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Dear Diabetes: Fatigue

Why do I feel fatigued or low energy?

Dear Diabetes: Why do I feel fatigued or low energy?

Adults living with type 2 diabetes (and those who care for them!) may sometimes feel fatigued, which doesn’t necessarily mean sleepy, but can mean they have low energy. If you or someone you care for is feeling fatigued, check with your diabetes care team; there are several issues that may contribute to feeling low energy when you live with type 2 diabetes, including:

Glucose available for energy

When I see people who are newly diagnosed with type 2 diabetes, they often report having very little energy. They tell me they have trouble getting up in the morning, and they spend a lot of time on the couch after work and on days off. At the cellular level, if the body doesn’t have enough insulin working, for whatever reason, glucose can’t be used properly to produce energy.

Sleep issues

People living with diabetes face several situations that can affect the amount and quality of sleep they get. High and low blood glucose may interfere with sleep; neuropathy can cause pain or burning in the feet/legs that can affect sleep; and some people living with type 2 diabetes have “restless legs syndrome,” which can also affect sleep. And finally, people with type 2 diabetes are at risk for sleep apnea, a condition in which there is shallow breathing, as well as repeated pauses in breathing during sleep.

Emotional concerns

Sometimes emotional issues, such as anxiety or depression, may create fatigue and/or low energy, and people living with diabetes are at risk for anxiety and depression. Anxiety or depression along with diabetes can be an unfortunate combination; I’ve seen a lack of energy lead to not doing the daily self-care tasks that diabetes requires.


Being overweight or obese can also play a role in low energy. People who carry extra weight may not have the energy to get out and do the things they enjoy.


The body’s natural response to stress is to release hormones that increase the amount of glucose in the blood. For people with type 2 diabetes, this rise in blood glucose can lead to decreased energy, as you read earlier. Not to mention, stress itself can be exhausting! It’s also important to note that taking care of diabetes – your own or someone else’s – can be stressful and energy-draining. (You can read more about stress and diabetes here.)

Jane K. Dickinson, RN, PhD, CDE* (@janekdickinson) is a nurse and diabetes educator in Northwestern Colorado. She is the program coordinator and faculty for the online Master of Science in Diabetes Education and Management program at Teachers College, Columbia University. She is also the author of People With Diabetes Can Eat Anything: It’s All About Balance. Dickinson is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.

*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.

© 2013 The DX: The Diabetes Experience

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