Why are diabetes patients prone to fatigue? What can be done to improve these symptoms?

Typical Symptoms of Diabetes-Related Fatigue

1. Poor sleep quality or insufficient rest, feeling tired even after long periods of rest.

2. Daytime drowsiness, especially noticeable in the afternoon.

3. A sense of heaviness and weakness that impacts daily activities.

4. Low mood, lack of motivation, and loss of interest in activities that were previously enjoyable.

Causes of Diabetes-Related Fatigue

1. Fluctuations in Blood Sugar Levels

Fatigue in diabetes patients is closely related to blood sugar fluctuations. Both hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar) can trigger fatigue.

• Hyperglycemia: When blood sugar is too high, food is broken down into glucose, but due to insufficient insulin secretion or insulin resistance, glucose cannot efficiently enter the cells, leading to elevated blood sugar levels. As a result, the cells lack the necessary energy supply, causing fatigue.

• Hypoglycemia: Low blood sugar is often a side effect of oral diabetes medications or insulin therapy. Rapid drops in blood sugar can also result in a profound sense of fatigue.

2. Symptoms of Diabetes

Typical symptoms of diabetes include frequent urination, excessive thirst, hunger, weight loss, and blurred vision. These symptoms may not directly cause fatigue, but when persistent, they can affect a patient’s mental state and lead to exhaustion.

For example, frequent nighttime urination can disrupt normal sleep, leading to pronounced daytime fatigue.

3. Diabetes Complications

Chronic complications of diabetes can also cause fatigue. For instance, advanced diabetic nephropathy (kidney disease) can lead to renal failure, resulting in constant fatigue. Diabetic neuropathy may cause discomfort and pain in the extremities, making it difficult to sleep at night and thereby worsening fatigue.

4. Adverse Effects of Medications

Many diabetes patients also suffer from hypertension, hyperlipidemia, coronary heart disease, and obesity, requiring multiple medications. Some of these medications may have fatigue as a side effect.

5. Mental and Emotional Factors

The incidence of depression and anxiety is significantly higher among diabetes patients than in the general population, and fatigue is a common symptom of depression. Long-term psychological stress, anxiety, or low mood can sap energy and worsen fatigue.

6. Obesity/Overweight

Overweight and obesity are common among type 2 diabetes patients and can contribute to fatigue in multiple ways. A sedentary lifestyle increases fatigue, and excess body weight means more energy expenditure during daily activities, leading to greater exhaustion. Obesity-related conditions, such as sleep apnea, can further disrupt nighttime sleep, causing daytime drowsiness and persistent fatigue.

1. Establish a Healthy Lifestyle

Healthy Eating Habits

• Control total daily caloric intake, and aim for about 80% fullness at each meal to avoid overeating.

• Focus on low glycemic index (GI) foods such as whole grains, vegetables, and fruits.

• Reduce intake of animal fats and sweets, control carbohydrate intake, and ensure balanced meals.

• Avoid consuming excessive high-sugar foods and maintain adequate hydration.

Regular Exercise

• Aim for 150–300 minutes of moderate-intensity exercise per week, such as brisk walking, swimming, cycling, or dancing.

• Exercise boosts metabolism, reduces insulin resistance, relieves stress, improves sleep quality, and enhances overall health.

• Diabetes patients should monitor blood sugar before exercising to prevent hypoglycemia and select exercises suitable for their physical condition to ensure safety and consistency.

Consistent, Adequate Sleep

• Maintain a regular bedtime and avoid staying up late, establishing a healthy daily routine.

• Aim for 7–9 hours of sleep per night and relax before bed, avoiding excessive caffeine or alcohol.

• Create a restful sleep environment.

Maintaining a Positive Mindset

• Understand diabetes to reduce anxiety and fear related to the disease.

• Cultivate hobbies, maintain a youthful outlook, and enjoy life’s pleasures.

• Express emotions to family or friends to relieve stress and avoid emotional buildup.

• Techniques like meditation, yoga, and deep breathing can help relax the mind and reduce anxiety.

2. TCM Therapies for Diabetes

From a TCM perspective, diabetes is considered a wasting and drying condition, linked to lung heat drying up bodily fluids, stomach dryness damaging fluids, spleen yin deficiency, and kidney yin deficiency.

The inability to properly use blood sugar is closely related to spleen and stomach qi deficiency, meaning the body lacks sufficient “dynamic energy” to convert excess blood sugar into usable energy, resulting in elevated blood sugar levels.

In TCM treatment for diabetes, blood sugar control is key, but improving spleen and stomach qi deficiency is also critical. Only by restoring sufficient body energy can more blood sugar be metabolized, leading to better insulin secretion stability.

Among TCM herbs:

• Eleutherococcus senticosus (Siberian Ginseng): Strengthens the body’s vital energy, improves mental clarity, supports kidney and spleen function. Its active compounds, eleutherosides, have blood sugar-regulating and antioxidant properties.

• Ginseng: Tonifies vital energy, strengthens the spleen and kidneys, generates fluids, and quenches thirst. It helps relieve symptoms such as thirst, poor appetite, and fatigue in diabetic patients. Ginseng also increases insulin sensitivity, helping to lower blood sugar levels.

• For patients with heat signs and symptoms like excessive eating and urination, TCM practitioners may prescribe Baihu Renshen Tang (White Tiger Decoction with Ginseng) to clear heat, generate fluids, relieve thirst, and reduce dryness.

TCM treatment is personalized, so it is recommended to consult with a licensed TCM practitioner for proper evaluation and individualized treatment.