, Volume 60, Issue 8, pp 1483–1490 | Cite as

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



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.


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.


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.


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.


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



Beta cell responsivity to glucose


Dynamic component of insulin secretion


Static component of insulin secretion


Area above basal


Disposition index


Endogenous glucose production

Meal Ra

Rate of meal appearance


Rate of glucose disappearance


Insulin sensitivity index



We gratefully acknowledge the contributions of our study coordinator P. D. Giesler and our research technicians J. Laugen and G. de Foster, and thank M. M. Davis for secretarial assistance (all from the Endocrine Research Unit, Mayo Clinic).

Data availability

All data generated or analysed during this study are included in this published article (and its supplementary information files).


This study was funded by awards from the Mayo Clinic General Clinical Research Center (UL1 TR000135). AV is supported by the National Institutes of Health (grant no. DK78646) and RTV is supported by a training grant (no. 5T32DK007352-37).

Duality of interest

The authors declare that there is no duality of interest associated with this manuscript.

Contribution statement

AV designed (assisted by AM and RAR) and oversaw the study; AS ran the study; CC, CDM, MCL and RTV assisted with data acquisition, AS and AV researched the data; MCL, CDM, RTV and CC analysed and interpreted the data; AS drafted the manuscript; AM, CC, CDM, MCL, RAR and RTV reviewed and/or edited the manuscript; and AV wrote the final version of the manuscript. All authors gave final approval of the version to be published. AV is the guarantor of this work and, as such, had full access to all of the study data and takes responsibility for data integrity and the accuracy of the data analysis.

Supplementary material

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


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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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