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Diabetes Management During Breastfeeding in Women with Type 1 Diabetes

  • Diabetes and Pregnancy (M-F Hivert and CE Powe, Section Editors)
  • Published:
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Abstract

Purpose of Review

To provide an update on glycemic management of type 1 diabetes during breastfeeding with focus on diet and insulin treatment to prevent hypoglycemia, ketoacidosis, and weight retention. Recommendations for insulin pump settings are given.

Recent Findings

Women with type 1 diabetes are encouraged to breastfeed. Hypoglycemia is a concern in the breastfeeding period among women with type 1 diabetes, and ketoacidosis may also occur. The usual goals for glucose values for persons with diabetes also apply during breastfeeding. The recommended minimum daily carbohydrate intake is 210 g during breastfeeding, and this may contribute to prevention of hypoglycemia and ketoacidosis while aiming for gradual weight loss. Insulin requirements are 21% lower during breastfeeding than before pregnancy.

Summary

Diabetes management in breastfeeding women with type 1 diabetes includes the same goals for glucose values as in other persons with diabetes, sufficient carbohydrate intake, and adequate reduction in insulin dose.

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Authors and Affiliations

  1. Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark

    Lene Ringholm, Sidse Kjærhus Nørgaard, Peter Damm & Elisabeth R. Mathiesen

  2. Department of Endocrinology PE7562, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark

    Lene Ringholm, Sidse Kjærhus Nørgaard & Elisabeth R. Mathiesen

  3. Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, DK-2820, Gentofte, Denmark

    Lene Ringholm & Elisabeth Buur Stougaard

  4. Department of Obstetrics, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark

    Peter Damm

  5. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Peter Damm & Elisabeth R. Mathiesen

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  1. Lene Ringholm
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  3. Sidse Kjærhus Nørgaard
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  4. Peter Damm
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Correspondence to Lene Ringholm.

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Conflict of Interest

Lene Ringholm reports a grant from Novo Nordisk for a clinical trial on insulin analogs.

Elisabeth Buur Stougaard and Sidse Kjærhus Nørgaard each declare no potential conflicts of interest.

Peter Damm is on an advisory board of a project concerning the use of insulin analogs in pregnancy. No personal fee is received, but his institution gets a small fee for this.

Elisabeth R. Mathiesen reports personal fees from Novo Nordisk for one time insulin trial and speaker’s fees.

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Ringholm, L., Stougaard, E.B., Nørgaard, S.K. et al. Diabetes Management During Breastfeeding in Women with Type 1 Diabetes. Curr Diab Rep 20, 34 (2020). https://doi.org/10.1007/s11892-020-01315-x

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