ABSTRACT
Background & Aims:
Breastfeeding improves glucose tolerance in the early postpartum period of
women with prior gestational diabetes GDM, but it is unclear whether future
risk of metabolic alterations, like type 2 diabetes, is reduced. The aim of
this study was to investigate the effect of lactation, three years after
pregnancy, on glucose and lipid metabolism in women with prior gestational
diabetes. Materials & Methods: A population of women with prior gestational
diabetes (Carpenter and Coustan Criteria) was evaluated with comparison of
results for “lactating” [BF] versus “nonlactating women” [non BF]. Breast
feeding was defined [BF] if lasting? 4 weeks. In each woman a 75-g oral glucose
tolerance test (OGTT) was performed to analyze the glucose tolerance, insulin
sensitivity/resistance and b-cell function. Fasting serum was used to study
their lipid profile (total cholesterol, high-density lipoprotein [HDL]
cholesterol, low-density lipoprotein [LDL] cholesterol, and triglycerides),
apolipoprotein B, apolipoprotein A1, homocysteine, fibrinogen, hsCRP, uric
acid, microalbuminuria. Statistics: Paired and Un-paired t-test, Mann-Whitney
and χ2 tests were used, as appropriate.
Results: A total of 81 women were evaluated (62 [BF] and 19 [non BF]). Maternal
age (37.1 ± 4.6 vs 37.4 ± 4.9
years), body mass index (26.3 ± 5.6 vs 26.4 ± 5.3
kg/m2), parity (1.9 ± 0.8 vs 1.7 ± 0.8)
and length of follow-up (32.2 ± 20.2 vs 32.1± 20,0) were not different between the
two groups. No effect was visible on glucose tolerance, HOMA-IR and other
b-cell function indexes as well as hs-CRP (not significantly lower in non BF),
uric acid, total cholesterol, HDL and LDL cholesterol. Levels of significance
were only reached for “HOMA-IS” [BF] 1.0 ± 0.7 vs [non BF] 0.6 ± 0.4,
p = 0.04) and triglycerides [BF] 83.8 ±46.7
vs [non BF] 123.2 ± 94.0 mg/dl, p = 0.02). Conclusions:
Breastfeeding does not improve the glucose tolerance of our women with prior
GDM three years after delivery, even though lower levels of triglycerides and
improved insulin sensitivity are still visible.
Share and Cite:
Mattei, L. , Colatrella, A. , Bitterman, O. , Bianchi, P. , Giuliani, C. , Roma, G. , Festa, C. , Merola, G. , Toscano, V. and Napoli, A. (2014) Long Lasting Effects of Breastfeeding on Metabolism in Women with Prior Gestational Diabetes.
Journal of Diabetes Mellitus,
4, 257-263. doi:
10.4236/jdm.2014.44037.