Fatigue levels

[WoogieBoogie]

I'm a diabetic (since 2005) - LADA and last cpeptide suggests am still producing insulin. Am on lantus, gliklazide, empagliflozin, metformin.

Some days (and with no obvious pattern) my energy levels seem very low. I know plenty of diabetics who seem full of beans. Anyone else picked out patterns? I can only think that some days my insulin resistance is worse than others and my cells struggle to get the fuel they need.
Have a good weekend all

 

[rebrascora]

Do you test your levels when you feel fatigued? It may be that you are going high after meals and then taking a while to come back down. If my levels get above 10 (sometimes 8) exercise will be more difficult and I will feel like I have lead weights on my ankles. If you only have long acting insulin, it may be that your body is not able to produce enough insulin to deal with the glucose release from meals and your levels are going high and making you feel like that. If you do some testing, you should be able to spot if this is the problem and then request a fast acting insulin and drop the other medications. Really not sure why they have kept you on those if you are LADA. There seems a resistance to put people on a full basal bolus system even with small doses until their pancreatic insulin production conks out altogether, when you could be on small doses and learning how to manage it and taking the strain of your failing pancreas, rather than flogging it to death with Gliclazide and making your kidneys work harder with Empagliflozin as well.

 

[WoogieBoogie]

Do you test your levels when you feel fatigued? It may be that you are going high after meals and then taking a while to come back down. If my levels get above 10 (sometimes 8) exercise will be more difficult and I will feel like I have lead weights on my ankles. If you only have long acting insulin, it may be that your body is not able to produce enough insulin to deal with the glucose release from meals and your levels are going high and making you feel like that. If you do some testing, you should be able to spot if this is the problem and then request a fast acting insulin and drop the other medications. Really not sure why they have kept you on those if you are LADA. There seems a resistance to put people on a full basal bolus system even with small doses until their pancreatic insulin production conks out altogether, when you could be on small doses and learning how to manage it and taking the strain of your failing pancreas, rather than flogging it to death with Gliclazide and making your kidneys work harder with Empagliflozin as well.

Thanks for this. Yes I've been using freestyle 2 libre for last two weeks and sometimes it doesn't correlate (predicted hb1ac at 42 and keep sugars under 10). I think they're keeping me on tablets because ultimately they're keeping me "well" and avoids the inconvenience of multi day injections. Perhaps though that day is coming and could have the short acting in small doses to manage any spikes

 

[rebrascora]

All tablets have side effects and if there is no gain to the tablets but they could potentially cause you damage then they are not "keeping you well" Sometimes I think clinicians loose sight of this particularly when the alternative is insulin. They seem to think it is something terrible to protect people from when it is often better than the oral meds they are dishing out instead. For instance, if you have been on Metformin for a while, then your fatigue could be due to a Vitamin B deficiency because Metformin had prevent the body from absorbing Vitamin B12 from your food. An oral supplement will not improve things because again, the Metformin blocks it, so it may be that you need a regular injected dose of Vitamin B12 if you are deficient. It is worth asking what your levels are like or if they have been checked. Anaemia could be causing your fatigue as could any other number of ailments, so make an appointment and get it checked at with your GP. Not everything is linked to your diabetes, but it could be linked to your diabetes medication!

 

[WoogieBoogie]

All tablets have side effects and if there is no gain to the tablets but they could potentially cause you damage then they are not "keeping you well" Sometimes I think clinicians loose sight of this particularly when the alternative is insulin. They seem to think it is something terrible to protect people from when it is often better than the oral meds they are dishing out instead. For instance, if you have been on Metformin for a while, then your fatigue could be due to a Vitamin B deficiency because Metformin had prevent the body from absorbing Vitamin B12 from your food. An oral supplement will not improve things because again, the Metformin blocks it, so it may be that you need a regular injected dose of Vitamin B12 if you are deficient. It is worth asking what your levels are like or if they have been checked. Anaemia could be causing your fatigue as could any other number of ailments, so make an appointment and get it checked at with your GP. Not everything is linked to your diabetes, but it could be linked to your diabetes medication!

