Circadian Misalignment and Chrononutrition in Type 2 Diabetes: Mechanistic Insights and Translational Gaps.
- 1Department of Pharmacology, Faculty of Pharmacy, Near East University, 99138 Nicosia, Cyprus.
- 2Department of Medical Pharmacology, Faculty of Medicine, Istanbul Atlas University, Kagithane, Anadolu Cad. No: 40, Istanbul 34408, Türkiye.
Abstract
Circadian rhythms regulate glucose metabolism, insulin secretion, hepatic glucose production, peripheral insulin sensitivity, nutrient handling, and energy balance. Observational studies have associated circadian timing disruption through shift work, irregular sleep, artificial light at night, social jet lag, late eating, or inconsistent meal timing with insulin resistance and type 2 diabetes mellitus (T2DM). This narrative review integrates molecular, clinical, nutritional, and pharmacological evidence linking circadian misalignment with diabetes, with emphasis on chrononutrition, time-restricted eating, glucose variability, diabetes-related complications, melatonin/MTNR1B-related susceptibility, exogenous melatonin, continuous glucose monitoring (CGM), digital phenotyping, and chronopharmacology. A structured narrative literature search was conducted to identify relevant studies on circadian biology, diabetes, meal timing, time-restricted eating, melatonin signaling, MTNR1B, circadian biomarkers, CGM, and time-informed therapeutic strategies. Mechanistic and preclinical studies establish clock-metabolism coupling, whereas controlled human physiological studies support time-of-day variation in insulin secretion, postprandial responses, and glucose handling; diabetes-specific interventional and complication-outcome evidence remains limited. Chrononutrition and time-restricted eating may support glycemic regulation only as individualized adjuncts to standard diabetes care, not as replacements for established treatment; medication review and hypoglycemia monitoring are essential, particularly for patients using insulin or insulin secretagogues. Translation into routine care requires longer diabetes-specific trials, standardized outcomes, validated biomarkers, and patient-centered implementation protocols.
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BibTeX
@article{haskologlu2026circadian,
title = {{Circadian Misalignment and Chrononutrition in Type 2 Diabetes: Mechanistic Insights and Translational Gaps.}},
author = {İsmail Celil Haskoloğlu and Zeynep Güneş Özünal},
journal = {International journal of molecular sciences},
year = {2026},
month = sep,
doi = {10.3390/ijms27198473},
url = {https://europepmc.org/article/MED/42883720},
note = {CC BY},
}
RIS
TY - JOUR
TI - Circadian Misalignment and Chrononutrition in Type 2 Diabetes: Mechanistic Insights and Translational Gaps.
AU - İsmail Celil Haskoloğlu
AU - Zeynep Güneş Özünal
PY - 2026
DA - 2026/09/23
JO - International journal of molecular sciences
DO - 10.3390/ijms27198473
UR - https://europepmc.org/article/MED/42883720
AB - Circadian rhythms regulate glucose metabolism, insulin secretion, hepatic glucose production, peripheral insulin sensitivity, nutrient handling, and energy balance. Observational studies have associated circadian timing disruption through shift work, irregular sleep, artificial light at night, social jet lag, late eating, or inconsistent meal timing with insulin resistance and type 2 diabetes mellitus (T2DM). This narrative review integrates molecular, clinical, nutritional, and pharmacological evidence linking circadian misalignment with diabetes, with emphasis on chrononutrition, time-restricted eating, glucose variability, diabetes-related complications, melatonin/MTNR1B-related susceptibility, exogenous melatonin, continuous glucose monitoring (CGM), digital phenotyping, and chronopharmacology. A structured narrative literature search was conducted to identify relevant studies on circadian biology, diabetes, meal timing, time-restricted eating, melatonin signaling, MTNR1B, circadian biomarkers, CGM, and time-informed therapeutic strategies. Mechanistic and preclinical studies establish clock-metabolism coupling, whereas controlled human physiological studies support time-of-day variation in insulin secretion, postprandial responses, and glucose handling; diabetes-specific interventional and complication-outcome evidence remains limited. Chrononutrition and time-restricted eating may support glycemic regulation only as individualized adjuncts to standard diabetes care, not as replacements for established treatment; medication review and hypoglycemia monitoring are essential, particularly for patients using insulin or insulin secretagogues. Translation into routine care requires longer diabetes-specific trials, standardized outcomes, validated biomarkers, and patient-centered implementation protocols.
SN - 1422-0067
ER -