Metabolic control in type 2 diabetic patients working shift patterns

Abstract

Introduction. Type 2 diabetes is a chronic disease with tendency to increase throughout the world. It represents 90% of all diabetes and is associated with obesity and insulin resistance. Treatment of diabetes requires weight loss, regular physical activity and intake of medicines. This regularity can be disturbed if the circadian rhythm fluctuates, depending on the form of employment. An interesting issue is the relationship between shift work and metabolic control.

Material and methods. The survey was conducted among group of 194 patients with type 2 diabetes (successfully treated for at least six months with oral antidiabetic drugs) from October 2014 to March 2015 in diabetes clinics in Zabrze, Tarnowskie Góry and Chrzanów. The inclusion criteria: type 2 diabetes, employed and working patient. Patients were asked to complete the anonymous questionnaire composed of 20 questions, including general information and details about diabetes control, working hours, lifestyle, health complications, sleep disorders and quality of life. Patients were divided into two groups: shift workers (n = 94) and non-shift workers (n = 100). The collected data was analyzed with Statistica 12.0.

Results. Patients who work shifts had higher fasting blood glucose — 130 mg/dl vs. 121 mg/dl (p < 0.034), lower quality of sleep — 7.78 vs. 5.21 points on the Athens Scale (p < 0.0002) and lower quality of life — 6.0 vs. 6.8 points (p < 0.007). Glycated hemoglobin (HbA1c), body mass index (BMI) and the duration of insulin therapy were not significantly different between the groups. In the study group more often appeared lipid disorders and there was less regularity in eating meals.

Conclusions. Shift work has little effect on glycemic control in type 2 diabetic patient. However, disrupting the circadian rhythm, affects the quality of life, quality of sleep and regularity of eating in patients with type 2 diabetes. Therefore, the treatment of type 2 diabetic patient working shifts, can be particularly demanding.