Diabetologia

, Volume 60, Issue 8, pp 1483–1490

Glucose metabolism during rotational shift-work in healthcare workers

  • Anu Sharma
  • Marcello C. Laurenti
  • Chiara Dalla Man
  • Ron T. Varghese
  • Claudio Cobelli
  • Robert A. Rizza
  • Aleksey Matveyenko
  • Adrian Vella
Article

Abstract

Aims/hypothesis

Shift-work is associated with circadian rhythm disruption and an increased risk of obesity and type 2 diabetes. We sought to determine the effect of rotational shift-work on glucose metabolism in humans.

Methods

We studied 12 otherwise healthy nurses performing rotational shift-work using a randomised crossover study design. On each occasion, participants underwent an isotope-labelled mixed meal test during a simulated day shift and a simulated night shift, enabling simultaneous measurement of glucose flux and beta cell function using the oral minimal model. We sought to determine differences in fasting and postprandial glucose metabolism during the day shift vs the night shift.

Results

Postprandial glycaemic excursion was higher during the night shift (381±33 vs 580±48 mmol/l per 5 h, p<0.01). The time to peak insulin and C-peptide and nadir glucagon suppression in response to meal ingestion was also delayed during the night shift. While insulin action did not differ between study days, the beta cell responsivity to glucose (59±5 vs 44±4 × 10−9 min−1; p<0.001) and disposition index were decreased during the night shift.

Conclusions/interpretation

Impaired beta cell function during the night shift may result from normal circadian variation, the effect of rotational shift-work or a combination of both. As a consequence, higher postprandial glucose concentrations are observed during the night shift.

Keywords

Alpha cell function Beta cell function Circadian rhythm Glucose tolerance Insulin secretion Shift-work 

Abbreviations

Ф

Beta cell responsivity to glucose

ϕd

Dynamic component of insulin secretion

ϕs

Static component of insulin secretion

AAB

Area above basal

DI

Disposition index

EGP

Endogenous glucose production

Meal Ra

Rate of meal appearance

Rd

Rate of glucose disappearance

Si

Insulin sensitivity index

Supplementary material

125_2017_4317_MOESM1_ESM.pdf (161 kb)
ESM(PDF 160 kb)

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Anu Sharma
    • 1
  • Marcello C. Laurenti
    • 2
  • Chiara Dalla Man
    • 2
  • Ron T. Varghese
    • 1
  • Claudio Cobelli
    • 2
  • Robert A. Rizza
    • 1
  • Aleksey Matveyenko
    • 3
  • Adrian Vella
    • 1
  1. 1.Endocrine Research Unit, Department of Endocrinology, Diabetes and NutritionMayo Clinic College of MedicineRochesterUSA
  2. 2.Department of Information EngineeringUniversity of PaduaPaduaItaly
  3. 3.Department of Physiology and Biomedical EngineeringMayo ClinicRochesterUSA

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