Why Do Diabetics Lose Weight and Feel Weak?

why do diabetics lose weight and feel weak

Unexplained, rapid weight loss refers to an unintentional decrease in body weight in a short amount of time without any medical or lifestyle interventions.  While it is normal for weight to occasionally fluctuate a pound or two, if you’re experiencing sudden and rapid weight loss, it could be an early warning sign of diabetes.

Type 1 and Type 2 diabetics lose weight due to the lack of or insufficient insulin in the body. Insulin is the hormone that transports glucose from your blood to all body cells for energy production. Glucose is your body’s preferred source of energy, so lower levels of the hormone can make you feel weak and tired.

In diabetes, this process is hindered by insulin resistance or the absence of insulin production, resulting in elevated blood sugar levels.

Severely increased glucose levels often come with a host of symptoms, one being unexplained sudden weight loss, which can occur over a few weeks to a couple of months.

This is caused when insulin fails to carry glucose to body cells. When glucose builds up in the bloodstream instead of being delivered to the cells it signals to your body it is in a state of starvation.

Because your body believes it is starving, it looks for other ways to compensate, often creating energy by burning fat and breaking down muscle at a rapid rate, ultimately creating a dramatic drop in body weight.

This phenomenon is called sudden diabetic weight loss. In addition, your kidneys begin to go into overdrive trying to eliminate excess sugars in your blood through increased urination, resulting in a loss of calories. This also uses additional energy and can lead to kidney damage.

Rapid Weight Loss For Diabetics

Rapid weight loss becomes a concern when an individual loses ten pounds or more, or five percent of their body weight over a period of six to twelve months.  

When healthcare providers look for a reason causing an individual’s dramatic weight loss, especially in individuals aged 65 years and older, they find an underlying medical condition in 72% of cases. One of those medical conditions is diabetes.

Unexplained weight loss can occur in individuals with Type 2 diabetes but is more commonly seen in individuals with Type 1 diabetes.  In individuals with Type 1 diabetes, your body goes through a similar pattern, but instead of your body being able to use insulin, it stops producing it altogether.

Rapid, unintentional weight loss due to diabetes is often accompanied by other symptoms, including:

  • increased thirst or hunger
  • excessive urination
  • unusual fatigue or weakness
  • itchy or dark skin
  • increased infections and slow healing

Why Do Some Diabetics Lose Weight In Their Legs?

Weight loss localized to the legs in individuals with diabetes is known as diabetic amyotrophy. Diabetic amyotrophy is believed to be caused by a compromised immune system that leads to microvasculitis. Microvasculitis is a condition in which the tiny blood vessels that supply the nerves located in the legs are damaged.

The main signs of diabetic amyotrophy are:

  • Weakness in the lower legs, buttocks, or hips
  • Muscle wasting, typically in the front of the thigh
  • Pain, sometimes severe, usually in the front of the thigh but sometimes in the hips, buttocks, or back

While gradual, intentional weight loss in people with diabetes is typically a beneficial part of managing their diagnosis, unintentional weight loss is not.

People with diabetes who are experiencing high blood sugar levels and increased urination may result in dehydration, which is a possible cause of unintentional weight loss.  This can become dangerous to heart health and cause rapid muscle wasting, which causes unhealthy weight loss as well.

If you are experiencing significant unintentional weight loss, especially in association with other symptoms such as excessive thirst, increased urination, and/or unusual fatigue, it is critical to contact your healthcare provider as soon as possible.

Why Does Diabetes Make You Feel Weak (and tired)?

The two most common reasons people with diabetes experience weakness and lethargy are hyperglycemia (high glucose levels) and hypoglycemia (low glucose levels). In both cases, the lack of insulin hormone affects the body’s ability to get glucose from the bloodstream into the cells to meet energy needs, leading to increased tiredness.

This result of increased feelings of tiredness is known as diabetes fatigue. Diabetes fatigue isn’t necessarily linked to poor management of diabetes, but rather a symptom you gain from having diabetes.

While imbalanced blood sugar levels may be the most obvious cause behind diabetes fatigue, several other related factors can account for the increased feelings of weakness and tiredness, including:

  • Poor nutrition (deficiencies in essential nutrients can lead to fatigue)
  • Sleep apnea (affects and disrupts normal sleeping patterns)
  • Dehydration (caused by excessive urination)
  • Widespread inflammation
  • Hypothyroidism (underactive thyroid)
  • Low testosterone levels
  • Kidney failure
  • Depression (diabetics are twice as likely to develop depression than non-diabetics. Depression can disturb sleep cycles and affect blood sugar control.)
  • Medication side effects

What Does Diabetes Fatigue Feel Like?

Fatigue is a frequently encountered symptom in people with diabetes. It is often described as a feeling of extreme tiredness and exhaustion that does not disappear with rest or sleep.

It may be a symptom that appears in the early stages of diabetes or in compilation with other symptoms, such as rapid weight loss. Fatigue in diabetics may be exacerbated by a variety of lifestyle, nutritional, medical, psychological, and/or medication factors.

Symptoms of diabetes fatigue include:

  • a total lack of energy, or fogginess 
  • feeling down or depressed (mental fatigue)
  • the inability to perform simple, everyday tasks without a feeling of exhaustion

How Do I Control Diabetes Weight Loss?

