
What Causes Fatigue In A Diabetic While On Metformin?

Unlikely
Detailed Answer:
Metformin is unlikely to cause only lower body weakness.
I see you have listed Januvia as one of his medications. Is he on this in addition to the weekly Trulicity injection? If so, it would be prudent to ask his doctor to consider discontinuing one of them as they act similarly. The standard practice is to prescribe one or the other.
The lower body weakness needs further assessment.
When I see someone like him in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)

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