scholarly journals The Impact of Shift Work on Diabetes Self-Management Activities

2019 ◽  
Vol 12 (1) ◽  
pp. 66-72
Author(s):  
Daniel J. Navarro ◽  
Patricia T. Alpert ◽  
Chad Cross
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Blood Glucose ◽  
Shift Work ◽  
Diabetes Care ◽  
Night Shift ◽  
Blood Glucose Control ◽  
Self Management ◽  
Shift Workers ◽  
The Impact

BackgroundOnce 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.ObjectiveTo 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.MethodsThis 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.ConclusionsThere 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 (X2[1, N = 85] = 8.73, p = .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 (X2[1, N = 79] = 43.037, p < .001).Implications for PracticeA 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.

scholarly journals Implications of remote monitoring Technology in Optimizing Traditional Self-Monitoring of blood glucose in adults with T2DM in primary care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alex R. Montero ◽  
David Toro-Tobon ◽  
Kelly Gann ◽  
Carine M. Nassar ◽  
Gretchen A. Youssef ◽  
...  
Keyword(s):  
Primary Care ◽  
Blood Glucose ◽  
Diabetes Care ◽  
Remote Monitoring ◽  
Secondary Analysis ◽  
Time Of Day ◽  
Trial Registration ◽  
Blood Glucose Monitoring ◽  
Self Monitoring ◽  
The Impact

Abstract Background Self-monitoring of blood glucose (SMBG) has been shown to reduce hemoglobin A1C (HbA1C). Accordingly, guidelines recommend SMBG up to 4–10 times daily for adults with type 2 diabetes (T2DM) on insulin. For persons not on insulin, recommendations are equivocal. Newer technology-enabled blood glucose monitoring (BGM) devices can facilitate remote monitoring of glycemic data. New evidence generated by remote BGM may help to guide best practices for frequency and timing of finger-stick blood glucose (FSBG) monitoring in uncontrolled T2DM patients managed in primary care settings. This study aims to evaluate the impact of SMBG utility and frequency on glycemic outcomes using a novel BGM system which auto-transfers near real-time FSBG data to a cloud-based dashboard using cellular networks. Methods Secondary analysis of the intervention arm of a comparative non-randomized trial with propensity-matched chart controls. Adults with T2DM and HbA1C > 9% receiving care in five primary care practices in a healthcare system participated in a 3-month diabetes boot camp (DBC) using telemedicine and a novel BGM to support comprehensive diabetes care management. The primary independent variable was frequency of FSBG. Secondary outcomes included frequency of FSBG by insulin status, distribution of FSBG checks by time of day, and hypoglycemia rates. Results 48,111 FSBGs were transmitted by 359 DBC completers. Participants performed 1.5 FSBG checks/day; with 1.6 checks/day for those on basal/bolus insulin. Higher FSBG frequency was associated with greater improvement in HbA1C independent of insulin treatment status (p = 0.0003). FSBG frequency was higher in patients treated with insulin (p = 0.003). FSBG checks were most common pre-breakfast and post-dinner. Hypoglycemia was rare (1.2% < 70 mg/dL). Conclusions Adults with uncontrolled T2DM achieved significant HbA1C improvement performing just 1.5 FSBGs daily during a technology-enabled diabetes care intervention. Among the 40% taking insulin, this improvement was achieved with a lower FSBG frequency than guidelines recommend. For those not on insulin, despite a lower frequency of FSBG, they achieved a greater reduction in A1C compared to patients on insulin. Low frequency FSBG monitoring pre-breakfast and post-dinner can potentially support optimization of glycemic control regardless of insulin status in the primary care setting. Trial registration Trial registration number:NCT02925312 (10/19/2016).

scholarly journals Night shift work is associated with an increased risk of asthma

Thorax ◽  
2020 ◽  
Vol 76 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Robert J Maidstone ◽  
James Turner ◽  
Celine Vetter ◽  
Hassan S Dashti ◽  
Richa Saxena ◽  
...  
Keyword(s):  
Public Health ◽  
Severe Asthma ◽  
Shift Work ◽  
Inflammatory Diseases ◽  
Large Population ◽  
Night Shift ◽  
Smoking History ◽  
Shift Workers ◽  
Increased Risk ◽  
The Impact

