NIGHT SHIFT WORK in individuals with type 2 diabetes is associated with altered dietary patterns, prolonged wakefulness, and increased glucose variability, according to new findings from a 10-day observational study in healthcare shift workers.
Night Shift Work and Type 2 Diabetes Outcomes
The study evaluated 37 healthcare workers with type 2 diabetes across night shifts, day shifts, and rest days, using continuous glucose monitoring, activity tracking, and diet and sleep diaries.
Participants were predominantly women (89.2%) and were mainly employed as nurses or midwives (62.2%). Within person comparisons were conducted for multiple glycaemic metrics, including mean glucose, coefficient of variation, mean absolute glucose change, mean amplitude of glycaemic excursion, and continuous overlapping net glycaemic action.
No significant differences were observed in mean glucose, mean amplitude of glycaemic excursion, or coefficient of variation across shift types. However, measures of glucose variability showed important distinctions.
Mean absolute glucose change and continuous overlapping net glycaemic action were higher during night shifts compared with rest days after night shifts (p=0.029), indicating greater glycaemic fluctuation during nocturnal work periods.
Dietary Behaviours and Energy Intake
Dietary intake varied significantly depending on work condition. Energy intake peaked on days involving night shifts, reaching 2199 kcal (standard deviation: 648).
The proportion of energy derived from sweet snacks was also higher during night shifts compared with rest days following night work (13.4 standard deviation: 12.0% versus 7.8 standard deviation: 11.8%; p=0.013).
Eating frequency differed markedly, with the highest number of eating occasions recorded on night shifts (7.0 standard deviation: 2.2) and the lowest on rest days after night shifts (3.4 standard deviation: 1.6; p<0.001).
Activity Levels and Wakefulness
Night shifts were further characterised by increased physical activity and extended wakefulness. Step counts were highest on night shift days (13,775 standard deviation: 4270; p=0.016), and participants remained awake for longer durations (22.2 h standard deviation: 2.4 h; p<0.001) compared with other day types.
These behavioural changes may contribute to the observed differences in glucose variability and dietary intake.
Clinical Implications
The findings highlight that night shift work introduces distinct challenges for individuals managing type 2 diabetes, particularly with regard to dietary habits, activity patterns, and glucose variability. Tailored interventions that address the unique demands of night work may be necessary to support optimal diabetes management in this population.
Reference
Gibson R et al. Characterising the impact of shift work on diet and glucose variability in healthcare employees living with type 2 diabetes: The Shift-Diabetes study. Diabetic Medicine. 2026;00:e70262.
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