Bouts of sleepiness, especially after meals, are some of the most common and disabling symptoms of diabetes. However, there are many causes of lethargy, besides diabetes. So how do you know whether you have diabetic lethargy and, if you do have it, what can you do to combat it?
Many diabetics feel, at times, extremely tired, fatigued or lethargic. Having periods when you feel so exhausted that you can only prevent yourself from falling asleep with great difficulty can seriously disrupt your daily life.
This tiredness can be caused by blood glucose levels that are too high or too low. But it can also be due to a dozen or so other causes such as stress, overwork, lack of a good night’s sleep and so on.
The glucose-insulin system
Glucose, a simple sugar, is your body’s primary source of energy. In fact, your muscle cells need glucose all the time so you can talk, walk, run, read a book, think etc.
When your food is being digested, glucose is released from your stomach into your bloodstream and carried to your muscle cells. At the same time, insulin, a hormone (type of chemical), is released into your bloodstream from your pancreas.
Insulin is needed to enable the glucose to enter your muscle cells. To do this, the insulin attaches itself to receptors in the surface of the cells and causes the cell membranes to allow glucose to enter. The cells then use the glucose as fuel.
Of course, if the receptors in your muscle cells are blocked by fat, the insulin will not be able to open them.
This is the essential problem faced by type 2 diabetics and is the reason why the only way to beat your diabetes is to eat an extremely low-fat diet designed to unblock the cell receptors.
Causes of diabetic lethargy
Two common reasons for tiredness or lethargy are having blood sugar levels that are too high or too low.
High blood glucose makes your blood ‘sludgy’, which slows your circulation so your cells cannot get the oxygen and nutrients they need, giving you a groggy, drugged feeling.
On the other hand, when your blood sugar is too low, there is not enough fuel for the cells to work properly, so you feel jaded.
Blood glucose levels go high when your pancreas is not producing enough insulin (such as when you have type 1 diabetes) or your insulin is not working effectively (as in type 2 diabetes).
In both cases, the sugar in your bloodstream cannot get into your muscle cells so these cells do not receive the energy they need. The result is tiredness.
Either way, you need to confirm that your lethargy or extreme tiredness is in fact caused by blood glucose levels that are too high or too low and not due to some other cause. To do so, all you have to do is test your blood using your home glucose tester when you become tired unexpectedly.
Having bouts of fatigue after meals indicates that you are eating too much carbohydrate or that the carbohydrates you are eating have high glycemic index (GI) values, ie they are digested very quickly and lead to a rapid, high rise in your blood glucose level.
The solution is to reduce the carbohydrates you are eating and/or change to low GI carbs. But when your blood glucose levels are too low, you need to take in more carbohydrate to provide your body with the energy it needs.
Other medical causes of intense fatigue
Diabetes is not the only cause of bouts of sleepiness. In fact, there are more than 15 known causes for fatigue, and too high and low blood glucose constitute only two of these causes.
Other medical conditions that cause fatigue include:
- anaemia, or low red blood cell counts
- thyroid problems
- low testosterone levels, especially in men
- undiagnosed heart disease
- side effects of medications for various medical conditions
There are at least seven other medical conditions that can cause extreme tiredness.
These medical conditions should be investigated by your doctor if you experience bouts of fatigue when your blood glucose levels are ‘normal’, ie neither too high nor too low.
Non-medical causes of extreme tiredness
There are also many not-entirely medical reasons why you can feel fatigued:
- Lack of sleep or poor sleep
- Rotating shift-work (messes with your body clock and disrupts your sleep)
- Depression (common among diabetics)
- Doing too much and not taking breaks
- Eating too much carbohydrate, especially refined carbs
- Drinking too much caffeine (causes fatigue through a rebound effect)
- Not drinking enough liquids
- Lack of exercise (resulting in weak muscles)
You are certainly able to exert some control over most of these factors except for the last item. Here’s what you can do.
Six (6) Tips for beating diabetic fatigue
You can beat diabetic fatigue by doing the same things, more or less, that you could do to beat your diabetes. These are:
 a diabetes beating diet
 staying hydrated
 vitamin supplements
 regular exercise
 treating sleep apnoea
 avoiding caffeine
 Diabetes-beating diet
The first thing you must do is eliminate all sources of fat as far as possible. Only by minimising your fat intake will you be able to unblock the receptors in your muscle cells and enable your insulin to do its job of getting glucose into the cells.
Minimising the fat in your diet entails eating a plant-focused diet of natural, unprocessed food. If you eat meat you must choose only the leanest cuts and you must exclude all eggs as well as dairy products. Get your protein from leans sources such as beans, tofu, fish, or skinless chicken breasts.
Your diet also needs to be low in sugar. This means not adding sugar to your tea and coffee, and avoiding all sweetened processed foods. You should concentrate on healthy carbohydrates from fruits, vegetables and whole grains.
About 85% of diabetics also suffer from abnormally high blood pressure, which is affected by an excessive intake of salt, and their risk of blood pressure related diseases such as heart disease and strokes is greater than non-diabetics who have issues with their blood pressure. Thus you diet must also be low in salt.
Fibre, both soluble and insoluble, is necessary to beating diabetes and diabetic lethargy because, among numerous other benefits, it slows the rate at which sugar is absorbed and makes you feel satiated quicker, so you don’t overeat. Thus your diet also needs to be high in fibre.
Foods that are high in fibre also have low GI values, ie they are digested slowly. Eating foods that are digested slowly is vital in order to avoid sugar rushes, ie rapid rises in your blood glucose that peak at high levels soon after you eat, thus causing diabetic lethargy.
As well as eating food that is low in fat, low in sugar, low in salt and high in fibre, with low GI values, you need to eat smaller meals but more often.
Avoid big meals with nothing in between and instead concentrate on a steady trickle of carbs over the course of the day, to keep your blood sugar level steady.
 Staying hydrated
You can become fatigued if you are dehydrated, so you also need to drink plenty of water. Aim for two to four litres a day in the form of water, juice, tea, coffee and soy milk. As well as helping your tiredness, this will help you absorb the fibre you eat.
 Vitamin supplements
You should also take a full range of quality dietary supplements in order to cover any possible dietary deficiencies you might encounter by avoiding eggs and dairy products (a major food group).
The B vitamins are especially important as they help preserve the health of you nerves. If you have diabetic nerve problems, such as diabetic neuropathy, make sure you’re getting these micro-nutrients. B vitamins will help you get your energy back and mitigate your diabetic lethargy.
 Regular exercise
It seems like a bit of a conundrum, but the more you move, the more energy you get. People who take a brisk, daily 30-minute walk are less tired than idle people.
Choose an activity you like, whether walking, gardening, tennis or swimming. Do it for at least 30 to 60 minutes a day. If you can’t spare that much time all at once, break it up into shorter (10-minute) periods of exercise that add up to 30 to 60 minutes a day.
 Treating sleep apnoea
Many people with diabetes briefly stop breathing abruptly and briefly several times at night. This sleep apnoea, as it is called, interrupts their sleep.
Symptoms include snoring at night, waking up with a headache or sore throat, feeling sleepy during the day and having trouble concentrating.
Sleep apnoea can be treated. And doing so will give you more energy during the daytime.
 Avoiding caffeine, especially late in the day.
Caffeine can keep some people awake and disrupt their sleep, though it has never had this affect on me. It can also make it harder to control blood sugar levels, if you overdo it.
Thus, if caffeine has an adverse effect on you, you should avoid it, especially in the evenings, to get a good night’s sleep.