doctor or diabetes educator about concerns that make living with diabetes harder for you.

· Work with a therapist. Managing diabetes is a 24/7 commitment. That alone can cause you to feel anxious, stressed, and depressed. And, in turn, depression can lead to fatigue and a lack of energy, Fritschi says. If you feel burdened and depressed by your diabetes, consider getting professional help. A therapist who is trained in treating depression can help you improve your mental health. Ask your doctor or diabetes  caregiver