Night-shift work is associated with poorer glycaemic control in patients with type 2 diabetes

J Sleep Res. 2017 Dec;26(6):764-772. doi: 10.1111/jsr.12554. Epub 2017 May 26.

Abstract

The circadian system plays a role in regulating metabolism. Night-shift work, a form of circadian misalignment, is associated with increased type 2 diabetes risk. This study aimed to determine if night-shift workers with type 2 diabetes experience poorer glycaemic control than non-shift workers. Patients with type 2 diabetes (104 unemployed, 85 day workers and 60 night-shift workers) participated. Sleep duration, sleep quality, morningness-eveningness preference, depressive symptoms and dietary intake were assessed using standardized questionnaires. Haemoglobin A1c levels were measured. Night-shift workers had significantly higher haemoglobin A1c levels compared with others, while there were no differences between day workers and unemployed participants (median 7.86% versus 7.24% versus 7.09%, respectively). Additionally, night-shift workers were younger, had a higher body mass index, and consumed more daily calories than others. Among night-shift workers, there were no significant differences in haemoglobin A1c levels between those performing rotating versus non-rotating shifts (P = 0.856), or those with clockwise versus counterclockwise shift rotation (P = 0.833). After adjusting for age, body mass index, insulin use, sleep duration, morningness-eveningness preference and percentage of daily intake from carbohydrates, night-shift work, compared with day work, was associated with significantly higher haemoglobin A1c (B = 0.059, P = 0.044), while there were no differences between unemployed participants and day workers (B = 0.016, P = 0.572). In summary, night-shift work is associated with poorer glycaemic control in patients with type 2 diabetes.

Keywords: Thailand; sleep apnea.

MeSH terms

  • Adult
  • Age Factors
  • Blood Glucose / metabolism*
  • Body Mass Index
  • Circadian Rhythm / physiology
  • Depression / complications
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diet
  • Energy Intake
  • Female
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Shift Work Schedule*
  • Sleep / physiology
  • Surveys and Questionnaires
  • Time Factors
  • Work Schedule Tolerance / physiology*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A