Temporal Tactics: Leveraging Circadian Rhythms in Diabetes Treatment

Diabetes mellitus (DM), a global metabolic disease, is closely associated with circadian rhythms (CRs), and the situation is quite multifaceted for clinicians. Chronobiological knowledge reveals the complex relationship between circadian cycle and DM. This review demonstrates that CRs controlled by the suprachiasmatic nucleus (SCN) play a complex role in glucose homeostasis, insulin sensitivity, and pancreatic β-cell function. Chronic disruption of CRs or chronodisruption worsens metabolic dysregulation; therefore, the timing of treatments should coincide with biological rhythms. Cycles and rhythms of diabetes incidence also emphasize the need for targeted interventions, as it is with chronotherapy and chronopharmacology. External factors such as shift work, irregular sleep, and jet lag are new contributors to chronodisruption, which further aggravate metabolic derangement in diabetes. Epidemiological data underline the necessity of interventions that are related to natural rhythms. This review maps the current state of knowledge of chronobiology in diabetes and uses clinical evidence to highlight the possibilities of chronobiological interventions. Deeper understanding of CRs may provide knowledge about the diabetes progression and point towards the development of more specific treatments. Measures such as light treatment, sleep hygiene, meal timing, and chronotherapy are potential approaches that may help to entrain CRs and enhance metabolic regulation in diabetic patients. Focusing on person-centerd strategies, healthcare providers can address specific aspects of patients’ lifestyles, thus improving glycaemic control and quality of life. Yet, more studies are needed to describe the specific processes and develop more specific approaches to treatment.