IntroductionShift work causes misalignment between internal circadian time and the external light/dark cycle and is associated with metabolic disorders and cancer. Approximately 20% of the working population in industrialised countries work permanent or rotating night shifts, exposing this large population to the risk of circadian misalignment-driven disease. Analysis of the impact of shift work on chronic inflammatory diseases is lacking. We investigated the association between shift work and asthma.MethodsWe describe the cross-sectional relationship between shift work and prevalent asthma in >280000 UK Biobank participants, making adjustments for major confounding factors (smoking history, ethnicity, socioeconomic status, physical activity, body mass index). We also investigated chronotype.ResultsCompared with day workers, ‘permanent’ night shift workers had a higher likelihood of moderate-severe asthma (OR 1.36 (95% CI 1.03 to 1.8)) and all asthma (OR 1.23 (95% CI 1.03 to 1.46)). Individuals doing any type of shift work had higher adjusted odds of wheeze/whistling in the chest. Shift workers who never or rarely worked on nights and people working permanent nights had a higher adjusted likelihood of having reduced lung function (FEV1 <80% predicted). We found an increase in the risk of moderate-severe asthma in morning chronotypes working irregular shifts, including nights (OR 1.55 (95% CI 1.06 to 2.27)).ConclusionsThe public health implications of these findings are far-reaching due to the high prevalence and co-occurrence of both asthma and shift work. Future longitudinal follow-up studies are needed to determine if modifying shift work schedules to take into account chronotype might present a public health measure to reduce the risk of developing inflammatory diseases such as asthma.

scholarly journals Shift work is associated with positive COVID-19 status in hospitalised patients

2020 ◽  
Author(s):  
Robert Maidstone ◽  
Simon G Anderson ◽  
David W Ray ◽  
Martin K Rutter ◽  
Hannah J Durrington ◽  
...  
Keyword(s):  
Shift Work ◽  
Healthcare Workers ◽  
Night Shift ◽  
Multivariate Logistic Regression ◽  
Shift Workers ◽  
Night Shift Work ◽  
Work Factors ◽  
Hospitalised Patients ◽  
Disease Exposure ◽  
The Impact

AbstractIntroductionShift work is associated with both mental, and physical ill health, including lung disease and infections. However, the impact of shift work on significant COVID-19 illness has not be assessed. We therefore investigated whether shift work is associated with COVID-19.Methods501,000 UK biobank participants were linked to secondary care SARS-CoV-2 PCR results from public health England. Healthcare workers and those without an occupational history were excluded from analysis.ResultsMultivariate logistic regression taking into account age, sex, ethnicity and deprivation index revealed that irregular shift work (OR 2.42 95%CI 1.92-3.05), permanent shift work (OR 2.5, 95%CI 1.95-3.19), day shift work (OR 2.01, 95%CI 1.55-2.6), irregular night shift work (OR 3.04, 95%CI 2.37-3.9) and permanent night shift work (OR 2.49, 95%CI 1.67-3.7) were all associated with positive COVID-19 tests compared to participants that did not perform shift work. This relationship persisted after adding sleep duration, chronotype, pre-morbid disease, BMI, alcohol and smoking. Work factors (proximity to a colleague combined with estimated disease exposure) were positively correlated with COVID-19 incidence (r2=0.248, p=0.02). If this was added to the model shift work frequency remained significantly associated with COVID-19. To control for non-measured occupational factors the incidence of COVID-19 in shift workers was compared to colleagues in the same job who did not do shift work. Shift workers had a higher incidence of COVID-19 (p<0.01).ConclusionsShift work is associated with a higher likelihood of in-hospital COVID-19 positivity. This risk could potentially be mitigated via additional workplace precautions or vaccination.

