Location

Virtual

Start Date

1-3-2024 12:25 PM

End Date

1-3-2024 12:40 PM

Keywords:

washington; pshmc; spokane

Description

Background:

Night shift work is essential in the hospital yet shift work among nurses is linked to negative outcomes such as chronic fatigue and cardiometabolic illnesses. Furthermore, nurses working night shift are more likely to have aberrant glucose levels, defined as greater than 140 mg/dl. Currently, it is unclear whether nurses working night shift eat differently than those working day shift which may explain aberrant glucose levels.

Purpose:

To determine whether night shift nurses have altered glucose levels and dietary intake compared to day shift nurses.

Methods/Approach:

Nurses regularly working full time 12-hour night shifts (n=12) or full time 12-hour day shifts (n = 9) completed the study. All nurses were recruited from a hospital and were involved in direct patient care. During the 6-day study period, all nurses worked the first 3 days, followed by 3 days off. A continuous blood glucose monitor was utilized. Participants reported all food and beverages consumed using the Automated Self-Administered 24-hour dietary assessment tool. Glucose and dietary intakes were averaged over the total 6-day duration of the study, the 3 day on-shift, and the 3-day off shift. Independent t-tests were conducted using SPSS to determine group differences.

Results:

No significant differences were found between day and night shift for average glucose levels during the 6-day period overall or when on versus off-shift (p>0.05). Of clinical significance, night shift nurses spent more time with glucose ≥ 140mg/dL (day = 136.2 minutes/day, night = 169 minutes/day) and demonstrated higher glucose variability over the 6-day period. No significant differences were detected in dietary intakes, although several clinically significant differences were detected. Night shift nurses reported lower caloric intake while on-shift, (1752.5 vs. 2129.4 kcals, p = 0.073) and greater caloric consumption while off-shift (2266 vs. 2021.7 kcals, p = 0.421). Sodium intake exceeded recommended daily intake of ≤ 2,300 mg per day in both groups and was the greatest in night shift (day = 3383.9 mg, night = 3796.8 mg). Additionally, fiber intake was lower than the recommended intake of 25g in both groups (day = 16.2g, night = 17.5g).

Conclusion:

Results should be interpreted with caution due to small sample size. However, night shift nurses in our sample consumed less calories while on-shift and ate more calories when off-shift and had higher sodium intake than day shift nurses. Additionally, our night shift nurses experienced greater glucose variability and spend more time in aberrant glucose ranges compared to day shift nurses. Future work is needed with larger sample sizes to verify findings.

Implications for practice:

Per our findings, dietary interventions may be needed to decrease sodium and increase fiber intake among nurses to reduce risk for cardiometabolic illnesses. Additionally, despite lower caloric intake when on-shift, night shift nurses spent more time on average than day shift nurses with glucose ≥ 140mg/dL, increasing risk for type 2 diabetes. Nurses, particularly when working night shift, should work closely with medical professionals to monitor blood glucose trends and take actions to prevent cardiometabolic illness like type 2 diabetes.

Clinical Institute

Kidney & Diabetes

Clinical Institute

Digestive Health

Specialty/Research Institute

Endocrinology

Specialty/Research Institute

Nursing

Specialty/Research Institute

Nutrition

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Mar 1st, 12:25 PM Mar 1st, 12:40 PM

Dietary intake and continuous blood glucose measurement in nurses working either 12-hour day shifts or night shifts

Virtual

Background:

Night shift work is essential in the hospital yet shift work among nurses is linked to negative outcomes such as chronic fatigue and cardiometabolic illnesses. Furthermore, nurses working night shift are more likely to have aberrant glucose levels, defined as greater than 140 mg/dl. Currently, it is unclear whether nurses working night shift eat differently than those working day shift which may explain aberrant glucose levels.

Purpose:

To determine whether night shift nurses have altered glucose levels and dietary intake compared to day shift nurses.

Methods/Approach:

Nurses regularly working full time 12-hour night shifts (n=12) or full time 12-hour day shifts (n = 9) completed the study. All nurses were recruited from a hospital and were involved in direct patient care. During the 6-day study period, all nurses worked the first 3 days, followed by 3 days off. A continuous blood glucose monitor was utilized. Participants reported all food and beverages consumed using the Automated Self-Administered 24-hour dietary assessment tool. Glucose and dietary intakes were averaged over the total 6-day duration of the study, the 3 day on-shift, and the 3-day off shift. Independent t-tests were conducted using SPSS to determine group differences.

Results:

No significant differences were found between day and night shift for average glucose levels during the 6-day period overall or when on versus off-shift (p>0.05). Of clinical significance, night shift nurses spent more time with glucose ≥ 140mg/dL (day = 136.2 minutes/day, night = 169 minutes/day) and demonstrated higher glucose variability over the 6-day period. No significant differences were detected in dietary intakes, although several clinically significant differences were detected. Night shift nurses reported lower caloric intake while on-shift, (1752.5 vs. 2129.4 kcals, p = 0.073) and greater caloric consumption while off-shift (2266 vs. 2021.7 kcals, p = 0.421). Sodium intake exceeded recommended daily intake of ≤ 2,300 mg per day in both groups and was the greatest in night shift (day = 3383.9 mg, night = 3796.8 mg). Additionally, fiber intake was lower than the recommended intake of 25g in both groups (day = 16.2g, night = 17.5g).

Conclusion:

Results should be interpreted with caution due to small sample size. However, night shift nurses in our sample consumed less calories while on-shift and ate more calories when off-shift and had higher sodium intake than day shift nurses. Additionally, our night shift nurses experienced greater glucose variability and spend more time in aberrant glucose ranges compared to day shift nurses. Future work is needed with larger sample sizes to verify findings.

Implications for practice:

Per our findings, dietary interventions may be needed to decrease sodium and increase fiber intake among nurses to reduce risk for cardiometabolic illnesses. Additionally, despite lower caloric intake when on-shift, night shift nurses spent more time on average than day shift nurses with glucose ≥ 140mg/dL, increasing risk for type 2 diabetes. Nurses, particularly when working night shift, should work closely with medical professionals to monitor blood glucose trends and take actions to prevent cardiometabolic illness like type 2 diabetes.