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I am diabetic and having severe insomia. Diagnosed with congestive heart failure. Feeling weak . Concerned

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
I was in the hospital about 3 weeks ago for 5 days with diagnosis of congestive heart failure.

i am male diabetic and weight 287 pounds which is about an 9 pound loss since in hospital. 5 ft 10 in.

I take many medications including some to ease swelling in right foot and ankle.
Here is my question. The other day for 2 or 3 days I was completely weak and fatigued and was worried about this but now today, I am much better. Does it mean anything in particular when i get so weak and fatigued?
I forgot to mention I have severe insomia and can only sleep 1 to 2 hours then wake up with arthritus pains. But am used to this as I have had it for 50 years. I am age 71
Posted Sat, 28 Jul 2012 in Diabetes
Answered by Dr. Ketan Vagholkar 41 minutes later
Thanks for writing in.
From the description you have given there can be various reasons for the feeling of being tired and run down.
1. Congestice cardiac failure itself can cause decrease oxygenation to the different body parts thereby giving rise to a feeling of fatigue. Intermittent periods of relief are due to sudden spurts of improvement in oxygenation of tissues.
2. Diabetes causes a serious alteration in the majority of body metabolisms. It specifically alters the carbohydrate, protein and fat metabolism and the integration of these metabolisms. As a result energy substrates are not available to the body as per its differential requirements giving rise to fatiguability.
3. Age related arthritic changes cause mild inflammatory changes in the joints and can cause a sick or run down feeling.
4. Inadequate sleep due any cause is also a significant factor for easy fatiguability.
The repair processes of the body take place when one is asleep. Therefore less sleep can hinder the repair process causing a downhill course in the body metabolism.
5. A combination of the aforementioned factors coupled with age related shrinkage of the brain volume and function can also lead to dementia thereby decreasing the stimulus for the various body parts to function optimally.
Therefore to overcome this feeling you have to follow a strict protocol of medications and regularity of personal habits within restraints imposed by various medical problems for a better quality of life.
I hope this answers your querry.
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