scholarly journals EFFECTS OF COGNITIVE DECLINE ON DIABETES SELF-MANAGEMENT EDUCATION AND CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S35-S36
Author(s):  
Shinduk Lee ◽  
Matthew L Smith ◽  
Marcia G Ory
Keyword(s):  
Physical Activity ◽  
Blood Glucose ◽  
Cognitive Decline ◽  
Diabetes Care ◽  
Regression Models ◽  
Diabetes Management ◽  
Management Education ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Self Management

Abstract People with diabetes experience a faster cognitive decline and have a greater risk for future dementia diagnoses. Cognitive impairment can negatively influence diabetes management activities. Diabetes self-management education (DSME) can enhance diabetes control, but limited evidence exists about the differential effects of DSME based on cognitive status. This study examines the moderation effects of cognition on the relationship between participation in DSME and diabetes management among older adults using Georgia 2017 BRFSS data (N=496). Primary outcomes were diabetes self-management (e.g., self-blood glucose monitoring, self-feet check, and physical activity) and clinical care (e.g., seeing a health professional for diabetes and A1C, feet, and eye exams). Multiple logistic regression models examined the effects of DSME and self-reported cognitive decline on diabetes care. Based on the Anderson-and-Newman Framework, all regression models were adjusted for predisposing (age, sex, race, ethnicity, and education), enabling (income, marital status, and health plan), and need (insulin treatment) factors. About 48% of participants participated in a DSME, and about 16% reported experiencing cognitive decline. DSME participation was positively associated with self-blood glucose monitoring (p=0.014), physical activity (p=0.024), seeing a health professional for diabetes (p=0.002), and feet exam (p=0.043), but cognitive decline was not significantly associated with most diabetes care (p&gt;0.05). Further, no significant difference in DSME impact on diabetes care based on reported cognitive decline was observed (p&gt;0.05). Findings suggest that DSME can benefit diabetes care among people with and without cognitive decline. Future research can expand upon impacts of rates and degrees of cognitive decline on program benefits.

scholarly journals High risk of near-crash driving events following night-shift work

2015 ◽  
Vol 113 (1) ◽  
pp. 176-181 ◽  
Author(s):  
Michael L. Lee ◽  
Mark E. Howard ◽  
William J. Horrey ◽  
Yulan Liang ◽  
Clare Anderson ◽  
...  
Keyword(s):  
High Risk ◽  
Shift Work ◽  
Occupational Safety ◽  
Motor Vehicle ◽  
Night Shift ◽  
Driving Performance ◽  
Previous Night ◽  
Shift Workers ◽  
Night Shift Work ◽  
The Impact

Night-shift workers are at high risk of drowsiness-related motor vehicle crashes as a result of circadian disruption and sleep restriction. However, the impact of actual night-shift work on measures of drowsiness and driving performance while operating a real motor vehicle remains unknown. Sixteen night-shift workers completed two 2-h daytime driving sessions on a closed driving track at the Liberty Mutual Research Institute for Safety: (i) a postsleep baseline driving session after an average of 7.6 ± 2.4 h sleep the previous night with no night-shift work, and (ii) a postnight-shift driving session following night-shift work. Physiological measures of drowsiness were collected, including infrared reflectance oculography, electroencephalography, and electrooculography. Driving performance measures included lane excursions, near-crash events, and drives terminated because of failure to maintain control of the vehicle. Eleven near-crashes occurred in 6 of 16 postnight-shift drives (37.5%), and 7 of 16 postnight-shift drives (43.8%) were terminated early for safety reasons, compared with zero near-crashes or early drive terminations during 16 postsleep drives (Fishers exact:P= 0.0088 andP= 0.0034, respectively). Participants had a significantly higher rate of lane excursions, average Johns Drowsiness Scale, blink duration, and number of slow eye movements during postnight-shift drives compared with postsleep drives (3.09/min vs. 1.49/min; 1.71 vs. 0.97; 125 ms vs. 100 ms; 35.8 vs. 19.1; respectively,P< 0.05 for all). Night-shift work increases driver drowsiness, degrading driving performance and increasing the risk of near-crash drive events. With more than 9.5 million Americans working overnight or rotating shifts and one-third of United States commutes exceeding 30 min, these results have implications for traffic and occupational safety.

