Working night shifts makes it harder for people with type 2 diabetes to manage their condition, according to new research led by King’s College London.
The study, funded by Diabetes UK and published in the journal Diabetic Medicine, examined how different shift patterns affect food choices and glucose levels within the same individuals.
Researchers monitored healthcare workers, including nurses, midwives and care home staff from NHS and private settings, over a 10-day period covering day shifts, night shifts and rest days.
Participants wore continuous glucose monitors and activity trackers, and kept detailed diet diaries.
The findings showed that night shifts were associated with poorer dietary patterns and greater variability in blood glucose.
Interviews with participants pointed to limited access to nutritious food overnight, with vending machines and 24-hour cafés often offering predominantly high-fat, high-sugar options.
A lack of time and facilities to prepare or store meals also contributed, with many participants relying on convenience foods during night shifts.
The study also identified marked differences in waking hours depending on shift patterns.
Participants were awake for around 22 hours during night shifts, compared with 17 hours on day shifts and 16 hours on rest days, creating what researchers described as a ‘concertina’ effect in day length.
Consider occupation when supporting type 2 diabetes patients
Dr Rachel Gibson PhD, registered dietitian, senior lecturer and the King’s Food Living Laboratory academic lead at King’s College London, who led the research, said: ‘What struck me is that these are people who work in healthcare, yet they don’t have access a healthy night-time food environment or tailored dietary advice.
‘These people might have been advised by their doctors to eat healthily to manage their diabetes, but if food choices are limited during the night, they might be unable to do so.’
She added that the findings highlighted a gap in how healthcare professionals consider occupation when supporting patients with type 2 diabetes.
‘Many clinicians don’t ask questions about work, despite this study revealing just how much of an impact someone’s nature of work can have on their behaviour and dietary choices,’ she said.
‘From an employer perspective, I believe we should take nutrition as seriously as other areas, like display screen equipment, already embedded into occupational health assessments.’
Co-author Dr Nicola Guess, an academic dietitian and researcher now at University of Oxford, said the research had been shaped by people living with type 2 diabetes who reported difficulties managing their condition while working shifts.
‘We hope the insights from this research will help us develop more personalised support for shift workers with type 2 diabetes and will lead to hospital policies which help employees to maintain health habits.’
Speaking about the recent NHS Staff Survey results, Danny Mortimer, director general (people) for NHS England, said: ‘We know about the everyday pressures staff face – such as not being able to get decent food on a night shift – and we haven’t moved fast enough to fix them.’
A version of this article was originally published by our sister publication The Pharmacist.
