When insulin levels are very low (as in diabetes),

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Insulin is responsible for allowing glucose to enter cells, particularly muscle and fat cells. When insulin levels are very low, such as in diabetes, glucose cannot enter cells efficiently which leads to high blood glucose levels. The glucose that does enter cells is used up quickly, leaving very little for energy production. This may result in feelings of fatigue and weakness. The brain, however, largely depends on glucose for energy and may not function optimally in low glucose conditions. Many cells will resort to using alternative sources of energy such as ketones in the absence of glucose, but this is not as efficient as using glucose.

When Insulin Levels Are Very Low (As in Diabetes)