Hello,

Thank you for choosing DoctorSpring.

I would like to know some additional details from you so that I can provide a solid and learned opinion.
You can reply as a followup

1. When was Diabetes diagnosed ?
2. What is usual Fasting and Post prandial blood sugar level ? Also HbA1C levels ?
3. Have you done any blood tests for this ? If so please share.
4. Do you have any chest pain, breathlessness on exertion ?
5. How is your sleep during the night ? Do you snore ? Do you feel out of breath anytime ?


Thank you

Thank you for the reply.

There seems to be no obvious cause for this fatigue symptoms for last 12 months. But with few investigations and a step by step approach I hope diagnosis can be reached.

The stomach pain is suggestive of a Acid Peptic disease or stomach ulcer. I feel you might have tried some anti ulcer medication also. I recommend an OTC anti ulcer medication like Prilosec once a day. This has to be taken just before sleep, without any food for 14 days.

The most common causes of the symptom set - trouble to wake up. easily fatigued by evening and stomach pain - is depressed mood and/or anxiety and/or stress. You will be the best person to judge this. Stress anxiety is one of the most common cause for the stomach ulcer also. Let me know if there is a history of depression , stress or anxiety.

If not the 3 causes I mentioned above the next step would be a comprehensive investigation. These are the set of investigations required. Many of them you might have done.

CBC
ESR, CRP
Liver function tests
Renal function tests
Thyroid function tests
Urine Creatinine ration
Urine routine
S.Calcium
Vitamin D levels
H Pylori breath tests

I would recommend you to take up a moderate aerobic exercise plan for 40 minutes five days a week. If you the reports of above mentioned blood tests please share.

Hope this helps
Thank you