Night Shifts Combined with an Unhealthy Lifestyle Increase Diabetes Risk Up to 3-Fold

In the modern world, the concept of 24-hour service means that many people work shifts. For example, in the United States, one in every 5 workers works in the evening or at night. Healthcare workers account for approximately %30 of shift workers, and nurses make up a large majority of this group.

People working evening or night shifts may have different social and biological rhythms from those working during the day. Altered eating habits, increased smoking and excess body fat are also frequently observed in night workers. Many studies to date have also found evidence that unhealthy lifestyle habits can increase the risk of type 2 diabetes.

In November 2018, British Medical Journal(BMJ) shared data from two large studies lasting 22 and 24 years. These large studies of female nurses working shifts, numbering 240 thousand, examined night shifts, unhealthy lifestyles and the risk of developing type 2 diabetes . Lifestyle factors were defined as 4 factors: diet, physical activity, smoking and body mass index.

Ultimately, when the two factors of shift work and an unhealthy lifestyle occur together, more than when they occur separately, the risk of developing type 2 diabetes increases as was observed.

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According to the Research Results;

• Night-shift work for less than 5 years was shown to increase the risk of type 2 diabetes by approximately %30.
• Among night-shift workers, the combined presence of unhealthy lifestyle factors such as smoking, poor nutrition or increased body weight increased the type 2 diabetes risk 2-fold.
• Women working night shifts for more than 5 years and having unhealthy lifestyle habits were found, for type 2 diabetes, to have a 2.83-fold higher risk than women without these factors; the two factors together increased the additional risk by %11.

Possible mechanisms explaining the findings include sleep loss and disrupted circadian rhythm , which are thought to be important. Other possible mechanisms include reduced physical activity, smoking and excess fat tissue, which have also been observed more often among shift / on-call workers. Similarly, previous studies emphasized that shift workers are predisposed to various chronic diseases including type 2 diabetes, cardiovascular diseases and various cancers. However, studies on shift work and cancer struggle to clearly establish causation. Is shift work itself increasing the risk, or is it behaviors such as smoking and unhealthy eating that are more common among shift workers?

On a positive note, these findings are also important because they suggest that most type 2 diabetes cases developing among night-shift workers can be prevented by maintaining healthy living habits. 

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