scholarly journals Analisis Kadar Glukosa Darah pada Pekerja Shift Pagi dan Shift Malam di PT. X Sidoarjo

2019 ◽  
Vol 2 (2) ◽  
pp. 116
Author(s):  
Yulia Indah Wulandari ◽  
Mulyono .
Keyword(s):  
Blood Glucose ◽  
Shift Work ◽  
Night Shift ◽  
Slow Rotation ◽  
Glucose Metabolism Disorders ◽  
Negative Effects ◽  
Shift Workers ◽  
Random Blood Glucose ◽  
Rotation Pattern ◽  
Morning Shift

Shift work, besides has several advantages also has a negative effects. The negatives effects are including physiological, social and performance effects. The physiological effects that arise among them such as blood glucose metabolism disorders which these risk may also occur to the shift workers. This study was conducted in PT. X at september 2015 aims to determine the pattern of PT. X shift working systems and also knows the difference between random blood glucose on morning shift and night shift workers at PT .X. This was a descriptive crossectional research. Sample in this study were using the total population of shift workers in Rolling Mill production unit who measured their random blood glucose levels while working on morning shift and the night shift and was not suffering from diabetes mellitus with total 26 respondents. The result showed that PT. X is applied weekly slow rotation and backward rotation pattern (night – day – morning) of shift working system.The difference between random blood glucose and blood pressure levels of the most respondents showed a higher levels while working on the night shift than morning shift. Based on the research, PT. X should apply a quick rotation and forward rotation pattern (morning – day – night) of shift working system and giving a 24 hours time rest at the end of night shift schedule. And they should held the routine exercise activity once a week at the plant and giving the explanation about the negative effects of the shift work to the related workers.

scholarly journals Social jetlag and sleep debts are altered in different rosters of night shift work

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262049
Author(s):  
Swaantje Casjens ◽  
Frank Brenscheidt ◽  
Anita Tisch ◽  
Beate Beermann ◽  
Thomas Brüning ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Deprivation ◽  
Sleep Duration ◽  
Shift Work ◽  
Night Shift ◽  
Shift Workers ◽  
Social Jetlag ◽  
Sleep Debt ◽  
The Impact ◽  
Night Shifts

Background Night and shift work are suspected to cause various adverse effects on health and sleep. Sleep deprivation through shift work is assumed to be compensated on free days. So far it is not clear how different shift systems and shift lengths affect sleep structure on work and free days. Especially working night shifts disrupts the circadian rhythm but also extended working hours (12h) might affect sleep characteristics. Hitherto, the magnitude of sleep debt, social jetlag, and Locomotor Inactivity During Sleep (LIDS) in different shift systems is unknown. Methods Here, we investigated the impact of five different shift rosters on sleep in 129 industrial workers from Germany. Permanent night work with multiple shift systems with and without night shifts and with different shift lengths were compared. Wrist-activity was monitored over 28 days revealing sleep on- and offsets as well as LIDS as proxy for sleep quality. Overall, 3,865 sleep bouts comprising 22,310 hours of sleep were examined. Results The mean daily age-adjusted sleep duration (including naps) was 6:43h and did not differ between shift workers of different rosters. However, sleep duration on workdays was particularly low in rotational shift systems with 12h-shifts (5:00h), while overall sleep debt was highest. Shift workers showed a median absolute social jetlag of 3:03h, which differed considerably between shift types and rosters (p<0.0001). Permanent night workers had the highest social jetlag (5:08h) and latest mid-sleeps on workdays and free days. Sleep quality was reduced in permanent night shift workers compared with shift workers in other rosters and differed between daytime and nighttime sleep. Conclusions Shift work leads to partial sleep deprivation, which particularly affects workers in 12h-shifts and permanent night shifts. Working these shifts resulted in higher sleep debts and larger absolute social jetlag whereas sleep quality was especially reduced in permanent night shift workers compared with shift workers of other rosters.

