Tiredness and lethargy are associated with diabetes, but are usually due to uncontrolled blood glucose (sugar) levels. However there may be other causes of tiredness as in the rest of the population, and these include anaemia. Awareness of anaemia in diabetes is low, both among patients and health-care professionals. Yet if anaemia is diagnosed and corrected, the result can be a major change in quality of life. One cause of anaemia in people with diabetes is kidney disease.