TITLE:
Long Lasting Effects of Breastfeeding on Metabolism in Women with Prior Gestational Diabetes
AUTHORS:
Luca Mattei, Antonietta Colatrella, Olimpia Bitterman, Paola Bianchi, Chiara Giuliani, Giona Roma, Camilla Festa, Gianluca Merola, Vincenzo Toscano, Angela Napoli
KEYWORDS:
Breastfeeding, Gestational Diabetes, Metabolism
JOURNAL NAME:
Journal of Diabetes Mellitus,
Vol.4 No.4,
October
16,
2014
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
andχ2tests 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.