scholarly journals Shift Work and Work-Family Conflict: A Systematic Review

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Anne Marit Wöhrmann ◽  
Grit Müller ◽  
Kathrin Ewert
Keyword(s):  
Shift Work ◽  
Family Conflict ◽  
Social Life ◽  
Night Shift ◽  
Inclusion Criteria ◽  
Work Family Conflict ◽  
Shift Workers ◽  
State Of Research ◽  
Work Family ◽  
The Impact

Shift work occupies precious time for family and social life. The aim of this review was to systematically assess the state of research on the impact of shift work on work-fam-ily conflict. A systematic literature search was conducted in PubMed and EBSCO to identify studies published between 1990 and 2017. In the end, 36 articles met the inclusion criteria and were considered in this review. Shift workers show higher levels of work-family conflict in comparison to workers in regular day schedules. Different shift types and a large variation of shift characteristics have been studied. Results point to a higher work-family conflict especially among night shift workers and those working in a shift schedule, including weekend work. Research testing for causality is missing.

scholarly journals P040 Night Shift Work and Disease: A Systematic Review of the Role of Oxidative Stress

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A34-A34
Author(s):  
M Gibson
Keyword(s):  
Oxidative Stress ◽  
Reactive Oxygen Species ◽  
Shift Work ◽  
Night Shift ◽  
Reactive Oxygen ◽  
Oxygen Species ◽  
Repair Capacity ◽  
Shift Workers ◽  
Night Shift Work ◽  
The Impact

Abstract Night shift workers make up an essential part of the modern workforce. However, night shift workers have higher incidences of late in life diseases and earlier mortality. Night shift workers are exposed to constant light and experience circadian rhythm disruption. Sleep disruption is thought to increase oxidative stress, defined as an imbalance of excess pro-oxidative factors and reactive oxygen species over anti-oxidative activity. Oxidative stress can damage cells, proteins and DNA and can eventually lead to varied chronic diseases such as cancer, diabetes, cardiovascular disease, Alzheimer’s and dementia. This review aimed to understand whether night shift workers were at greater risk of oxidative stress and to contribute to a consensus on this relationship. Twelve studies published in 2001–2019 examining 2,081 workers were included in the review. Studies compared both the impact of working a single shift and in comparisons between those who regularly work night shifts and only day shifts. All studies had evidence to support this relationship across a range of oxidative stress indicators, including: increased DNA damage, reduced DNA repair capacity, increased lipid peroxidation, higher levels of reactive oxygen species, and to a lesser extent, a reduction in antioxidant defence. This research supports the theory that melatonin and the sleep wake cycle mediate the relationship between shift work and oxidative stress. It is concluded that night shift work increases the risk for oxidative stress and therefore future disease. Recommendations are made to promote the long-term health of shift workers considering these findings.

scholarly journals Working the Night Shift: The Impact of Compensating Wages and Local Economic Conditions on Shift Choice

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Colene Trent ◽  
Walter J. Mayer
Keyword(s):  
Regression Model ◽  
Shift Work ◽  
Night Shift ◽  
Economic Conditions ◽  
Compensating Differentials ◽  
Switching Regression ◽  
Shift Workers ◽  
Night Shift Work ◽  
The Impact ◽  
Night Shifts

The theory of compensating differentials asserts that night shift workers should receive compensating wage differentials due to undesirable work conditions. In weak local economies, workers may have difficulty finding jobs; thus, these workers might be more likely to accept night shift work and be less concerned with the size of the compensating differential for night shifts. Using CPS data from 2001, this paper employs maximum likelihood estimation of an endogenous switching regression model to analyze wages of day and night shift workers and shift choice. The findings indicate the presence of selection bias, thus emphasizing the importance of correcting for self-selection into night shifts. The average of the estimated wage differentials for night shift work is negative for the overall sample, with differentials varying by worker characteristics. The shift differential is found to be a statistically significant predictor of shift choice, indicating that shift premiums play an important role in motivating individuals to select night shift work. Using two measures of local economic conditions and a new method of analyzing interaction effects in the context of an endogenous switching regression model, this paper finds limited evidence that weak local economic conditions lessen the impact of compensating differentials on shift choice.

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