Fatigue in Adults with Type 2 Diabetes: A Systematic Review and Meta-analysis

This review aimed to evaluate the level of fatigue in adults with type 2 diabetes measured by the validated Diabetes Symptom Checklist (DSC)and related factors. Ten studies were included. Both DSC (n = 4) and the revised (n = 6) have been used to measure fatigue. When the latter was used (n = 1082), the pooled level of fatigue was 1.77 (on a 0–5 scale). When the former was used (n = 674), the pooled level of fatigue was 1.73 (on a 0–10 scale). Participant demographics (e.g., gender), health information (e.g., BMI), and diabetes-specific factors (e.g., A1C and diabetes distress) were associated with fatigue. Fatigue was negatively related to self-care behaviors. The prevalence of significant fatigue remains unclear due to a lack of a cut-off point of the instrument. Future research is warranted to identify the threshold for clinically significant fatigue and investigate the causal relationship. Nurses are recommended to perform a routine assessment of fatigue.