New study by Black Women’s Health Study says African American women are at risk for Type 2 diabetes if working graveyard shift.
Diabetes is serious illness for many Americans. The CDC estimates that 1 in 11 people have either Type 1 or Type 2 and 1 in 4 are entirely unaware. Studies show that 1 in 3 million people, or 86 million, may have prediabetes and 90% of those may be unaware.
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Given the price of medicine in the United States, the numbers can be troubling for diabetics and health professionals. And news for African American women just got a little worse and the prevalence was already twice as likely as in white women.
If an African American woman does night shift work, she's more likely to run the risk of Type 2 diabetes. Medscape reports that the metabolism is affected since shift work disrupts circadian rhythms and disrupts sleep schedules. Night shift runs from midnight until 8am—also known as the graveyard shift.
And previous research "circadian misalignment with increased insulin resistance, inflammation, decreased leptin levels, increased glucose and insulin levels, increased mean arterial pressure, and inversion of the normal diurnal cortisol-secretion pattern."
That can't be good on the body. When a diabetic's metabolism is disrupted, the distribution of insulin fails as well.
The study, published in Diabetologia, discovered a higher risk in women under 50 night workers than older women, especially the younger women working for more than a decade. During the prospective cohort study for the Black Women’s Health Study, the authors followed 28,041 participants between 2005 and 2013. In the 8 years intervening, 1,786 cases of diabetes occurred and those working the night shift had a higher BMI.
Statistics show that 17,722 women never worked the night shift and 1,379 worked for more than a decade. Shift workers were found to live in the poorest neighborhoods. The information matches similar results in a previous study of white night shift nurses.
Socioeconomic status and education often go hand-in-hand and poor neighborhoods are not afforded the same level of good health commitment as the wealthier areas and businesses. In addition, many night workers are forced to sacrifice sleep in order to do errands in business hours.
The paper does admit to a possible bias as the questionnaire asked about night work, but also proposes “the fact that women who did not answer the night-shift questions had similar characteristics regarding major risk factors for type 2 diabetes…suggests that selection bias might have a minor effect in the present results.”
In short, Type 2 diabetes is a problem for black women in the United States, especially those working the night shift.
Lead author Dr Varsha G. Vimalananda of Boston University's School of Medicine in Massachusetts told Medscape Medical News that 35% of non-Hispanic blacks work shift schedules and the increase holds "public-health implications."
As noted earlier, insulin and diabetes supply costs are high, even with insurance. The United States hasn't followed the European model of generic prescriptions quite yet. Right now, Publix supermarkets offer Metformin and Lisinopril free as part of their Diabetes Management system.
Type 2 diabetes is treatable and preventable, so the ability to control the disease's progression has high hopes. However, Dr. Vimalananda cautions that more research is primary since “shift work may be unavoidable.” Shift work for women often poses another shift after employment, often called the second-shift, where housework takes even more time away from sleep and health maintenance.
In May 2012, the CDC posted about research on work schedules and work-related sleep loss and found depression, personal injury and poor health were common for those working shift work. Those working without social support at work often suffered from insomnia as well. Adding in the fact many night workers sleep during when the sun is up, often disrupting sleep cycles as the sunlight isn’t fully blocked out. All the physical stress on the body would not help control or prevent Type 2 diabetes.
Vimalananda advises discussing the possibility of changing the schedule with patients if possible. “Clinicians should discuss the adverse metabolic consequences of shift work and sleep disruption and sleep loss in general with patients.”
Although changing shifts are not always possible, the doctor warns that African American women must put their health on the top of the list, too.
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