Investigation of intake pattern of SGLT2 inhibitors among shift workers with diabetes: a crossover study

BACKGROUND: Shift workers experience regular changes in their waking hours due to fluctuating work schedules. The timing of their medication intake differs depending on whether they are working a day or night shift. Sodium-glucose co-transporter 2 (SGLT2) inhibitors are prescribed once a day and are often taken before or after breakfast. However, studies on the optimal dosing times for the effective treatment of shift workers are lacking. In this study, we investigated whether the effects were different by the pattern of SGLT2 inhibitor intake for shift workers with diabetes. METHODS: Seven shift workers with diabetes who were taking an SGLT2 inhibitor were analyzed. All participants took the medication upon waking for 14 days, followed by administration at a fixed time for another 14 days. Glucose levels were measured over 14 days when the drug was administered either upon waking or at a fixed time of day. The time in range (TIR), which indicates the percentage of time during which the glucose level is within the range of 70-180 mg/dL, was used as the main evaluation index. RESULTS: The mean HbA1c of the participants was 7.1%. The TIR was 88.5% in the administration upon waking group and 84.9% in the administration at a fixed time group. No significant difference in TIR values was observed between the two administration groups. CONCLUSION: A TIR of 70% or higher is recommended to prevent the onset of diabetic complications. Consistent intake of SGLT2 inhibitors, regardless of whether it is during the day or night shift, may help stabilize blood glucose levels in shift workers throughout the day and night, thereby preventing the development of complications.