On the pump and feel exhausted

I don't know if it's just a coincidence, but I am just exhausted, and on a near daily basis. Like I want to pull the car over tired.

I didn't feel this way until after I started using a pump in December. Since then, my BGs are great, the best they've ever been. My HBA1C is between 6.0 and 6.2, for which I am grateful. When I tried to research the fatigue all the stuff that came up said that BG swings and uncontrolled diabetes caused fatigue, but I'm not uncontrolled. I don't think a "swing" from 108-121 should make me feel so tired. Or maybe I'm just getting older. Or stressed out.

it's probably the adjustment in your blood sugars. what was your A1C before pumping, if you're used to higher numbers, this could be the reason. if i run high for a while, my body gets used to those highs. i too can feel exhausted, and it's almost a feeling of being on some type of sedative or sleep pill for me, when my numbers turn 'normal'.

are you hypothyroid? Have you been checked for hypothyroid?
This is a very common comorbidity with diabetes. You need to be checked for FT3 and FT4 (not just TSH), and FT3 and 4 should be at least middle of the reference range, preferably a little higher. If below mid-range, thyroid meds may be required.

If not thyroid, get checked for anaemia.

May or may not be related to diabetes directly.

I had a similar problem, I just had the feeling that with a pump, my BGs need to be perfect and therefore i worked very hard and tested a lot to adjust my pump settings. I just thought this cannot be it. So, for a short period of time, i am back on MDI, and don't care as much and still have good control. We often forget the psychological aspects of being diabetic and doctors telling us that we have the tools to achieve great BG.
You can try to step back a bit from diabetes management and work a little less maybe, an a1c of 6.8 is still great and you wont have as much effort.
Just an idea, maybe it can help.

I thought of that too. Nope, no anemia and thyroid is fine. Both my mother and my grandmother have thyroid issues so I've been screened heavily for it for a long time.

I was about 7.1 before pumping, then when I got on the pump in December I went to 6.5 and then 6.2, where I've stayed. Your idea makes sense to me, but I hope if that's the case I wouldn't still be feeling like this after 9-10 months of pumping.

I DO recognize that I start to feel crappy at much lower numbers than I used to. When I was at my worst control, I would get to about 220 before I started feeling bad. Now it's about 165 when I feel like something's wrong.

I am sorry you are having these feelings of exhaustion. Are there any other things going on in your life that roughly coincide with going on the pump?

Depression, anxiety, stress (relationships, career, financial, etc) are certainly the "usual suspects". Could you be experiencing undetected lows? Lows regularly exhaust me and result in what I call "lost days".

Certainly 108-121 should not cause your symptoms, especially considering that a 13 point "swing" is in the range of error for any meter out there (IOW, they could be the SAME reading!).

I have spent the past three months researching this same topic. I am someone who is also too low on red blood cells so that is part of the problem. But I have found after doing all the thyroid tests, that JustLookin mentioned, I added in the antibodies and found they were all negative, so I am definitely not a hypothyroid person, but I had already done lots of research and found out there is a condition called Euthyroid or Non-Thyroidal Illness Syndrome NTIS.

So the two tests that did show a problem were….a very low, below range T3 and also above mid-range reverse T3 which happened because I am always dieting and don't eat a lot, so apparently the body creates more reverse T3 to slow down the metabolism. That is not good because I now have no energy to do any exercise, so that sounds a bit like you wanting to stop and rest.

You can look up the terms. It is a situation that does exist and it does not mean the person has a thyroid issue that is long term. There is a short term solution and I will be doing it for the next 2-3 months.

A very fast test you can do yourself is find out how much your temperature is in the morning before you even get up to go to the toilet. Mine has been in the 95-96 F range and the average for the middle of the day for a normal healthy person is 98.6. It would be normal if I were 98.2 on awaking, as temp does go down while asleep, but when I am 95.2 F like I was Aug 19th I was so tired I could not do anything. It means my temp is 3 degrees lower than it should be.

The body builder sites say that each 1 degree below the norm means a 13% reduction in metabolism. So I am therefore 3 degrees below what it should be which means my metabolism is 39% worse than it would be if I had enough T3 action actually happening, but the reverse T3 was nature’s way of trying to slow down the body in face of starvation. So I suggest at a minimum you should do repeated morning temperature checking. You might not be as badly off as I have been. You might be only 1-2 degrees lower, but that still creates fatigue.

And if you do get the TSH, FT3, FT4, above all don't forget to get a “Reverse T3 test”...insist on it...because lots of doctors say that is a dubious theory, but there are several doctors who do understand it. Believe me I have read on the topic for three months now trying to solve a likely similar fatigue problem. In Canada they do not offer the Reverse T3 test and I had to pay to get it done, just $35 but I insisted because I was reading about it….and it turned out to be precisely what my problem is.

