What are the links between diabetes and fatigue?

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Fatigue, a scourge of modern-day life, is also a very common symptom of type 1 diabetes. It’s important to note the  difference between acute fatigue, the reasons for which are usually clear, and persistent chronic fatigue, which is sometimes difficult to identify and tackle. 

Bouts of fatigue

The most common cause of acute fatigue in people with type 1 diabetes is hypoglycemia. A symptom of low blood sugar that is sometimes missed, a feeling of sudden tiredness or being drained of all energy should prompt you to check your glucose levels. This is particularly true for people who do not really, or no longer, experience the adrenergic symptoms (caused by the secretion of adrenalin) of hypoglycemia, such as trembling, sweating, feeling sick, “pins and needles”, etc. 

But since nothing is ever simple with diabetes, sudden fatigue can also be a symptom of hyperglycemia, especially after a big meal. Again, the best way to know is to check your glucose levels. 


Difficult-to-identify chronic fatigue 

The term chronic fatigue¹ is used to describe persistent tiredness present for over 6 months. Often blamed on stress, too much work or difficult times in life, chronic fatigue may also be related to poor diabetes management. In the end sufferers often just accept the fatigue and live with it; as a result, people living with type 1 diabetes no longer make the link between their diabetes and their fatigue.     

Chronic hyperglycemia generates a dire situation for the human body, forcing it to draw on its reserves. Unable to use blood sugar as an energy source, it burns fat instead and runs on energy-saving mode. It is this excessive use of energy reserves that causes the fatigue experienced. 

Better glucose control often solves the problem.


Sometimes subtle causes

But diabetes-related fatigue isn’t always a question of glucose control. Although they are more unusual, other causes should be considered.

Type 1 diabetes may be associated with other autoimmune diseases, such as hypothyroidism. Chronic fatigue can also be linked to weight loss, hypothermia or gastrointestinal problems. It is for this reason that regular blood tests are carried out in patients with type 1 diabetes to measure TSH levels to detect any thyroid issues.

Psychological pressure and burnout

A chronic disease that requires constant management and attention, type 1 diabetes is a source of stress and psychological pressure for both patients themselves and their families, which can sometimes lead to a phenomenon of “burnout”. People with the condition are also more prone to depression², which may develop after the diabetes is diagnosed or after living with it for several years. In this case, fatigue is a physical manifestation of angst or psychological distress that should not be ignored.

¹Fritschi C, Quinn L. Fatigue in patients with diabetes: a review. J Psychosom Res. 2010;69(1):33-41. doi:10.1016/j.jpsychores.2010.01.021

²Diabetes Complications and Depressive Symptoms: Prospective Results From the Montreal Diabetes Health and Well-Being Study

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