Extreme tiredness

[richwiltshire]

Hi

I was diagnosed with diabetes in late May of this year.  I am slim build and 34 years old and I was originally thought to be type 1 however my GAD results were negative and as I only require about 6 units of slow acting insulin (insulartard) a day my health care team now think I am type 2.  My problem is with extreme tiredness.  

Since a few days after diagnosis I have been suffering with extreme tiredness which has been getting worse and now I can't even work.  I was tired in the months (and years) before diagnosis however this feels very different.  It is like my gas tank is empty and I feel wiped out often after only a few chores or similar.  My blood glucose levels are relatively stable and within limits.  My doctor has run tests for thyroid and anemia plus others and they have come back as negative. She now says that there are no other tests she can run.  My diabetes team say they can't help as my blood glucose levels are normal.  

At diagnosis my A1C was 12.8% and although my diet had been moderately healthy it was very carb heavy, possibly about 70% of more of my diet..  Now my carb intake is much lower at about 30%.

Does anyone have any ideas on what might be causing my tiredness?  I would be very grateful for any suggestions I could investigate.

best wishes

Rich

[richwiltshire]

Thanks again both. I have started to feel better in both mind and body.

Chickaboom,
It is reassuring to see your comments on adjusting to new blood sugar levels.    I quite agree.  My experience has been very similar.   I've researched the B complex vitamins and started to take one daily. It has certainly helped.

Waverider,
I've certainly had most of those test but am going to request a c-pep test when I see my diabetes team next weeks.

I'm very grateful for your time and advice.  It has most appreciated.

best
Rich

[WaveRider]

"I'm not sure what a TSH, T3 and T4 readings are."
Thyroid test results. If your thryoid is misfiring it will affect how this gland converts the food we eat into energy for the body. One common symptom is fatigue and weakness.

The C-peptide looks to see if your pancreas is producing the correct amount of insulin. It helps to determine if you have autoimmune disorders too. If so, your pancreas insulin production will be affected.

"My blood sugar levels are around 100-110 mg/dl before a meal and around 126-144 mg/dl after.  They've been like this for most of the time since my diagnosis in late May"
Impossible if your A1c was 12.8%. One of these results is incorrect. Which one? Get another A1c. Your home meter may be out of calibration.

Have you tested for Hepatitis A, B and C? Hep C can live dormant in your body as long as 30-35 years, then rear its life threatening ugly head by attacking the liver.
Has your liver been tested? AST and ALT enzymes?
Have you had your kidneys tested? Creatinine Kinase?
Irregularities with any of the above can and will produce sudden and overwhelming fatigue and weakness. Not mild but slam your butt down fatigue /exhaustion.

[ChickaBoom]

Something is wrong. You need help. Your doctor knows how bad you are feeling and has nothing to offer?  If so, have you got a generalist you can go to?  Sometimes it is better to see someone who takes everything into consideration and not just one piece.

My best guess is that you body isn't happy with your new "normal" blood sugar. You were probably running a high blood sugar for a long time and your muscles - and I include your brain as a muscle - got use to the high level. When the level was dropped to "normal" you muscles felt like they were being starved. (People with longterm high blood pressure have to have the blood pressure lowered gradually or the kidney and brain can shut down since they reset for the high levels. I think blood sugare is a lot like this too but doubt a medical person would agree. I base it on how I felt the week I went from a high blood sugar to a normal level - all the medical people were real pleased with my numbers and me - I couldn't think my way out of a paper sack or exercise for more than a minute. And, it took over 3 months for me to feel normal. I just kept smiling and trying not to worry because I was assured I would feel better soon. I finally did but I think it was because I made some changes in what I was doing.)

It takes time to readjust but I would think 3 months is long time to feel this way. Sounds like something else is involved. I am wondering about other things such as B12 deficiency. Your diet sounds like you are a vegetarian. Are you getting your B12 supplement. If so, is there any reason to think you can't absorb it such as age over 50, previous stomach surgery,,,,

I take a B complex because I read a lot of information on diabetes and decided it was prudent for me to take a good B complex. I do feel better when I take it. I just switched to Solaray's Mega B-Stress because it was what the store had in time release.

