Shift work, particularly night shifts, can be challenging for people with diabetes.
Changes in routine can present a number of potential difficulties from meal times to medication schedules.
In addition, varying shifts can affect your ‘body clock’ if sleep becomes disrupted which can lead to difficulties in controlling your diabetes.
Research suggests that night shifts in particular may increase the risk of putting on weight and developing type 2 diabetes
Shift work and diabetes management
Shift work can affect people with type 1 diabetes and type 2 diabetes in a number of ways. Factors such as the times you eat, stress and changes to your body clock can all be significant.
Shift work can alter the body’s circadian rhythms, internal body clocks that respond to natural daylight and darkness. Consequently, blood sugar levels can be affected: altering sleep times can lead to greater problems with hyperglycemia (too high blood sugar) and hypoglycemia (low blood sugar).
If you are susceptible to hypoglycemia, you should keep fast-acting glucose on you at all times and be aware of how to manage hypos at work
Changes in sleep or shift times can also affect when you feel hungry during the day. This can make it more challenging to eat healthily and avoid snacking on the wrong foods.
Shift work and the risk of type 2 diabetes
It’s all too easy for people not to be aware of the risks that stem from shift work.
When circadian rhythms are disrupted through shift work, short-term effects can include insomnia, while long-term effects may include obesity, type 2 diabetes and high blood pressure.
In 2012, Brigham and Women’s Hospital reported that disrupted sleep patterns increased the risk of obesity and type 2 diabetes ; and a 2014 Chinese study similarly observed that shift work was linked to a 37 per cent increased risk of diabetes
You can reduce these risks, however, by making healthy lifestyle changes
Healthy lifestyle changes
If you work shifts, there are some lifestyle changes worth making to improve your health.
Three key areas to maximise your health during shift work are: [287]
- Diet – meal planning and snacking
- Physical activity
- Sleep
Diet – meal planning and snacking
Shift work can be disruptive to mealtimes, which is likely to make meal planning more difficult.
This can increase reliance on ready meals and snacks that are typically high in carbohydrate and lacking in nutritional value.
It is healthier to prepare home-cooked meals in advance to ensure you are eating nutritious food. Planning meals days in advance can be useful so you’re not rushing to cook food in-between shifts.
Additionally, try to bring your own healthy snacks to work rather than buying something processed from a shop or a vending machine.
The Low Carb Program can help you prepare healthy meals and snacks that are favourable for blood sugar levels and keep you satiated throughout your shift.
Physical activity
Physical activity is beneficial for everyone, whether you have diabetes or are at risk of it.
Shift work can make it harder to stick to an exercise routine, but try to keep physically active as often as possible outside of work hours.
Physical activity is beneficial not just for blood glucose levels but is also good for the heart and for mental health.
Sleep
Working shifts can throw your sleeping pattern off track and can affect your quality of sleep. Disrupted sleep can affect sugar levels and too high or low sugar levels can also impact upon sleep.
Shift work can sometimes lead to an uncomfortably vicious circle developing. Getting good sleep and achieving good blood sugars can both help to stop problems occurring.
Shift work can sometimes lead to an uncomfortably vicious circle developing. Getting good sleep and achieving good blood sugars can both help to stop problems occurring.
Techniques to improve your sleep include:
- Avoid stimulants before bed: Drinking alcohol or caffeine, exercising, smoking and doing housework all have stimulating effects. If done before bed they can make it difficult to sleep
- Create ideal sleeping conditions: Make sure your bedroom is dark and free from noise; buying a sleep mask or ear plugs can make it easier to nod off
- Make your brain associate bed with sleep: Avoid using electronic devices before bed, such as your smartphone, iPad or TV as they can make your brain think it is daytime when it’s not. By dissociating bed with non-sleeping activities, your brain will naturally be inclined to drift off
- Practice relaxation and medication techniques: Techniques such as mindfulness can help improve your sleep quality
Your employer should accommodate you
If shift work is causing you problems with your diabetes management then your employer should accommodate your situation. For example, your employer might offer to alter your shift patterns, make shift times more regular or suggest a different role in the same organisation.
Insulin dosing
Frequent changes in routine can lead to problems with timing and dosing of insulin injections, particularly basal insulin, which could lead to inconsistent diabetes control.
If shift work is affecting your insulin management, you may need to raise this with your employer. They may be happy to put you onto a more regular shift so that you’re not having to regularly adapt to different routines.
Free health assessments
Employers must ensure free health assessments are offered to night workers, but workers do not have to accept this. Furthermore, stress levels of employees should be taken into account among night workers. [288]