All fair points. Yep my B12 is normal and iron levels OK. Ferritin was rock bottom last summer but had an infusion ( - nothing sinister found after endoscopy etc so maybe absorption). I know what you mean about insulin.. having been on lantus for a few years I'm probably more receptive to having option to occasionally use fast acting insulin on occasion (eg big meal out). Thanks for replying - I certainly had considered that the raft of meds probably a contributory factor. I'm quite auto immuney as also on thyroxine (thyroidectomy in 2012)

 

[EmmaL76]

I can’t offer any insight because I’ve been battling this myself for the last 2 years. There is no pattern it doesn’t correlate with blood sugars (I’m also LADA) I’ve corrected my anaemia, I’m exercising everyday. I’m eating more food and am no longer underweight. I’ve had thyroid checked numerous times. For me it’s not just tired it’s chronic fatigue. Like I’m walking through treacle. Currently I’m having heart issues and am under investigation for those which may or may not be contributing. It gets me down, I usually wake up ok, and go downhill a few hours after that. Im chronically tired all day but pick up in the evening for a few hours. I can go out with family and sometimes when we get where we are going I can struggle to get out of the car! I know it’s not normal and it’s driving me insane. So although I cannot help, I can sympathise

 

[WoogieBoogie]

I can’t offer any insight because I’ve been battling this myself for the last 2 years. There is no pattern it doesn’t correlate with blood sugars (I’m also LADA) I’ve corrected my anaemia, I’m exercising everyday. I’m eating more food and am no longer underweight. I’ve had thyroid checked numerous times. For me it’s not just tired it’s chronic fatigue. Like I’m walking through treacle. Currently I’m having heart issues and am under investigation for those which may or may not be contributing. It gets me down, I usually wake up ok, and go downhill a few hours after that. Im chronically tired all day but pick up in the evening for a few hours. I can go out with family and sometimes when we get where we are going I can struggle to get out of the car! I know it’s not normal and it’s driving me insane. So although I cannot help, I can sympathise

That sounds challenging. If you have had all the physical checks it's worth also considering anxiety. It can manifest itself in odd ways and even if you don't consciously feel anxious you might be. You're relatively newly diagnosed and have had a lot to process /deal with. I completely sympathise - I try and go out for the odd run even though I struggle to keep going. Take care

 

[EmmaL76]

That sounds challenging. If you have had all the physical checks it's worth also considering anxiety. It can manifest itself in odd ways and even if you don't consciously feel anxious you might be. You're relatively newly diagnosed and have had a lot to process /deal with. I completely sympathise - I try and go out for the odd run even though I struggle to keep going. Take care

See that’s the odd thing about me, I run every day and I’m fine, even feel great afterwards. Anxiety has been a big problem for me in the past with a bit of PTSD and depression thrown in, recently though that has really lifted and I’ve felt mentally ok however this heart stuff set me back a bit. Thanks for your kind words. I wish you well xx

 

[WoogieBoogie]

Definitely worth speaking to your GP, especially around trialing on an anxiety med. Keep positive, you're doing great by running

 

[WoogieBoogie]

Worth also trying a bit of self hypnosis and mindfulness (eg headspace)

 

[EmmaL76]

Worth also trying a bit of self hypnosis and mindfulness (eg headspace)

Thanks … I have been on various meds. I’ve also had therapy / counselling where hypnosis was attempted. She would try every session to get me into a trance like state to do some kind of memory reversal is the only way I can describe it, she gave up because I could not clear my mind enough. My head is broken

 

[berryr99]

I'm a diabetic (since 2005) - LADA and last cpeptide suggests am still producing insulin. Am on lantus, gliklazide, empagliflozin, metformin.

Some days (and with no obvious pattern) my energy levels seem very low. I know plenty of diabetics who seem full of beans. Anyone else picked out patterns? I can only think that some days my insulin resistance is worse than others and my cells struggle to get the fuel they need.
Have a good weekend all

This is exactly where I am. Had this problem for the last 10 years and have no explanations (or interest from GP). I suspect I may be a bit depressed as strength isn't the problem - its the "get up and go" that isn't there.

 

[WoogieBoogie]

That's interesting and maybe is something thats a mix of physical and mental. Feels like a huge push most days to grind through the tiredness. Keep positive and make small short term plans for yourself (steps, less carbs, lower hb1ac). We'll get there