I hope you find an answer for this.

[richwiltshire]

Thanks both Chickaboom and Waverider for your prompt responses.

To clarify a few points:

Chickaboom,

- I am only on insulin no medication.  I was put on Glibenclamide by my doctor which I took for a day but it had no effect on reducing my blood sugars.  Thats when my diabetes health team put me on insulin.  I questioned my diabetes consultant (the most senior level physician) on medication and he said that as I was neither insulin resistant nor over-weight there wass no medication that was appropriate.

- I am both mentally as well as physically exhausted.  I would have posted sooner but I've found it difficult using a computer recently.

- I am interested in the complex B vitamin you take. Which one do you take and why specifically do you take it?  I had my diet analyzed by a nutritionist shortly after I was diagnosed who said I was deficient in Zinc and magnesium and I've changed my diet to compensate.  My protein intake is sufficient.

Waverider,

- The GAD (Glutamic Acid Decarboxylase) test I was referring to came back negative.  There were no antibodies in my pancreas or islets. (I think that this was two tests altogether.) It was after this test that it was thought that I was type 2 rather than type 1. I've not had a c-pepetide test yet but intend to request one.  I'm not sure what a TSH, T3 and T4 readings are.

- My blood sugar levels are around 100-110 mg/dl before a meal and around 126-144 mg/dl after.  They've been like this for most of the time since my diagnosis in late May.  Very occasionally if I am eating out and misjudge something they go up to 162 mg/dl post meal. In the last few weeks due to my inactivity they have begun to creep up slightly on my regular levels but not by significant amounts.

- I am following a low GI diet and keep up with the latest research on what to eat.  In addition to my good carbs I eat lots of salad and vegetables (which I grow myself) plus beans and lentils etc. I eat porridge for breakfast, pasta for lunch and quinoa for dinner for my carbs.

- I was diagnosed in late May but I was likely diabetic since November 2008 since thats when I started feeling rough and losing weight.  I lost about 10 pounds in that time and am now around 130 pounds.   My BMI is 19.

Thanks again.

[WaveRider]

Further information is needed. Please answer the following questions.
Which GAD test did you take?
a. Generalized Anxiety Disorder - mRNA
b. Glutamic Acid Decarboxylase - 65 and 67
What was the GAD test result number?
What was your TSH reading?
What were your T3 and T4 reading?
Have you had your C-peptide tested?
Have you had an Insulin Antibodies (IAA) test?
Have you had your pancreas tested?
Provide test results and ranges too.

Several times you state your glucose is normal. How can that be if your A1c is 12.8%. Fact: an A1c of 12.8% equates to a daily glucose average of 360.8 mg/dl. Normal fasting is 70-99 mg/dl. Plain and simple, your glucose level is not normal but jacked up.

What kind of carbs make up the 30% daily intake? Good or bad?  Google search "good carbs vs  bad carbs" so you understand what to eat and what not to eat. Your diet appears to be unstable.

You should see an Endocrinologist, a doctor who specializes in diabetes for further evaluation.

[ChickaBoom]

It could be your body needs time to adjust to the lower level of blood sugar - it is like it needs to reset its thermostat but looks like you have been having this problem for 3 months? - I would think your body would be starting to adjust. Is your brain working OK? I would think if it was a problem with your body cells needing to reset you would also be having problems with thinking and problem solving.

Are you only on insulin and not an oral medication also such as Metformin? Sometimes it is the medication itself - even the  type of insulin. Your doctor didn't have anything to suggest for the tiredness?

Are you eating enough protein? Should be 1 gram for every 2 grams of carbs. (Plus, I take a complex B vitamin - slow release.)  Maybe go out to a site like http://www.fitday.com/ and enter what you are eating. Keep up with it for a couple of weeks and just see if any deficiencies are showing up....