Fatigue

Hi,
I was diagnosed as a T2 in 2005. I will be 60 in November.

A couple of months ago, I began taking Lantus and Novalog. Prior to that, my A1C was TERRIBLE. For the first time, at least since my diagnosis, I have obtained tight control. I'm very excited by that, but I'm disturbed that I'm still very, very tired, and that I still can get sleepy after meals.

I would appreciate any comments or advise. Thank you.

-Kathi

Hey Kathi:

Have you had your thyroid checked? Hypothyroidism often goes hand in hand with diabetes and is not uncommon even in non-diabetics as they age. An under performing thyroid will leave you very sluggish and tired.

Christopher

Hi Chris,
That is a good suggestion. I haven't had my thyroid checked in a number of years. I think it is time I had it checked again. Thanks!
-Kathi

For me, post meal sleepiness often equates to out-of-range blood glucose levels. I get tired and full of yawns when my blood glucose is low or high, especially if it's climbing quickly.

If you share these symptoms with me, it will be easy to check and see it it may be causing your drowsiness. Eat a meal and then do a fingerstick check at mealtime and every 30 minutes thereafter out to four hours post-meal. Do this for at least three meals at different times of day before you draw any conclusions.

On rare occasion, I will consume some extravagant treat, like a chocolate milkshake. There's no way I can effectively dose insulin to stay up with that radical of a post meal food spike, but I try nonetheless. As my blood sugar rises and accelerates after my decadent treat, I usually feel overwhelmingly drowsy and all I want to do is climb in bed and close my eyes. This despite having adequate sleep overall.

It's just a thought. I wish you the best in solving this puzzle. Your curiosity is healthy; I only wish doctors would strongly follow-up on these kind of symptom reports. I guess there are not enough hours in the day for them.

Hi Terry,
Thank you for your suggestion-- I’ll try it. I’ve only been doing 2-hr posts,and they have been fine. For example, my fasting BG was 84 mg/dL this a.m., my post breakfast was 115 mg/dL, and my post lunch was 97 mg/dL. Perhaps I’m going higher than I realize after eating. I’ll check it out.
Kathi

I get the extreme tiredness with eating and I know it is due to fluctuating blood sugars and makes me crazy and mad!!! Today I had a small salad and stayed in range. Bottom line it is all about what we eat and how we dose and time insulin correctly. As always moderation is key, but............ I have a lot of tired lunches as that is when I struggle the most with carbohydrates and the times on the weekends when I eat out. So it sucks and I eat a lot of salads.

Kathi - Your post-meal numbers are superb! I wouldn't suspect you have symptoms like I described above. I hope you find the answer you're looking for.

Hi Karen,
I know exactly what you mean. Prior to the insulin, I would get so discouraged. The insulin is helping me, but I’m restricting my carb intake to limit the amount of novalog I need to take. I find that with bread, milk, and fruit I have to cover 15 g with two units. I’ve been avoiding pasta, rice, and potatoes, and I have only eaten out once since I started the insulin. Work has been a nightmare because everyone keeps trying to feed me donuts and the like. I’m terrified I’m going to cave at some point.
Right now, I just take it one day at a time.

Hi Terry,
I did what you suggested after dinner:
30 min post 118 mg/dL 6:10 pm
1 hr post 149 mg/dL 6:40 pm
1.5 hr post 149 mg/dL 7:10 pm
2 h post 123 mg/dL 7:40 pm
I am going up a little higher than I would like at the one hour mark. I find that using insulin is more of an art. I’m still trying to master it.
-Kathi

Your numbers are what I pray for everyday. I think I am tired because if I go high and/or low after a meal I tend to stay there for a long time, therefore creating the fatigue factor.

I understand. This is such a difficult disease to manage.