The effect of breastfeeding on postpartum glucose tolerance and lipid profiles in women with gestational diabetes mellitus

Alexis Shub,Elizabeth A Mccarthy,Martha Lappas,Manisha Miranda,Harry M Georgiou

doi:10.1186/s13006-019-0238-5

Alexis Shub, Elizabeth A Mccarthy + Show 3 more

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https://doi.org/10.1186/s13006-019-0238-5

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Abstract

BackgroundWe aimed to investigate the association of breastfeeding on postpartum glucose levels and lipid profiles in women diagnosed with gestational diabetes mellitus (GDM) and women without GDM.MethodsWe performed a secondary analysis of a cohort study of 243 women, 159 women with GDM and 84 normally glucose tolerant women between 2012 and 2017. At approximately 6–10 weeks postpartum, we measured fasting blood glucose and plasma lipid levels. Breastfeeding behaviour was self-defined as exclusive breastfeeding or not exclusive breastfeeding.ResultsThe mean (SD) glucose in the group of women who breastfed exclusively was 4.6 (0.49) mmol/L, compared to 4.9 (0.58) mmol/L (95% CI 0.45, 0.15, p < 0.001) among women who did not exclusively breastfeed. Among women with GDM, the reduction in fasting glucose in women who were breastfeeding was 0.22 mmol/L (95% CI 0.39, 0.05, p = 0.004), and in women who were not GDM, the reduction was 0.14 mmol/L (95% CI 0.37, 0.09, p = 0.24,). After adjustment for GDM status in pregnancy, maternal body mass index (BMI), maternal age and ethnicity, and exclusive breastfeeding was associated with a decreased fasting glucose of 0.19 (95% CI 0.318, 0.061, p = 0.004). After similar adjustment, there was no significant difference in triglycerides, high density lipoprotein cholesterol or low-density lipoprotein cholesterol between women who were breastfeeding and women who were not breastfeeding.ConclusionsBreastfeeding is associated with a reduction in fasting glucose levels postpartum, but not maternal lipid profile. Breastfeeding may play a role in reducing glucose intolerance in women who have had GDM.

Highlights

We aimed to investigate the association of breastfeeding on postpartum glucose levels and lipid profiles in women diagnosed with gestational diabetes mellitus (GDM) and women without GDM
The diagnosis of GDM was made by an oral glucose tolerance test (OGTT) at 24– 28 weeks of gestation, according to the Australasian Diabetes in Pregnancy Society (ADIPS) guidelines by either a fasting venous plasma concentration of ≥5.5 mmol/L glucose and/or ≥ 8.0 mmol/L glucose 2 h after a 75 g oral glucose load [11]
One hundred and forty-nine women without GDM in the index or previous pregnancies were recruited between December 2016 and May 2017, and were classified as not having diabetes based on the current ADIPS criteria

Summary

Introduction

We aimed to investigate the association of breastfeeding on postpartum glucose levels and lipid profiles in women diagnosed with gestational diabetes mellitus (GDM) and women without GDM. 5% of women will develop T2DM in the first six months after a pregnancy with GDM, and a further 10% will develop diabetes 1–2 years postpartum [2]. Information on the role of breastfeeding in reduction of progression to T2DM has been mixed, with studies both supporting and refuting this [5,6,7]. This protective effect was still demonstrated 30 years after the index pregnancy in a prospective cohort of women with and without GDM [8].

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