So, don't worry it doesn't necessarily mean you have a hypothyroid problem that is long term. You might have all the symptoms, but if it is because of the terrible reverse T3 issue then that can be solved fairly quickly, and you could be back to normal in 2-3 months.

Things should be calmer now. I just got married, so no more bridal stress, and I just finished my master's degree, so no more school stress, and I just got a raise (linked to the new master's degree) so really, I should be less stressed than ever! That's part of why I waited to start asking questions. I figured a master's degree and a wedding were fatigue triggers from stress. That's why it's so odd.

Thank you. I'll definitely look into that and let you know how it goes!

Here is another factor that could cause lower T4 and hence lower T3 even being made, even though you maybe still quite able....Do you get enough fish and food that would have iodine in it? I know I avoid salt, so cannot count on the iodine in salt, and I had been scared off from buying tuna in tins after getting high mercury as a result of two experiments with 36 tins of tuna and then 20 tins of tuna and re testing for mercury and finding it higher, way back 12 years ago. For that there is a solution. Just mix in vitamin C into the tuna fish salad and that will act as a chelating agent for the mercury. So I take kelp tablets as I am not likely to start eating fish as I am not that much enamoured with it. But a person can't make enough thyroid hormone without the raw materials and the numbers in T4 and T3 refer to the iodine molecules on the thyroid hormones.

I would be really curious if you do avoid fish like I do. Anyway, I sympathize with the need to find an answer for fatigue….it really is not normal and there would be a reason.

I had also considered it to be due to the low red blood cells issue I have had for 12 years, that I am still working on and have more ways to improve it.

I had no idea about the reverse T3 issue until the past 3 months, even though someone here had mentioned it to me 3 years ago. I just did not get it tested until this year.

I recommend you consider seeing a neurologist for a sleep study. It could be unrelated to your diabetes. Even if you think you are sleeping, you could have a problem preventing you from getting restful sleep. There are many sleep disorders.

I was thinking the same thing as Kelly. I had a sleep study done in January and am now on a CPAP machine. It has made all the difference in the world.

It's curious that you say that. I've been on a pump for 13 years, but recently went through a long bout of rollercoaster BG's and thanks to a new endo, have been tightening up my control. My A1C has dropped from 7.1 (OK but bumpy) to 6.3 in just a few weeks. But I'm exhausted! And I'm suddenly feeling some neuropathy I've never felt before. So I wonder if it's like people say...you will feel worse before you feel better when going through the tightening process. I can only hope I'll feel better. Stress could certainly do it too, though. Are you sleeping OK? Do you know if you snore? I had undiagnosed sleep apnea for years, but never realized it because I didn't snore, and only diagnosed when I complained to my doc about being super sleepy all day like you say. Let us know how things turn out!

Check your vitamin b12. Pernicious anemia occurs when the body cannot absorb b-12 and use it properly. It is a co-morbid autoimmune disorder with type one. I had it in 2002, and was constantly so tired that when driving, I daily had to pull over to the side of the road and nap in the middle of the day, and was losing balance and falling, because I had no proprioceptive feedback in my legs or feet. I had tingling neuropathies and poor muscular control. It had nothing to do with my diabetes control, which was great at the time (5.7-6.0)I have never been that sick in my life; not before nor since. I eventually had to be hospitalized due to the multiple nerve problems and fatigue symptoms. At the time it was a "Dr. House" disease and no one could diagnosis it until I ended up in the emergency room unable to walk with no balance,thought by the head ER Dr. to have a " conversion disorder" ( Now girlie, it is all in your head); and finally the neurologist on call had them to check my b-12 levels, which had never been checked by anyof docotors in my 35 years of type one. PLEASE Get your /b-12 levels checked, please!!

God Bless,

When I was on a pump, I ran low A1Cs like that, but I was having major swings. I felt really bad. I got off the pump and try to run my A1Cs higher than that now. I don't like to get below 6.8 or 7 because I don't feel as well below that. That doesn't seem applicable to you, though. Are you all running that low these days? I know that's the trend - to try and push them down as low as possible. Anybody ever hit five-point-something?

These comments are well though out. Could be any of these things. Your not adult-onset, are you? You must be middle aged female if they are talking 'hypothyroid?' Is there a thyroid-type 1 correlation? For some reason, I always associate that with type 2. Totally could be associated with blood pressure. When I was working a stressful job for three years, my BP shot from 120/80 to 190/90. I felt so weak at times that I thought my heart wasn't pumping effectively. The old Docs didn't bat an eyelash at 190/90, though. Do you have blood pressure meds? Had the dosage adjusted lately?