What is the possibly remedy for the tiredness/fatigue even if blood glucose level is fine?

[AndBreathe]

Pumper Sue
I try ask my GP about thyroid test. I don't think I have coeliac because I don't eat any medium carb foods such as bread, grain, etc. I always stick with a variety of low carb vegetables.

Thanks for your response.

I‘d second @Pumper_Sue ’s post related to unexpected sources of gluten. As a long term low carber I was astonished where it hid - for example, soy sauce, worcestershire sauce, cold drinks, and some bought pre-prepared vegetables.

I found going totally GF much harder than low carving, and GF has to be 100% GF. The odd little bit here and there really does matter.

 

[AndBreathe]

It is true that I have a lot of stress, I need more rest and sleep.

Definitely, more iron and try multi-vitamin tablets could help.

Thank you for your response.

Multi-vitamin tablets rarely have enough of anything to help if the person is deficient in anything.

Please have tests done to identify any deficiencies, the treat as required. For example, to keep my vitamin D in a very good place I take 4000iu a day. Holland & Barrett’s multivitamin has 200iu. That would be totally useless for me.

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[Inka]

I don't have Freestyle Libre yet but will get one soon. I use Humalog insulin (fast-acting during meal). Certainly, my blood sugar range is tight. Sometimes, it goes up and down.

I don't think I have coeliac because I don't eat any medium carb foods such as bread, grain, etc. I stick with a variety of low carb vegetables.

I am thinking the same about the vitamin B, iron and zinc. I eat very small amount of protein foods and other foods. I will try sort this out to see if it works.

Thanks for your response.

Is it just Humalog insulin that you take? No basal insulin? If so, that’s very unusual for a Type 1. You mention having Type 2 first - how did they diagnose Type 1? Did they say your original diagnosis was wrong? Did they do antibody tests and a C Peptide?

If you’re on insulin and Type 1, you should be able to eat a normal diet, including sufficient amounts of protein. Perhaps you’re just not getting enough nutrients, calories, carbs, protein, etc?

 

[rebrascora]

I totally agree with @Inka.

It sounds like you are probably a LADA (Latent Autoimmune Diabetes in Adults) which is a slow onset form of Type 1 often misdiagnosed as Type 2 in the early months/years. It would be useful if you could tell us a bit more detail about how your diabetes diagnosis came about and things like have you lost any weight and do you have much/any to lose.

Is there a reason why you just have Humalog. It is normal for a Type 1 to be given 2 different types of insulin a slow acting basal insulin which covers the glucose released into the blood stream by the liver which is a bit like a back up battery and provides glucose to fuel your vital organs when you have no food in your system. Then a quick acting insulin like your Humalog to deal with the food you eat.
On a low carb diet, you need to make up for the lack of calories and glucose that you are not getting from carbs by eating more fat and a bit more protein. This is because the liver needs to synthesize glucose from the protein and fat so that it can provide that trickle of glucose to help keep you functioning, especially if you are eating very low carb. The insulin is there to allow your body to access that glucose, so you need to give it enough food whether that is in the form of carbs and/or protein and fat to function and use enough insulin to allow it to do so.

As a Type 1 diabetic you should be offered Freestyle Libre sensors or other CGM on prescription. This would allow you to see what is happening to your BG levels in between meals and indicate if your levels are going high or low when you feel really tired and give an indication of whether the bouts of fatigue you feel may be linked to your diabetes or unrelated. Of course you could also finger prick and test your levels when you feel shattered and keep a diary of those results and how you feel and when the fatigue happened in relation to when you ate and what you ate as that info could all be helpful in trying to identify the problem. It really sounds like you are not getting the support you should have with managing your diabetes though from the information you have given us.

 

[void]

I'd get the tiredness thing. I was getting undetected (till libre2) overnight lows. Once bg performance was normalised, I got proper sleep and woke refreshed.

 

[void]

also be on the lookout for long covid

 

[s14ali]

What sorts of food do you eat? It may be that you’re not actually getting enough energy from your food. But yes everyone else has covered the things I would suggest asking your doctor to test for.

Well, I am trying to avoid any medium carbs but very limited. I eat a range of vegetable foods, varied small meats, and a combination of mixed nuts/seeds.

 

[s14ali]

Is it just Humalog insulin that you take? No basal insulin? If so, that’s very unusual for a Type 1. You mention having Type 2 first - how did they diagnose Type 1? Did they say your original diagnosis was wrong? Did they do antibody tests and a C Peptide?

If you’re on insulin and Type 1, you should be able to eat a normal diet, including sufficient amounts of protein. Perhaps you’re just not getting enough nutrients, calories, carbs, protein, etc?

