Dr. Ahmed
Diabetes Weakness in the legs can be due to several reasons. One of the earliest complications of diabetes is diabetic neuropathy which primarily affects the legs.
Other causes of diabetes weakness can be due to a deficiency of vitamins, and minerals, infections, hormonal problems, inactivity, stress, and many more.
Treatment of diabetes weakness is aimed to identify and correct any underlying condition that could be causing the symptoms of weakness and fatigue.
Secondly, appropriate advice on a healthy and balanced diet along with physical activity is all that is required by most patients.
However, initiating a change in life such as regular physical activity and dietary intervention is sometimes difficult for the patient.
It’s always better to start slow and gradually improve. The results are then long-lasting and easily sustainable.
Don’t fear moving slowly forward, fear standing still
Treatment of diabetes weakness is aimed:
- control blood glucose
- control complications of diabetes
- identify concomitant illnesses that may be causing weakness
- choose medicines that do not cause weakness
- add supplements such as neurobion and vitamin B12.
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A Brief Overview of Diabetes Weakness and Fatigue:
Diabetes mellitus, a major public health problem, has affected a great number of the world’s population and the numbers are increasing so rapidly that it has been named an epidemic.
Among the other comorbid conditions of hypertension, CVD, renal impairment, and neuropathy, diabetes is also responsible for weakness, fatigue, sexual dysfunction, and depression.
Although fatigue is also commonly seen along with other diseases, it is of greater importance among patients with diabetes.
It may be caused due to an imbalance in blood sugar levels or as a result of stress, depression, or physical inactivity.
Fatigue and tiredness may appear similar but both are different because tiredness is relieved after taking rest but when a person has fatigue, he gets persistent feelings of exhaustion and lethargy.
When fatigue is left untreated, there is a high risk of negative effects on a patient’s behavior. A patient with persistent fatigue is more likely to avoid all the management techniques of the disease.
Although fatigue is a manageable condition it requires a well-informed patient and supportive health care professional.
Tiredness is relieved after rest, fatigue is not
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What is Fatigue?
Definitions of fatigue vary greatly. This word is often used for terms like sleepiness, tiredness, exhaustion, and lack of energy.
Fatigue is commonly physical or mental exhaustion that is triggered by stress, medication, workload, and mental or physical illness. It can be acute or chronic.
Acute fatigue is a protective mechanism that signals the body’s need to take rest. Chronic fatigue is mostly caused due to an underlying health problem, it is persistent and tends to continue despite rest.
Chronic fatigue is referred commonly to as “unrefreshed by sleep” or “unresponsive to rest”.
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Why Fatigue is Common in Diabetes Patients?
Fatigue in diabetes is most common and is due to multiple factors including:
Glucose Metabolism
One of the reasons behind fatigue in diabetics is the physiological factors which include alteration in blood glucose levels.
This altered glucose metabolism may result in episodes of hyperglycemia or hypoglycemia. These glycemic irregularities and their associated conditions are linked with an increased incidence of fatigue in diabetics.
Various types of research conducted on people with type 2 diabetes suggest that acute hyperglycemia has a greater association with fatigue than chronic hyperglycemia.
And it is more commonly present with increased fasting blood sugar levels, a high BMI, and female gender.
Fluctuations in blood glucose levels that occur both in type 1 and type 2 diabetes cause oxidative stress which in turn is associated with feelings of tiredness and fatigue.
Diabetes-Related Long-Term Complications
The long-term complications related to diabetes are associated with fatigue. Diabetes is the main cause of end-stage renal disease (ESRD).
Renal impairment causes anemia which results in increased fatigue. Diabetic patients undergoing dialysis show greater symptoms of fatigue than non-diabetic patients.
Neuropathy, another major complication of diabetes mellitus increases the risk of fatigue. Peripheral neuropathy causes physical inactivity and physical fatigue.
Inadequate blood supply to the extremities deprives the tissues of oxygen and other essential nutrients along with impaired waste removal.
These factors add up to infection risk, reduced physical activity, and poor substrate utilization which contribute to weakness and fatigue.
Diabetes and emotional distress
Diabetes-related emotional distress is a field of psychological and behavioral disturbances seen in diabetic patients with complications. This is related to the stress that patients experience in the management of diabetes.
Many researchers have directly linked this distress to fatigue. When diabetic patients do not get positive results from their efforts at managing diabetes, they may experience negative effects and lack of accomplishment which over time changes to distress and emotional fatigue.
Does your lifestyle affect you?
People often forget the impact of their lifestyle on their health. Lifestyle affects diabetics in many ways and it has a great association with fatigue.
The major two factors that have a great influence on fatigue are Body Mass Index (BMI) and physical inactivity.
Body Mass Index
Obese and overweight individuals are associated with higher levels of fatigue.
With increased body weight there is an increased risk of inflammation and pro-inflammatory cytokines are secreted at greater levels, these play a major role in an increased level of fatigue among overweight and obese individuals.
