Effects Of Breastfeeding On Blood Glucose Regulation In Obese Latino
Women With A History Of Gestational Diabetes
MF Villacorta, MS, RD; C.B. Hollenbeck,
PhD; YM, Gutierrez, PhD, RD; L. McProud, PhD, RD.
San Jose State
University, San Jose CA and
Stanford University, Palo Alto, CA
The purpose of the present study was to determine the effects of
breastfeeding on day long glucose regulation during the three months
postpartum in Latino women with a history of gestational diabetes
mellitus (GDM). Eighteen Mexican - American women from the California
Diabetes and Pregnancy Program with a diagnosis of GDM participated
in the study. Capillary plasma glucose was measured five times per
day, three days per week during the entire 3-month study period.
Random capillary plasma blood glucose levels from the day of delivery
were obtained from medical records. Maternal weights were assessed
at 6 weeks and 12 weeks postpartum. Blood glucose was measured 5
times per day, 3-day per week and defined as ambient blood glucose
(AMBG). Repeated measurements were analyzed using a general linear
model and the means were compared using independent t-test. Thirteen
women chose to exclusively breastfeed (BF) and 5 women chose to
exclusively formula-feed (FF). Blood glucose levels on the day of
delivery were not significantly different between the groups. Both
groups gained wt over the 3-month period but did not differ significantly.
Fasting blood glucose levels (FBG) increased significantly over
time in both groups. There were significant differences in fasting
plasma glucose and rate of change in fasting glucose concentrations
between the two groups. The rate of change in FBG increased at a
lower rate in the BF group (0.836 mg/dl/wk; P = 0.008) than in the
FF group (1.94 mg/dl/wk; P = 0.002). AMBG levels were significantly
lower in the BF group than the FF group over the 3 - month period
and increased significantly over time. The rate of change in AMBG
for the BF group was 0.50 mg/dl/wk vs 0.69 mg/dl/wk for the FF group.
These data demonstrate that breastfeeding slows the normal rise
in blood glucose levels observed in FF women during the first 3
months postpartum, and suggest that it may provide protection for
Latino women with previous history of GDM. These data add clarity
of the regulation of glucose regulation in the immediate months
postpartum in Latino women with GDM, and provides the impetus to
encourage breastfeeding in this group.
Effects of Breastfeeding on Dietary Intake and Weight Regulation in Obese Latino Women with a History of Gestational Diabetes
MF Villacorta, MS, RD; C.B. Hollenbeck,
PhD; YM, Gutierrez, PhD, RD; L. McProud, PhD, RD.
San Jose State
University, San Jose, CA and
Stanford University, Palo Alto, CA
The purpose of the present study was to assess the role of breast
feeding (BF) on dietary intake & changes in maternal and infant
weight during the first 3-months postpartum in women with gestational
diabetes mellitus (GDM). Eighteen women from the California Diabetes
and Pregnancy Program participated in the study. Thirteen women
chose to breastfeed (BF) & 5 women chose to formula-feed (FF).
Mean age, parity, level of education, and BMI did not differ significantly
between the two groups. However, the FF group had a significantly
higher incidence of pregnancy. The study group was overweight with
a mean pre-pregnancy BMI of 27.6 ± 4 kg/m2. All subjects
collected 3-day maternal food records. Energy and macronutrient
intakes were analyzed during first 2 weeks (FW), mid 2 weeks (MW)
and last 2 weeks (LW). The BF group recorded the number of times
they breastfed on these same 3 days. Repeated measurements of Kcal
and macronutrients were analyzed by general linear model and linear
regression, and the means compared using independent t-test. Maternal
and infant weights were assessed at 6 weeks and 12 weeks. Blood
glucose levels from the date of delivery did not differ significantly
between the groups. The frequency of breastfeeding did not differ
among the BF subjects. Kcal increased as time progressed in the
BF group, while kcal in the FF group decreased during MW and increased
during LW. Kcals were significantly different only during the MW
period (P = 0.003). The amount of fat (P = 0.04) and carbohydrate
(P = 0.001) changed significantly with time in both groups while
protein did not, while percent distribution of calories from, fat,
carbohydrate and protein did not change significantly over time,
and did not different between the groups. Infant weights at birth,
6 and 12 weeks & maternal pre-pregnancy, 6 and 12 weeks weights
did not differ between the groups. However, both groups showed a
significant increase in weight from week 6 to week 12 (P = 0.05).
Thus, these data do not support the notion that breastfeeding may
aid in weight reduction during the first 3 months postpartum in
women with GDM. It is possible, that longer periods of BF may be
necessary to achieve meaningful weight loss.