The first step in managing unintentional diabetes weight loss is learning how to get your blood sugar levels under control.

If you are experiencing rapid weight loss, especially in the presence of imbalanced glucose levels, contact your physician or healthcare provider. By working with a healthcare provider, they will provide you with a treatment plan with guidance that is specific to your individual goal.

Diet, exercise, and other lifestyle changes may help some diabetic individuals control their blood sugar levels, specifically those who are not taking medications.

However, many individuals with type 1 diabetes, as well as some with type 2 diabetes, will find it necessary to take insulin or other diabetic drugs to help get their blood sugar levels balanced and under control.

Typically, once an individual gets proper diabetes treatment and normalizes their blood sugars, their unintentional weight loss will begin to stabilize.

How Do I Safely Gain Weight As a Diabetic?

To gain weight, an individual must increase their calorie intake. However, this needs to be done carefully, especially for individuals with diabetes. It is important to learn how to create a balanced diet and choose the right foods to avoid blood sugar spikes.

Here are some considerations when trying to safely gain weight as a person with diabetes:

  • For individuals that use insulin, ensure you are administering the correct amount that is suitable for your dietary habits and current weight
  • Avoid highly processed, high-carb foods like cookies and pastries, as they can cause spikes in blood sugar levels. These foods are also often high in calories but low in nutrients, and can lead to nutritional deficiencies, and therefore may worsen diabetic symptoms
  • Choose nutrient-dense, high-calorie foods like nuts, seeds, avocados, nut butters, brown rice, beans, oily fish, and granola
  • Increase your protein intake, it is essential for all body functions, including muscle building
  • Some high-protein foods include poultry, fish, eggs, lentils, and tofu
  • Limit caffeine, alcohol, and soda as they can suppress your appetite and lead to blood sugar spikes from their high sugar content
  • Drink more water, freshly squeezed juice with the pulp, milk, and smoothies

Lastly, meet with a healthcare professional, like a Registered Dietitian wto help you create a meal plan that consciously increases calories while also considering your overall nutrition needs and personal dietary requirements.

How Do I Control Diabetes Fatigue?

You may find it most efficacious to treat diabetes and fatigue together, rather than as separate conditions. Creating healthy lifestyle changes, gaining social support, and incorporating mental health therapies are key components that will synergistically impact diabetes and fatigue in a positive way.

One of the first recommendations for improving overall health and well-being is to eat right and exercise often. And when it comes to diabetes and fatigue, it’s no different.

While making lifestyle changes takes time and willpower, the long-term benefits are worth it. Maintaining a regular exercise routine and practicing healthy weight management can boost energy and help to control blood sugar levels.

How Much Exercise is Needed For Diabetics?

The ADA (American Dietetic Association) recommends a minimum of 2.5 hours of exercise per week without taking more than two days off in a row. Combine aerobic exercise, resistance training, and flexibility movements to keep your exercise routine interesting.

Learning how to eat right and getting proper nutrition is also pertinent because a poor diet can also be a leading cause of diabetic fatigue.

Work with your healthcare provider or meet with a Registered Dietitian to create a diet plan that helps manage diabetes and fatigue.

Building a strong support system is an important factor in any diabetes management journey. Friends and family can help ease some of the mental and emotional stress that comes with having diabetes and experiencing its many symptoms.

Researchers found talking with family members and building a support system to help you with your diabetes management can significantly improve symptoms.

Get your friends and family involved in activities and hobbies that interest you that also support your diabetes management plan, like going for walks, learning to cook healthier meals, or trying a new workout class.

Fatigue, depression, and diabetes tend to group together. In fact, diabetics are twice as likely to experience depression than non-diabetic individuals, so focusing on mental health therapies is vital.

Talking with a licensed therapist may be a helpful resource in lowering your risk of mental fatigue. Also, discovering an antidepressant that doesn’t cause sleep disturbances or insomnia might be another option that will work for you.

Exercise also helps depression by increasing serotonin levels and helps combat fatigue.

Tips to boost energy when dealing with diabetes fatigue:

  • Aim for 7 to 9 hours of sleep each night
  • Reduce or eliminate processed foods and sugar from your diet
  • Reduce alcohol intake
  • Drink caffeine in moderation
  • Try relaxation techniques, like yoga or meditation

When Should You Consult With Your Doctor?

If you are experiencing unintentional, rapid weight loss of ten pounds or more, or five percent or more of your usual body weight between six to twelve months, you should contact your healthcare provider immediately.

Your healthcare provider will be able to assess the cause of your weight loss and create a treatment plan for weight management with diabetes.

It is also advised to contact your healthcare provider if you are experiencing any excessive symptoms of diabetes such as fatigue, especially if your symptoms do not resolve despite lifestyle changes and diabetes management.

Other symptoms that warrant insight from your healthcare provider include extreme hunger or thirst, slow healing, and excessive urination.


How Is Rapid Weight Loss Related to Diabetes? (verywellhealth.com)

Unexplained Weight Loss and Diabetes – Cleveland Clinic

Article: Living with Diabetes: How to Manage Fatigue (bassmedicalgroup.com)

Diabetic Amyotrophy | Patient

Diabetes Symptoms: Sudden Weight Loss | Sutter Health

Diabetes Fatigue Syndrome – PMC (nih.gov)

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