Night Work, Sleep Deprivation and Their Association with Progression of Prediabetes into Diabetes Mellitus: Insights from Elsa-Brasil

Introduction: Both night work and sleep deprivation are independently associated with diabetes mellitus (T2DM). Despite the high incidence of T2DM among adults with prediabetes, few studies investigate work schedules and sleep deprivation in relation to the progression from prediabetes into T2DM. This study aimed to analyze night work and sleep deprivation as to their association with the progression of prediabetes into T2DM.

Methods: Participants from the Brazilian Longitudinal Study of Adult Health were evaluated longitudinally at two distinct time points: 2012–2014 (wave 2; N = 14,014) and 2017–2019 (wave 3; N = 12,636). To evaluate the progression from prediabetes to T2DM, we considered a sample that comprises only workers with prediabetes at wave 2 (N = 4,500). The exposure variables were sleep deprivation and night work. Sleep deprivation was estimated using data from wave 2 considering the difference between the desired number of hours of sleep and the number of hours slept. The difference was categorized as “non-sleep deprived” when it was 1 hour or less and “sleep deprived” when it was more than 1 hour. For the work schedule, participants were divided into three groups: day workers (reference group), former night workers, and current night workers. T2DM diagnoses were based on laboratory measurements and self-reported information. Prediabetes was considered if laboratory values reached the threshold for fasting plasma glucose (>=100 mg/dL and < 126 mg/dL) or 2-hour plasma glucose (>= 140 mg/dL and < 200 mg/dL). The outcome was divided into two categories: no diagnosis of T2DM at both waves (reference group) and progression from prediabetes (wave 2) to T2DM (wave 3). Logistic regression was employed (odds ratio (OR), 95% confidence interval (CI).

Results: Sleep deprivation was shown to be associated with the progression from pre-diabetics to T2DM (OR = 1.37; 95%IC = 1.17; 1.61), whereas night work was not associated – former night workers (OR = 1.04; 95%IC= 0.87; 1.25); night workers (OR = 1.20; 95%IC = 0.91; 1.54). Among 2348 workers who were not sleep deprived in wave 2, 19.8% showed a progression to T2DM. This group corresponded to 24.8% of night workers, 18.2% of former night workers, and 18.0% of day workers. Among non-sleep deprived workers, night work was associated with the progression to T2DM (OR=1.53; IC=1.02;2.27), whereas former night work was not (OR = 1.01; IC= 0.76; 1.34). No significant association was observed among sleep deprived workers.

Conclusion: Findings contribute to the understanding of the relationships between night work, sleep deprivation and metabolic function related to glucose. The possibility to disentangle night work from sleep deprivation is relevant as a way to evidence the influence of night work on glucose metabolism independent from sleep deprivation. Support: Brazil’s Ministry of Health and Ministry of Science, Technology and Innovation; FINEP; CNPq; FAPERJ.

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Artikel online veröffentlicht:
08. Oktober 2025