Diabetes Forecast

How can I manage insulin and meals while working the night shift?

Christy L. Parkin, MSN, RN, CDE, responds

There is evidence that shift work, particularly the night shift, can lead to erratic blood glucose levels.

What to Know

Diabetes always responds better to a consistent routine, and the unpredictable demands of night shift work can have negative effects on your diabetes control. Night workers often have disruptions of the circadian rhythm (your sleep-wake cycle), hormonal imbalances, changes in eating and exercise habits, and weight gain.

Find Out More

If you work the night shift, take steps to ensure your diabetes is well managed: Plan your meals and snacks carefully. Bringing your own food will help you avoid the temptation of unhealthy vending machine fare. And always have a source of glucose readily available to treat lows.

Night shift workers spend more time awake than their schedules otherwise suggest. Once they’re off work, they have to make the journey home, then possibly tend to family responsibilities before they can sleep. One study found the average sleep time for people working 12-hour night shifts was only 5.2 hours, and the quality of sleep was extremely poor. Nurses, for example, report that switching from night to day shifts is very difficult and they rarely feel fully rested.

Much has been reported about the harmful effects of sleep deprivation. It’s a recipe for lapses in attention that can lead to errors and car accidents. Consider these tips when preparing for night shift work:

  • Check your blood glucose as directed for basal-bolus insulin therapy and always before bedtime.
  • Watch for patterns that may help you in insulin dosing.
  • Bond with your coworkers so that they can assist you if your blood glucose drops and you need a fast-acting glucose source or a glucagon injection.
  • Keep up your exercise. Walk during downtime—it’ll help you feel more alert.
  • Avoid consuming caffeine four to six hours before sleep, and avoid heavy meals before bedtime.
  • Work with your health care team to find a treatment plan that works with your schedule.
  • Think about using insulin pens, which are more convenient and portable than vials and syringes.
  • Consider using an insulin pump for more convenient, flexible dosing.
  • Consider a continuous glucose monitor to see blood glucose readings and trends. This can be a game changer for people who have inconsistent schedules.


Mealtime during the night shift is all about planning ahead so you’re neither hungry nor tempted by junk food. Do your best to be prepared, stay safe, and get sufficient sleep.

Christy L. Parkin, MSN, RN, CDE, is a diabetes educator in Carmel, Indiana.



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