The Impact of Shift Work on Diabetes Self-Management Activities.

Background: Once a person is diagnosed with diabetes, aggressive management is imperative to minimize poor glycemic control devastating outcomes. However, for some patients reaching optimum blood glucose levels is challenging due to the complexity of diabetes care. To achieve good blood glucose control, patients affected by diabetes must engage in self-care activities that include routine blood glucose check, dietary control, physical activity, medication regimen, and routine medical provider visits. Diabetes-associated self-care activities aimed to reach good blood glucose control can be hindered by multiple factors including shift work.

Objective: To evaluate self-management activities of individuals affected by diabetes who are employed as shift workers. This study also informs primary care nurse practitioners of the challenges shift workers face in managing their disease.

Methods: This was a cross-sectional descriptive study. Participants were individuals affected by type II diabetes from a single primary care practice (N = 86); 45 were individuals working on the dayshift and 41 worked on the evening/night shift. Each participant completed the diabetes self-management questionnaire and author-developed demographic/supplemental questionnaire.

Conclusions: There were no differences in self-reported diabetes management activities (i.e., physical activity, glucose management, and healthcare use) between the two groups. Thirty-nine percent of participants working shifts reported worse sleep patterns compared to their dayshift counterparts ( [1, = 85] = 8.73, = .003). Evening/night shift workers also reported more symptoms such as leg pain, fungal infection, numbness of the feet and legs, dizziness, and vision changes ( [1, = 79] = 43.037, < .001).

Implications For Practice: A better understanding of the impact that shift work has on diabetes care may help healthcare providers formulate meaningful treatment plans to meet the needs of evening/night shift diabetic workers. The use of a patient-centered medical home is one strategy.