Physical activity
Physical activity has an inverse relation to fatigue. The more a person engages in physical activity, the less he is at risk of developing fatigue.
Physical activity has been shown to improve aerobic capacity, enhance metabolism, improve mental health, and regulate muscle mass.
It has been noted that individuals who were exercising had no fatigue symptoms and cessation of physical activity resulted in greater levels of fatigue and emotional distress.
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Treatment of Diabetes Weakness With Diet:
A nutritional intervention to combat fatigue involves the intake of energy-boosting foods.
These foods are part of a balanced diet and promote the overall physical and mental well-being of an individual. No single food product can treat tiredness and fatigue.
Those high-energy-boosting food products and medications are a myth because there is no evidence that a single food can provide an energy boost. This all lies in balance, moderation, variety, and nutrient density.
Fatigue and tiredness often have a great impact on eating habits and appetite. Some people have increased food cravings yet, others quit eating and skip meals when they are fatigued.
Eating at regular times keeps the blood sugar levels in control, which keeps fatigue and tiredness away.
A good breakfast:
People often tend to skip breakfast as skipping breakfast seems the easiest way to save time. A patient with diabetes needs to have a proper breakfast to keep blood sugar levels normal.
Skipping breakfast can cause acute hypoglycemia which is associated with fatigue. Quick, easy, and nutrient-dense breakfast recipes include:
- Cereal with yogurt and fruit
- Oatmeal or porridge
- Sliced boiled eggs, a glass of milk, and brown bread
- Brown bread with peanut butter and Fruit
- Omelet with chapatti
Carbohydrates
Although diabetics need to carefully monitor their carbohydrate intake, carbs are a great source of energy and an appropriate portion of complex carbs in their diet can help in reducing fatigue.
Complex carbohydrates are slow-burning and they tend to sustain blood sugars, without an adequate amount of carbohydrates a person feels tired.
Complex carbohydrates include whole grains, brown rice, oats, wheat, etc. The high sugar snacks including chocolate bars increase blood sugar levels that leave a person more fatigued.
So, fruits and vegetables must be added to snacks rather than food products that increase blood sugar levels.
Fats
Unsaturated fat consumption is linked to a reduced risk of complications and obesity. Diabetic patients must include poly and monounsaturated fatty acids in their diet.
Saturated fats are associated with weight gain and increased BMI which is directly associated with increased levels of fatigue.
Saturated fats tend to increase cholesterol resulting in cardiovascular disorders, with increased complications management becomes difficult, and the patient experiences emotional distress and fatigue.
Protein
Carbohydrates and fats provide energy to the body while protein regulates the release of power.
Proteins assist the growth and maintenance of cells, transport vitamins and minerals, and build up muscle mass. Protein deficiency can lead to weakness which contributes to fatigue.
Diabetics should consume a protein-rich diet to keep themselves strong and active. Some rich protein sources include:
- Seafood
- Eggs
- Yogurt
- Milk
- Beans and pulses
- Meat and poultry
Food and drink to avoid
Some foods that worsen the symptoms of fatigue and weakness include:
- Processed foods contain high levels of sugar and salt that interfere with the normal management of diabetes. Diabetics must avoid processed and canned food products.
- Caffeine-free drinks must be used to regulate energy levels.
- Patients must quit alcohol.
- Quit smoking.
- Refined carbohydrates should be restricted due to the low nutrient density and very low fiber content found in them.
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Fatigue and erectile dysfunction in Diabetes Patients:
Erectile dysfunction is the most neglected complication of diabetes mellitus and it was thought to be inevitable.
This misconception was also caused due to men’s naturally reluctant behavior toward discussing their sexual problems with healthcare professionals.
Awareness among patients regarding ED has now made its treatment successful. Men with diabetes are at a greater risk of developing erectile dysfunction.
The risk of Erectile dysfunction is 50% higher in men with diabetes than in those who do not have diabetes. Men may develop ED at some time in life but men with diabetes develop ED 5-10 years earlier than others.
Erectile dysfunction is mainly due to poor circulation to the penis, Emotional stress, and impaired nerve supply to the penis, diabetes contributes to all of these factors directly or indirectly.
The two main diabetes-related causes are:
Damage to blood vessels
Diabetes is a condition in which blood sugar levels are alleviated which means more sugar is present in the bloodstream which can damage small blood vessels.
This leads to many problems like kidney damage, loss of vision, poor blood supply to the peripheries, and poor blood supply to small blood vessels in the penis leads to erectile dysfunction.
Damage to the nerve supply
High blood sugar levels interfere with nervous coordination, and an altered nerve supply makes the erection harder.
Treatment
Some preventive measures that reduce the risk of developing erectile dysfunction include
- A good glycemic control
- Proper management of hypertension
- Reduced alcohol consumption
- Abstinence from smoking
Once Erectile dysfunction has developed, Sildenafil is often prescribed for the treatment of ED, however, the use of such a drug is still controversial due to the side effects it causes.
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