Chronic Fatigue Common in T1DM

Patients with comorbidities or depressive symptoms were more often fatigued than those without….

Researchers investigated the prevalence and impact of chronic fatigue in T1DM patients and compared those results to a matching control group. The study also aimed to find potential determinants of chronic fatigue. Chronic fatigue is defined as persisting for at least 6 months and leading to impairment of daily function. Acute fatigue can vary during the day and does not cause functional impairment.

From a Dutch diabetes clinic database, 214 patients with T1DM were matched to a group of controls. The participants were given a questionnaire to assess chronic fatigue, functional impairments, current health status, comorbidity, diabetes-related factors, and fatigue-related cognition/behaviors. HbA1c levels and comorbidities were confirmed with medical records. The fatigue subscale of the Checklist Individual Strength was used to assess the severity of fatigue over the previous two weeks. A group of participants were asked to take part in a separate substudy where glucose levels were continuously monitored for 5 days. Mean glucose, glucose variability, time spent in hypoglycemia, and time spent in hyperglycemia were analyzed.

Results show that 40% of T1DM were chronically fatigued compared to 7% in the matched controls. This shows that chronic fatigue is a part of diabetes, but why? T1DM patients with comorbidities or depressive symptoms were more often fatigued than those without comorbidities (55 vs. 36%). Patients with other diabetes complications were also more chronically fatigued than those without. Fatigue was the most troublesome symptom on a list of 34 assessed diabetes related symptoms. Being younger, having relevant depressive symptoms, more pain, sleeping problems, lower level of physical activity, and self efficacy were showed to be predictive of having chronic fatigue. No significant difference in glucose levels was seen between the two groups on chronic fatigue, and none of the four parameters were associated with acute fatigue either. While the results clearly show that chronic fatigue is highly prevalent in T1DM, blood glucose is only weakly associated at most.

• Fatigue was the most troublesome symptom amongst T1DM in this study.
• In this group, if T1DM, nearly 40% were chronically fatigued compared to 7% of the matched control population.

Diabetes Care, January 2014

Goedendorp, M. et al. Chronic Fatigue in Type 1 Diabetes: highly Prevalent but Not Explained by Hyperglycemia or Glucose Variability. Diabetes Care;37(1):73-80. January 2014.