Researchers from the University of Illinois College of Nursing measured the blood sugar levels of 83 diabetic women over the age of 40, and also asked them general questions about their health. Instead of shifting blood sugar levels being linked with fatigue—as is often assumed by doctors—other factors, like depression and BMI, were shown to be greater indicators of whether women felt constantly tired. More from Prevention: The Problem With Being Tired All The Time “People have always assumed blood sugar is the cause of fatigue,” says lead study author Cynthia Fritschi, RN, PhD. “It really isn’t. Stress, depression, sleep—all of these play a bigger factor in fatigue than blood sugar or blood glucose.” Here’s the problem: Being tired makes you less likely to do what you need to do to keep your diabetes in check, like exercising and eating healthy meals. And doctors don’t typically pick up on these lifestyle issues. “People want to know why they’re lacking that get-up-and-go, but doctors don’t ask how are you feeling? how are you sleeping? how is your daytime activity?” says Fritschi. Here’s how to make sure your fatigue is being addressed: Be specific. When discussing symptoms with your doctor, state the outcome as well, says Fritschi: Because I’m tired, I’m not able to do x, y and z. “It helps your doctor see that your fatigue is not just a symptom; it’s keeping you from taking care of yourself.” Take your own health inventory. “Think of the things you can control,” says Fritschi. “What’s your diet and level of physical activity like? Are you going to bed at a regular time? Are you skipping meals?” If you’re running into problems in any of these areas, bring it up with your doctor. Consider therapy. “People with diabetes are constantly being judged. There’s a lot of stigma,” says Fritschi. If dealing with diabetes is causing you anxiety, stress, or depression—all of which can contribute to fatigue—a trained therapist can help you work through it. More from Prevention: Are You Bummed Out, Or Depressed? Pay attention to sleep. Fifty percent of people with diabetes are at risk for sleep disturbances, Fritschi says. It goes without saying that lack of sleep makes you tired, getting more sleep can be a challenge. See the best ways to get more with these 20 Ways to Sleep Better Every Night.