I am 45 years old, and I have had type 2 diabetes for 12 years now treated with three diabetes medications as well as insulin. I also take pills for high blood pressure and high cholesterol. My problem is that I am overweight and very tired all the time. What can I do to decrease the exhaustion level so that I can increase my activity level to help me lose weight?

Speak with your doctor about possible causes for the level of exhaustion that you are feeling. Be sure that he or she understands the degree of your symptoms, and ask that an answer be sought.

You don’t say what your hemoglobin A1c levels are, or how your overall control is, but poor control of diabetes can certainly be one cause of exhaustion. However, there are many other causes (including thyroid disease and sleep apnea), and some of the medications used to treat high blood pressure may cause excessive fatigue. Exhaustion can also be a symptom of heart disease itself. Ask your doctor to discuss these issues with you. Finding the answer as to “why” there is so much exhaustion will put you on the road to addressing it.

As long as there is no medical reason for your level of exhaustion, you may find that getting some regular exercise and gradually increasing your activity levels actually help to energize you. Think about what time of day you have the most energy and, if possible, make that your exercise time. You may need to start with just 5 or 10 minutes of activity (for example, walking) and repeat this three to five times during the course of a day. Exercising with a family member or friend may help to keep you motivated and committed to the process. Don’t forget diet and nutrition in this process as well.

DMW