Hi there and thanks for using HCM. Your symptoms; fatigue, low energy, requiring more effort to expand your lungs and the blood result; high blood sugar suggest a metabolic cause and possibly, a hormonal imbalance, that might have led to this condition. More information is required to help point you in the right direction: 1. Age? 2. Gender? 3. Weight and height / BMI to give a rough idea of how your metabolism is 4. Occupation? 5. What is your blood cholesterol and blood pressure like? 6. Any significant family history 7. Dietary preference i.e. vegetarian / vegan? 8. If female, any gynaecological issues? How is your menstruation like? 9. What is your nutrition like? If you are getting too much carbs, too little protein and vegetables, you need to take a step back and reconsider your diet. Processed foods and fast food are not good sources of nourishment. Insulin resistance and diabetes: Chances are you could be insulin-resistant (your body is no longer able to respond normally to insulin, thus it is unable to utilize sugar from your blood for energy) and are at great risk of developing diabetes. Low energy and fatigue is present in the prediabetes state. To be very sure, I would recommend you do fasting insulin levels, a sugar test (oral glucose tolerance test) and HbA1c. There is a lot that can be done to prevent the development of full blown diabetes. Losing excess weight, cleaning up your diet and exercising are great ways to combat insulin resistance. Supplementation may also help - consider going on a course of probiotics, get a good multivitamin and enough omega -3. If you are female, you are more likely to develop hypothyroidism which can lead to insulin reisstance and higher blood sugar, so I d consider testing the thyroid function fully (TSH, free T4 and free T3). Males may still have problems with the thyroid, though this is far less common. Hope my answer helps point you in the right direction towards wellness. Take care and good luck. Dr Shabnam