Fatigue is among the most common symptoms of diabetes, alongside symptoms such as weight loss, blurry vision, and frequent urination. Some people are so affected that they’re diagnosed with diabetes fatigue syndrome.

Even if you don’t experience extreme fatigue, you may be tired more often if you have type 1 diabetes (diabetes mellitus), or fatigue may have more significant effects on your life than it would if you didn’t have that diagnosis.

Here’s what you need to know so you can understand fatigue and manage it. That way, you can keep your quality of life high and your sense of well-being strong.

How Do People Living With Type 1 Diabetes Experience Fatigue?

On myT1Dteam, people talk a lot about feeling tired. One person summed up many people’s experiences when they commented, “So exhausted today. But again, I am exhausted every day!”

Several members tie their fatigue to type 1 diabetes, like one who said, “Very tired. Plus, blood glucose has been in the 200s since last night. Head hurts, my eyes just want to close!” Another shared, “I sometimes feel like people don’t know how having a blood sugar episode can cause you to feel bad for hours after. I’m exhausted today.”

Some people experience fatigue alongside body aches and pains. “Having one of those days. Blood sugars are OK, just having body aches and really tired,” one member explained. Another added, “The fatigue and body pain is disheartening.”

For some, fatigue interferes with daily lives and plans: “Feeling tired today. Had plans to get housework done but have accomplished only a little.” Others find that daily tasks bring on fatigue. “Totally fatigued after grocery shopping,” someone shared.

Fatigue can interfere with healthy sleep patterns, too. “I’ve been in and out of sleep all day, probably because my body was exhausted,” a member said. Another asked, “Anyone else tired all the time but also have trouble falling or staying asleep or waking up early and not being able to go back to sleep?”

These comments align with research findings on fatigue and type 1 diabetes. In a 2020 study, 40 percent of 214 people with type 1 diabetes said they experience fatigue, compared with just 7 percent of people without that diagnosis.

Understanding fatigue and how to manage it with type 1 diabetes could help you feel better, participate more in daily life, and improve your sleep, too.

Does Type 1 Diabetes Cause Fatigue?

Type 1 diabetes may cause fatigue for many reasons.

Blood Sugar and Energy

Blood glucose levels likely contribute to how tired a person feels. Hyperglycemia (high blood sugar) may interfere with how your body uses sugar for energy. Basically, there’s not enough insulin to transport the sugar to where it’s needed in the body. If you don’t have enough energy, you may end up feeling fatigued.

Hypoglycemia (low blood sugar) can also cause fatigue. If there’s not enough sugar in your bloodstream, there’s nothing for the insulin to transport. Your body doesn’t have what it needs to produce the energy that will make you feel less tired.

More research needs to be done to understand these connections better. In some studies, the links between blood sugar levels and fatigue aren’t strong, so people living with type 1 diabetes may be tired for reasons that go beyond blood sugar readings.

Blood Sugar and Sleep

People diagnosed with diabetes are also more likely to have problems sleeping than those who don’t have the condition. You or your child may have trouble sleeping when blood sugar is high, either because it disrupts sleep or because a monitor goes off and wakes you. Having to urinate more often than usual due to type 1 diabetes can interrupt sleep, too. Type 1 diabetes may also cause nerve damage, called neuropathy, resulting in leg pain, as well as a tingling or burning sensation, that can keep you up at night.

Nerve damage from diabetes can also affect the digestive tract and cause diarrhea, especially at night, awakening you multiple times. If you wake up with a headache at night or in the morning, you may have experienced low blood sugar. Having low blood sugar at night can also determine poor sleep quality.

Stress Levels and Mental Health

Finding out that you're living with type 1 diabetes, then putting a lot of effort into tracking and managing it, can be stressful and may keep you awake at night. In fact, stress may cause more fatigue in people who are living with type 1 diabetes than blood sugar levels do, though more research is needed to confirm this.

People with type 1 diabetes are nearly twice as likely to also be diagnosed with depression, which may or may not be tied to stress levels. Either way, depression itself can cause you to feel tired or fatigued.

What Else Causes Fatigue in Type 1 Diabetes?

Even if you or your child has been diagnosed with type 1 diabetes, it may not necessarily be the reason for fatigue. It’s important to investigate all possible causes with your health care team so you can figure out what is going on with your body.

Other possible causes of fatigue include:

• Infections
• Thyroid problems
• Anemia or low iron (even without anemia)
• Chronic kidney disease (which also causes anemia)
• Grief
• Chronic fatigue syndrome
• Chronic pain
• Celiac disease
• Cancer
• Obstructive sleep apnea (disrupted nighttime breathing due to blocked airways)
• Central sleep apnea (caused by improper brain signaling to muscles that control breathing)
• Insomnia or poor sleep quality
• Regular drug or alcohol use

Several other conditions can result in fatigue, too. Some medications, like allergy drugs or steroids, may also cause fatigue. Type 1 diabetes medications aren’t generally associated with fatigue.

How Is Fatigue Related to Type 1 Diabetes Managed?

If you're experiencing fatigue, whether or not it’s type 1 diabetes-related, you can take a few steps to manage it.

• Engage in regular exercise or physical activity, which can improve your mood and energy levels.
• Consider cognitive behavioral therapy. One study showed this approach may help reduce fatigue in people with type 1 diabetes.
• Monitor your blood sugar, and work to keep it from going too high or too low.
• Reduce stress by taking time to relax, balancing work and home life, and resolving hard situations.

It’s important to note that stimulants like caffeine aren’t usually effective at reducing fatigue. Instead, you need to find out the source of your fatigue so you can pinpoint an effective way to treat the root cause.

Talk to Your Doctor About Fatigue

If you or your child is feeling fatigued and you aren’t sure why, talk to your health care provider right away. They may be able to help you figure out what’s causing it and if it’s tied to type 1 diabetes. You can then get treatment so you can have more energy again soon.

If you and your diabetes care team determine that type 1 diabetes is likely causing fatigue, you can talk about changing your carbohydrate intake or your medication levels. Don’t do this on your own unless you have permission and direction from a medical provider.

Your doctor may want you to test your blood sugar more often, specifically first thing in the morning and throughout the night as needed. It may help to get a continuous glucose monitor and connect it to an insulin pump so you can monitor or maintain glucose levels without waking up.

Find Your Team

On myT1Dteam, the social network for people with type 1 diabetes and their loved ones, more than 3,200 members come together to ask questions, give advice, and share their stories with others who understand life with type 1 diabetes.

Are you wondering if the fatigue experienced by you or your loved one is related to type 1 diabetes? Do you have tips for managing fatigue? Share your experience in the comments below, or start a conversation by posting on your Activities page.