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Diabetes and fatigue are often discussed as a cause and effect. In fact, if you have diabetes, you’re more than likely going to experience fatigue at some point. However, there may be much more to this seemingly simple correlation.

About 2.5 million people in the United States have chronic fatigue syndrome (CFS). CFS is marked by ongoing fatigue that significantly disrupts everyday life. People with this type of extreme fatigue use up their energy sources without necessarily being active. Walking to your car, for example, can zap all your energy. It’s thought that CFS is related to inflammation that disrupts your muscle metabolites.

Diabetes, which affects your blood sugar (glucose) and the production of insulin by the pancreas, can also have inflammatory markers. A wealth of studies have looked at the possible connections between diabetes and fatigue.

It can be challenging to treat both diabetes and fatigue. However, there are numerous options that can help. You may first need to see your doctor to determine the exact cause of your fatigue.

There are numerous studies connecting diabetes and fatigue. One such study looked at the results of a survey on sleep quality. Researchers reported that 31 percent of people with type 1 diabetes had poor sleep quality. The prevalence was slightly larger in adults who had type 2 diabetes, at 42 percent.

According to another study from 2015, about 40 percent of people with type 1 diabetes have fatigue longer than six months. The authors also noted that the fatigue is often so severe that it impacts everyday tasks as well as quality of life.

A 2013 study was conducted on 37 people with diabetes, as well as 33 without diabetes. This way, the researchers could look at differences in fatigue levels. The participants anonymously answered questions on fatigue surveys. Researchers concluded that fatigue was much higher in the group with diabetes. However, they couldn’t identify any specific factors.

Fatigue seems to occur in both type 1 and type 2 diabetes. A 2014 study found a strong relationship between hyperglycemia (high blood sugar) and chronic fatigue in people with type 1 diabetes.

Blood glucose fluctuation is often thought of as the first cause of fatigue in diabetes. But the authors of a study of 155 adults with type 2 diabetes suggested that blood glucose was the cause of fatigue in only 7 percent of participants. These findings suggest that diabetes fatigue may not be necessarily linked to the condition itself, but perhaps with other symptoms of diabetes.

Other related factors, often seen in people with diabetes, that can contribute to fatigue include the following:

Treating both diabetes and fatigue is most successful when regarded as whole, rather than separate, conditions. Healthy lifestyle habits, social support, and mental health therapies can positively impact diabetes and fatigue at the same time. Read one woman’s tips for coping with CFS.

Lifestyle changes

Healthy lifestyle habits are at the heart of good health. These include regular exercise, nutrition, and weight control. All these can help boost energy while also controlling your blood sugar. According to a 2012 study, there was a strong correlation to a high body mass index (BMI) score and fatigue in women with type 2 diabetes.

Regular exercise may decrease the risk for developing type 2 diabetes in the first place. But the American Diabetes Association (ADA) says that exercise can help blood glucose even if you already have diabetes. The ADA recommends a minimum of 2.5 hours of exercise per week without taking more than two days off in a row. You can try a combination of aerobics and resistance training, as well as balance and flexibility routines, such as yoga. Check out more on how diet and exercise can help you if you have diabetes.

Social support

Social support is another area of research being investigated. A 2013 study of 1,657 adults with type 2 diabetes found significant correlations between social support and diabetes fatigue. Researchers found that support from family and other resources decreased fatigue related to diabetes.

Talk with your family to make sure they’re supportive of your diabetes management and care. Make it a point to go out with friends when you can, and engage in your favorite hobbies when you have the energy to do so.

Mental health

Depression runs high in diabetes. According to the journal Current Diabetes Reports, people with diabetes are twice as likely to have depression. This can be caused by biological changes, or by long-term psychological changes. Learn more about the link between these two conditions.

If you’re already being treated for depression, your antidepressant might be disrupting your sleep at night. You can talk to your doctor about possibly switching medications to see if your sleep improves.

Exercise can also help depression by increasing serotonin levels. You may also benefit from group or one-on-one counseling with a therapist.

CFS is worrisome, especially when it interferes with everyday activities, such as work, school, and family obligations. You should see your doctor if your symptoms of fatigue fail to improve despite lifestyle changes and diabetes control. The fatigue could be related to secondary symptoms of diabetes, or another condition altogether.

Your doctor may order some blood tests to rule out any other conditions, such as thyroid disease. Switching your diabetes medications is another possibility.

Fatigue is common with diabetes, but it doesn’t have to last forever. Talk to your doctor about ways you can manage both diabetes and fatigue. With a few lifestyle and treatment changes, along with patience, your fatigue may improve over time.