Social jet lag and (changes in) glycemic and metabolic control in people with type 2 diabetes

Abstract

Objective: Social jet lag, i.e., the discordance among social and biological rhythms, is associated with poor metabolic control. This study aimed to assess cross-sectional and longitudinal associations among social jet lag and glycemic and metabolic control in people with type 2 diabetes.Methods: In a prospective cohort (N = 990) with type 2 diabetes, social jet lag was measured at baseline using daily diaries and was categorized (high, moderate, or low).Metabolic outcomes were assessed at baseline and at 1 and 2 years of follow-up.Associations among social jet lag and glycemic and metabolic control were analyzed using linear regression and linear mixed models adjusted for confounding factors.Analyses were stratified for work status (retired vs. working; p value for interaction = 0.007 for glycated hemoglobin [HbA1c]).Results: In working people, a cross-sectional association between high social jet lag and HbA1c (1.87 mmol/mol [95% CI: 0.75 to 2.99]) and blood pressure (5.81 mm Hg [95% CI: 4.04 to 7.59]) was observed. For retired people, high social jet lag was negatively associated with HbA1c (À1.58 mmol/mol [95% CI: À2.54 to À0.62]), glucose (À0.19 mmoL/L [95% CI:À0.36 to À0.01]), and blood pressure (À3.70 mm Hg [95% CI: À5.36 to À2.04]), and the association with BMI was positive (1.12 kg/m 2 [95% CI: 0.74 to 1.51]). Prospective associations had the same direction as cross-sectional findings but were nonsignificant for working or retired people.Conclusions: Social jet lag was cross-sectionally, but not prospectively, associated with glycemic and metabolic markers. Interaction with work status was present, and directions of the associations were generally detrimental in the working population, whereas higher social jet lag was associated with improved glycemic and metabolic control for retired people.

Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes

“…Social jet lag is a subtle and common example of circadian misalignment in modern societies, with a prevalence superior to 50% [ 55 , 141 ]. The clinical impact of social jet lag has been reported in various epidemiological studies [ 141 , 142 ]. Individuals with social jetlag greater than 1 hour have a 1.75 times higher prevalence of diabetes or prediabetes than those with less than 1 hour of social jetlag [ 141 ].…”

Wake up! It's time to recognize the importance of sleep in metabolic health

“…Within‐person deviations in sleep timing over time also are associated with metabolic risk in adults [26]. Adding to this emerging area of research is a paper from Bauman and colleagues showing that greater difference in the timing of sleep between weekends and weekdays, termed social jet lag, was positively associated with hemoglobin A 1c and blood pressure among working adults with type 2 diabetes (T2D) [27]. In contrast, among retired adults with T2D, social jet lag ≥ 2 hours related to favorable glycemic traits despite also being associated with elevated body mass index (BMI).…”

How can social jetlag affect health?

“…The study population in Bouman et al 4 (shown in the dashed grey box in Fig. 1 ) has lower social jetlag than younger people (that is, those <60 years old).…”

“… 3 ). The most recent epidemiological study, by Bouman and colleagues 4 , reports apparently contradicting results that offer explanations on how social jetlag and health might be connected. The authors assessed social jetlag and metabolic and glycaemic outcomes in approximately 1,000 people over the age of 60 with type 2 diabetes mellitus (T2DM), using both a cross-sectional and longitudinal design (re-testing after 2 years).…”

“…The blue area indicates where social jetlag is smaller than 20 min, which appears to be the tolerable limit for people 6 . The average age ± standard deviation of the study population in Bouman et al 4 is indicated by the dashed grey box. …”