Fatigue in a person with diabetes may result from high glucose causing dehydration and inefficient energy use, or from low glucose related to treatment. Poor sleep, sleep apnoea, anaemia, thyroid disease, declining kidney function, infection, medicine effects, anxiety and depression are also common contributors.
It can help to record when fatigue occurs together with glucose readings, meals, sleep, medicines, activity and other symptoms. Persistent fatigue may require review of glucose control, blood count, kidney and thyroid function and sleep. Medicines should not be stopped because of tiredness without advice, and supplements should not be used merely to mask the cause.
TCM may provide supportive care based on appetite, thirst, sleep, bowel patterns and general wellbeing, but descriptions such as qi or yin deficiency do not replace investigation of treatable causes. Low glucose with sweating, shaking or confusion, or fatigue with chest pain, breathlessness or sudden weakness, requires immediate attention.
When fatigue relates to meals, activity or medicine timing, record the glucose level and how it was treated. Recurrent low glucose may require changes to dosage, meal timing or exercise planning. Repeatedly eating extra sweets to prevent it can make overall glucose control more difficult.
