Artificial Light at Night and Type 2 Diabetes Mellitus

Abstract

The widespread and pervasive use of artificial light at night (ALAN) in our modern 24-hour society has emerged as a substantial disruptor of natural circadian rhythms, potentially leading to a rise in unhealthy lifestyle-related behaviors (e.g., poor sleep; shift work). This phenomenon has been associated with an increased risk of type 2 diabetes mellitus (T2DM), which is a pressing global public health concern. However, to date, reviews summarizing associations between ALAN and T2DM have primarily focused on the limited characteristics of exposure (e.g., intensity) to ALAN. This literature review extends beyond prior reviews by consolidating recent studies from 2000 to 2024 regarding associations between both indoor and outdoor ALAN exposure and the incidence or prevalence of T2DM. We also described potential biological mechanisms through which ALAN modulates glucose metabolism. Furthermore, we outlined knowledge gaps and investigated how various ALAN characteristics beyond only light intensity (including light type, timing, duration, wavelength, and individual sensitivity) influence T2DM risk. Recognizing the detrimental impact of ALAN on sleep health and the behavioral correlates of physical activity and dietary patterns, we additionally summarized studies investigating the potential mediating role of each component in the relationship between ALAN and glucose metabolism. Lastly, we proposed implications of chronotherapies and chrononutrition for diabetes management in the context of ALAN exposure.

Keywords: Circadian rhythm; Diabetes mellitus, type 2; Dietary patterns; Exercise; Insulin resistance; Light pollution; Sleep.

Fig. 1.

Possible clinical pathway: artificial light at night (ALAN), sleep disturbance, evening chronotype, and abnormal glucose metabolism in patients with type 2 diabetes mellitus. The black arrows denote the direction of the pathway. T-bars indicate the suppression of the following pathway. The dotted arrows represent possible bidirectional pathways between two components. HGP, hepatic glucose production.