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Breastfeeding and insulin requirements in women with Type 1 diabetes mellitus in the first year postpartum

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Abstract

Aims

To explore whether breastfeeding affects postpartum insulin requirements, HbA1c levels, and pregnancy weight retention in women with Type 1 Diabetes Mellitus (T1DM).

Methods

This prospective study included 66 women with T1DM. The women were divided into two groups based on whether they were breastfeeding (BF) at 6 months postpartum (BFyes, n = 32) or not (BFno, n = 34). Mean daily insulin requirement (MDIR), HbA1c levels, and pregnancy weight retention at 5 time-points from discharge to 12 months postpartum were compared.

Results

MDIR increased by 35% from 35.7 IU at discharge to 48.1 IU at 12 months postpartum (p < 0.001). MDIR in BFyes and BFno were comparable, however in BFyes, MDIR were continuously lower compared to BFno. Postpartum HbA1c increased rapidly from 6.8% at 1 month to 7.4% at 3 months postpartum and settled at 7.5% at 12 months postpartum. The increase in HbA1c during the first 3 months postpartum was most pronounced in BFno (p < 0.001). Although neither were statistically significant, from 3 months postpartum HbA1c levels were highest in the BFno and BFno had a higher pregnancy weight retention compared to BFyes (p = 0.31).

Conclusion

In women with T1DM, breastfeeding did not significantly affect postpartum insulin requirements, HbA1c levels or pregnancy weight retention in the first year after delivery.

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Acknowledgements

The authors would like to thank all the participants and nurse Dorte Svenstrup for collecting data from all the participants. The authors also thank Biostatistical Advisory Service at the Faculty of Health, Aarhus University, for helping with all statistical analysis.

Funding

U. Kampmann and PG. Ovesen have received research grants from the Novo Nordisk Foundation. GO. Skajaa and J. Fuglsang have no financial disclosures. The funding sources had no role in the study design, inclusion process, data analysis, or statistical considerations or in the writing of this report.

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Authors and Affiliations

  1. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

    Gitte Øskov Skajaa, Ulla Kampmann, Per Glud Ovesen & Jens Fuglsang

  2. Department of Obstetrics and Gynecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8210, Aarhus, Denmark

    Gitte Øskov Skajaa, Per Glud Ovesen & Jens Fuglsang

  3. Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark

    Ulla Kampmann, Per Glud Ovesen & Jens Fuglsang

Authors
  1. Gitte Øskov Skajaa
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Correspondence to Gitte Øskov Skajaa.

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Conflict of interest

Author Ulla Kampmann and author Per G. Ovesen have received research support from the Novo Nordisk Foundation. Author Gitte Ø. Skajaa and author Jens Fuglsang declare that they have no financial interests. The funding sources had no role in the study design, inclusion process, data analysis, or statistical considerations or in the writing of this paper.

Ethical Standard Statement

The study was conducted in accordance with the Helsinki Declaration and approved by the Regional Ethical Committee (No. 1-10-72-258-14).

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Verbal and written consent was obtained from all participants.

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Skajaa, G.Ø., Kampmann, U., Ovesen, P.G. et al. Breastfeeding and insulin requirements in women with Type 1 diabetes mellitus in the first year postpartum. Acta Diabetol 60, 899–906 (2023). https://doi.org/10.1007/s00592-023-02068-1

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