I use Humalog - bolus for during mealtime and Levemir for overnight

There is no explanation how it shifted from Type 2 to Type 1. I assume that it was misdiagnosed. I recall that I felt unwell over the summertime in 2017 and contacted GP that metformin tablets weren't working, I had Anti GAD blood test and it revealed the positive - Type 1. I was shocked and it seems impossible. Not sure about C peptide but will discuss it with GP.

 

[Inka]

Being misdiagnosed as Type 2 when you’re actually Type 1 is more common than you’d think @s14ali The good thing is that you have the right diagnosis now.

Type 1 is a very different condition to Type 2. With Type 1, it’s the insulin that’s important - you aim to ‘be your own pancreas’ and inject appropriate amounts of basal and bolus (meal) insulin. While Type 2s might need to limit their carbs, Type 1s can eat a pretty normal diet. I do think you’re limiting your food and nutrients unnecessarily. If you eat something and your blood sugar goes up, that’s not the fault of the food, it’s simply because your insulin wasn’t quite right. A Type 1 could eat nothing but lettuce but if their insulin was wrong, they’d have high sugars. It’s not the food that’s the problem with Type 1, it’s the insulin. If your insulin is wrong, the most wonderful and perfect diet in the world won’t stop high sugars. What will is the correct doses of both types of insulin. We can eat a normal diet.

 

[s14ali]

I totally agree with @Inka.

It sounds like you are probably a LADA (Latent Autoimmune Diabetes in Adults) which is a slow onset form of Type 1 often misdiagnosed as Type 2 in the early months/years. It would be useful if you could tell us a bit more detail about how your diabetes diagnosis came about and things like have you lost any weight and do you have much/any to lose.

Is there a reason why you just have Humalog. It is normal for a Type 1 to be given 2 different types of insulin a slow acting basal insulin which covers the glucose released into the blood stream by the liver which is a bit like a back up battery and provides glucose to fuel your vital organs when you have no food in your system. Then a quick acting insulin like your Humalog to deal with the food you eat.
On a low carb diet, you need to make up for the lack of calories and glucose that you are not getting from carbs by eating more fat and a bit more protein. This is because the liver needs to synthesize glucose from the protein and fat so that it can provide that trickle of glucose to help keep you functioning, especially if you are eating very low carb. The insulin is there to allow your body to access that glucose, so you need to give it enough food whether that is in the form of carbs and/or protein and fat to function and use enough insulin to allow it to do so.

As a Type 1 diabetic you should be offered Freestyle Libre sensors or other CGM on prescription. This would allow you to see what is happening to your BG levels in between meals and indicate if your levels are going high or low when you feel really tired and give an indication of whether the bouts of fatigue you feel may be linked to your diabetes or unrelated. Of course you could also finger prick and test your levels when you feel shattered and keep a diary of those results and how you feel and when the fatigue happened in relation to when you ate and what you ate as that info could all be helpful in trying to identify the problem. It really sounds like you are not getting the support you should have with managing your diabetes though from the information you have given us.

You might be right about LADA.

Sure, I can tell you more about early diagnosis before type 1. When I had Type 2, I ate many low-carbs foods but still lost a lot of weight because of possibly metformin and limited carbs/protein as well. However, both blood test monitor at home and HBAC1 results were very good for 5 years. Then I tried to slightly increase the food carbs and protein to improve the health/body weight for another three months. But later, I felt ill and found out that I have Type 1. I assume that's probably why my pancreas had to work hard between metformin/insulins and large amount of food carbs then attacked the further cells within a pancreas. Or maybe misdiagnosis or LADA as you said.

Additionally, you and other diabetic people might be surprised about this one. I keep go to toilet, feel thirsty and sometimes feel tired when blood glucose level is between 5mmol/L and 7mmol/L. If above 9mmol/L, I feel like not need to go toilet or thirsty but mostly feeling hot. The symptoms are supposed to be opposite. It is happened to Type 2 and Type 1 as well. I talked to doctors/nurses and they were confused!

I was thinking about having two different insulins and already discussed it with specialist diabetes nurse but she suggested that one insulin should be enough. I try to contact them again. I will receive Freestyle Libre in a few weeks and hope it can help and will do the fingerprick to ensure if Libre is working and match the blood level.

 

[Inka]

I use Humalog - bolus for during mealtime and Levemir for overnight

I was thinking about having two different insulins and already discussed it with specialist diabetes nurse but she suggested that one insulin should be enough.

When we mentioned having two insulins that was because you gave the impression initially that you were only taking Humalog. However, you then clarified that you take Levemir too. The Humalog is a bolus/meal insulin and the Levemir is a basal/background insulin - bolus insulin plus basal insulin is a normal regime for Type 1s and what we were referring too when we said about taking two insulins. So you don’t need to ask your nurse because you’re already doing it 🙂 If you meant having two dose of Levemir instead of one, then yes you could ask about that.