The Impact of Shift Work on Diabetes Self-Management Activities

Abstract

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.

Consequences of Shift Work and Night Work: A Literature Review

“…In terms of health, sleep and fatigue were the most studied variables in the literature (n = 27), with studies related to sleep predominating on the topic of fatigue [34,38,44,[55][56][57]. The second most referenced subcategory was lifestyles (n = 19), where eating habits stood out [58][59][60][61][62][63][64][65][66], followed by physical exercise [66][67][68], alcoholism [67,69], smoking [67,68], and health behaviors [71,72]. The cardiovascular system references (n = 17) were divided into cardio-metabolic risk factors [65,[73][74][75][76][77][78][79][80][81][82], hypertension [81,[83][84][85], and heart rate [34,86].…”

Barriers and facilitators in the acquisition of diabetes knowledge among tertiary-care nurses in central and southern Malawi: An exploratory-descriptive qualitative study

“…As such, the health systems are characterised by a focus on the acute management of infectious diseases and are not ready to effectively respond to the complex care demands of diabetes [11,12]. The complex and challenging nature of diabetes also requires healthcare workers, such as nurses to have the capacity to provide optimal levels of care for the patients [13,14].…”

Patient‐centred care, diabetes self‐management and glycaemic control among Omani patients with type‐2 diabetes

“…Diabetes self‐management, including glucose management, dietary control, physical activity, foot care, healthcare utilization (Schmitt et al, 2013) and medication adherence (Navarro et al, 2019), has been offered as an essential strategy to improve individuals' health outcomes associated with T2DM (Agency for Healthcare Research and Quality, 2020). Poor self‐care management and lack of adherence among Omani patients with T2DM have been identified in primary healthcare (PHC) settings (Abdulhadi et al, 2013; Alrahbi, 2014).…”