Why Diabetes and GLP-1s Can Make You Tired

If you have type 2 diabetes and feel tired all the time, you’re not imagining it — and you’re not alone. Virta member Becky remembers feeling so drained that exercise felt impossible. Over time, her energy dipped even further as her weight, A1c and blood pressure climbed.

Diabetes and GLP-1 related fatigue has real, physical causes, often linked to blood sugar highs and lows, dehydration, sleep disruptions, inflammation and even medication side effects. Here’s what diabetes and GLP-1 fatigue can feel like, why it happens and the most effective ways to start feeling like yourself again.

What Does Diabetes Fatigue Feel Like?

Diabetes fatigue can manifest in different ways and can vary from person to person. Common feelings include:

• Trouble concentrating
• Difficulty exercising
• Low motivation
• Brain fog
• Heavy limbs
• Weakness

You may notice decreased energy if you:

• Don’t sleep well
• Eat a high-carb meal
• Miss a meal
• Change your medication dosage

Why Diabetes Causes Fatigue (Key Reasons)

Type 2 diabetes-related fatigue is caused by a variety of factors.

Blood Sugar Swings

Having blood sugar that’s too high or too low can affect your energy levels.

High blood sugar can leave you feeling tired because your body can’t use glucose efficiently. Additionally, you may become dehydrated from increased urination that can accompany high blood sugar.

Low blood sugar can also cause weakness, difficulty concentrating and low energy.

Insulin Resistance

With insulin resistance, your muscles, fat and liver don’t respond well to insulin, so glucose remains in your bloodstream instead of moving into your cells. This means there’s plenty of fuel in your blood, but your cells are under-fueled, leaving you fatigued.

Dehydration

If you have high blood sugar, you’ll have more glucose in your urine, which can cause more frequent urination. This can lead to dehydration, fatigue and headaches.

Poor Sleep Quality

Diabetes is linked with sleep problems, including sleep apnea. Poor sleep can worsen glucose tolerance and insulin sensitivity, creating a constant loop of fatigue.

Inflammation and Hormonal Changes

Type 2 diabetes often overlaps with having excess body fat, elevated stress hormones and low-grade inflammation, which can contribute to feeling run down. Improving your blood sugar levels and exercising regularly can help reduce inflammation in the body.

Nutrient Deficiencies

Long-term metformin use can reduce vitamin B12 levels, leading to fatigue.

Medications

Some diabetes and weight-loss medications list fatigue as a side effect. Others can cause insomnia, low appetite and gastrointestinal (GI) issues like nausea and diarrhea, which can indirectly lead to tiredness.

Can GLP-1 Medications Make You Tired?

Fatigue can occur with GLP-1 medication, most often early in treatment and during dose increases. This type of fatigue is often associated with reduced calorie intake, dehydration, GI side effects and changes in glucose levels.

• Ozempic (semaglutide): Side effects can include low blood sugar, dehydration and GI symptoms, which can contribute to low energy.
• WeGovy (semaglutide): Side effects that affect energy levels include fatigue, GI symptoms and low blood sugar.
• Rybelsus (oral semaglutide): Side effects can include GI symptoms, which can influence energy levels.
• Mounjaro (tirzepatide): Side effects can include GI symptoms, low blood sugar  and decreased appetite, which can contribute to tiredness.  
• Zepbound (tirzepatide): Side effects may include dehydration, GI issues and low blood sugar, which can lead to fatigue.
• Trulicity (dulaglutide): Possible side effects include fatigue, GI symptoms and decreased appetite.

Do Other Weight-Loss Medications Cause Tiredness?

Other diabetes medications can impact your energy levels too:

• Metformin: Fatigue is a possible side effect.
• Contrave: Potential side effects that influence energy levels include trouble sleeping and GI symptoms.
• Qsymia: Possible energy-impacting side effects can include trouble sleeping and increased acid in the bloodstream.
• Orlistat: GI issues are a potential side effect that can impact your energy.

How to Reduce Diabetes-Related Fatigue

There are several ways you can help reduce diabetes-related fatigue:

• Stabilize your blood sugar: Choose balanced meals that include protein, healthy fat and fiber.
• Stay hydrated: This is particularly important if you experience frequent urination, diarrhea or nausea.
• Prioritize sleep: Talk to your healthcare provider if you experience side effects that impact your sleep, such as nighttime urination, reflux and snoring/suspected sleep apnea. Aim for seven to nine hours of sleep per night.
• Move regularly: While it can be challenging to exercise when you’re exhausted, even short walks can help increase your energy and help your body process glucose after a meal.
• Review your medications and dosage: Talk to your provider if you notice fatigue after starting or increasing GLP-1s or other medications.
• Ask about vitamin deficiencies: It can also be helpful to talk to your provider about testing for vitamin deficiencies that can affect your energy levels.

[H2] When to Talk to Your Healthcare Provider about Fatigue

Contact your healthcare provider if you experience:

• Fatigue that’s sudden or severe
• Frequent low blood sugar
• Confusion
• Fainting
• Shortness of breath
• Chest pain
• Dehydration that doesn’t improve
• Possible sleep apnea symptoms, like loud snoring, gasping and morning headaches

The Takeaway

While diabetes can make you tired, the cause may be tied to a number of factors. Talk to your healthcare provider if you experience frequent fatigue to determine what can help you feel energized again.

If you are diagnosed with type 2 diabetes and want to live a healthier lifestyle, Virta Health may be able to help. By making healthy lifestyle changes in a medical setting with supportive resources like 1:1 virtual coaching, you can regain control of your health and feel like yourself again. See if you’re eligible for Virta Health here.