Approximately 8.3 percent of the U.S. population has diabetes and many of these are shift workers. Working a night shift is part of many jobs, and it can lead to a higher pay and other advantages. However, night shift work has been shown to be a risk factor for health problems. It is important for a person with diabetes to plan the time and content of meals and snacks when working a night shift and to alter medication timing to accommodate a new sleep--wake schedule.
Diabetes
Diabetes is a group of diseases that is characterized by the body's inability to produce or use insulin. According to the American Diabetes Association, 25.8 million Americans had diabetes in 2011. Common complications of diabetes include cardiovascular disease, blindness, kidney disease, nervous system diseases and amputation. The ADA states that adopting a healthy diet, increasing physical activity and maintaining a healthy weight are positive steps toward reducing the risk of developing diabetes.
Night-Shift Work
According to a report by the U.S. Bureau of Labor Statistics, in May of 2004, 27 million full-time workers had flexible work schedules, and 14.8 percent of all full-time wage workers worked a shift other than daytime, and 4.7 percent worked an evening shift, 3.2 percent worked the night shift, and the remaining percentage worked irregular or rotating shifts. Researchers at Brigham and Women's Hospital in Boston have investigated the health risks of shift work and found that shift work is associated with an increased risk of obesity, diabetes and cardiovascular disease. The increased risk is possibly related to the adverse metabolic and cardiovascular effects of chronic misalignment of the circadian rhythm. The circadian rhythm is the body's internal regulatory center linked to the day's light-dark cycle.
Considerations -- Type 1 & Type 2
A Type 1 diabetic who requires insulin injections must adjust his injections to accommodate changes in his work schedule. It may be easier to take a long-acting insulin and then cover meals with a rapid-acting insulin to allow for irregular meal times. A physician or diabetes educator can assist with meal planning and adopting a successful insulin regimen.
Type 2 diabetics who take oral medications to control blood glucose will also need to adjust the timing of these doses, especially those medications that stimulate insulin release, such as sulfonylureas. These can be given before beginning the night shift, when the person is awake and having meals. It is a good idea to monitor blood sugars more often with a portable meter when starting new working hours.
Diet Plan
The Americans with Disabilities Act requires that employers accommodate people with diabetes by providing reasonable adjustments for the individual, such as a private area to test blood sugars, or regular breaks for snacks.
The American Diabetes Association's publication "101 Nutrition Tips for People with Diabetes" highlights some schedule adjustments for diabetics who work the night shift. For instance, if a person works the 11 p.m. to 7 a.m. shift, she should eat before she goes to work, and have her next meal at 3 a.m. If a snack is needed, she can take it between 3 and 7 in the morning. The third meal of the day should be eaten at home in the 8 a.m. hour. The long-acting insulin that would usually be taken before breakfast should be taken with the first meal before going in to work at night. Further, a person with diabetes working an 11 p.m. to 7 a.m. shift could sleep between 9 a.m and 4 p.m. and have a snack after waking.
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Overall
Regardless of the duration or schedule of work hours, a healthy, balanced diet is the best choice for a diabetic. Special consideration should be given to the amount of carbohydrates at each meal, and snacks with the goal of keeping blood glucose levels within the goal range established by a physician.
References
- American Diabetes Association; Diabetes Statistics; January 2011
- Bureau of Labor Statistics; Workers on Flexible and Shift Schedules in May 2004; May 2004
- "Proceedings of the National Academy of Science of the United States of America"; Adverse Metabolic and Cardiovascular Consequences of Circadian misalignment; Scheer FA, et al.; March 2009
- "Progress in Brain Research"; Organization of Circadian Functions: Interaction with the Body; Buijs RM, et al.;2006
- "101 Nutrition Tips for People with Diabetes"; Patti B.Geil and Lea Ann Holzmeister; 2006
