Findings. In patients with A1C less than or equal to 7%, fatigue was related to
diabetes distress and diabetes symptoms, but not to A1C directly or indirectly. In
the group with A1C greater than 7%, fatigue was indirectly related to A1C; this
relationship was mediated through diabetes symptoms, depression and diabetes
distress.
Conclusion. Our findings suggest that fatigue is indirectly related to glucose
control, but only in patients who have elevated A1C levels. In those with adequate
glucose control, fatigue is mainly influenced by the presence of diabetes symptoms
and distress. In both groups, the number and severity of diabetes symptoms were
the strongest predictors of fatigue, regardless of blood glucose control.