Diabetes and the Night Shift Factor

Photo courtesy of Cleveland Clinic

Working irregular hours may increase type 2 diabetes risk

–By Marwan Hamaty, MD

These days, more people work night and rotating shifts, either in a primary job or in a second one.

That’s tough enough. Tougher still is that recent studies suggest night shift work may increase your chance of developing type 2 diabetes.

Studies also show you are at more risk if you are a rotating shift worker. A rotating shift worker not only works night shifts, but rotates shift schedules or works irregular hours outside of 8 a.m. to 5 p.m.

For people with diabetes, things are also more difficult. Many of my patients struggle to cope with their diabetes, and I know it’s hard to maintain a regimen of proper diet and exercise. Working odd hours only makes it harder.

Planning ahead can make all the difference in managing your risk factor and staying healthy.

How shift work can affect your health

Disrupting the body’s internal clock, or circadian rhythm, affects us in many areas including:

• Cardiovascular system
• Metabolism
• Appetite and food intake
• Digestion
• Immune system
• Hormonal balance

So considering all this, if you work odd or extra hours — or hours that are constantly changing — you need to be extra vigilant maintaining your regimen if you have diabetes or are at risk for developing it.

Diabetes Guides

2 tips to help you stay healthy

Here is what I suggest for patients who work rotating and night shifts:

1. Maintain 3 meals per day. Have meals or meal replacements on schedule even though your hours may be off. If you have diabetes, be vigilant in sticking to your diet. Make sure to maintain a proper balance of protein and carbs, low saturated fats and plenty of fiber. Rather than skipping meals, using meal replacement options like Glucerna® shakes can be very helpful. Packing your lunch or dinner is often a key to maintaining a healthy eating.
2. Adapt exercise to your work situation. To get your exercise in, take short walks during a break. Alternate steady walking with bursts of fast walking – varying speeds will increase the efficiency of your exercise. If you can, jog (again, alternating a steady pace with bursts) or have access to workout facilities and a treadmill, even better. Exercising frequently for short periods will add up — say, 10 to 15 minutes a few times a day. Aim to have at minimum 150 minutes of exercise per week, with the optimum at 300 minutes per week.

If you continue to be diligent with exercise, plan ahead for meals and get a reasonable amount (six to eight hours) of sleep, you can manage your risk. It’s a matter of adjustment; you can do it!

Medication help may be on the horizon

As of today, we have no medication that can overcome disturbed internal clock (circadian rhythm) per se. But there is hope on the horizon.

One diabetes medication, bromocriptin quick release, is thought to improve blood sugars by resetting your internal clock (at least, relevant to glucose metabolism). To achieve the desired benefit from this medication, it should be taken within the first two hours of waking up.

At this point, it isn’t clear whether bromocriptin quick release would be of specific help for people who work night shifts. However, this type of medication might pave the way for future research in defining better treatments for people with, or at risk to develop diabetes (especially those with pre-diabetes) among night shift workers.