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

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 (BF_yes, n = 32) or not (BF_no, 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 BF_yes and BF_no were comparable, however in BF_yes, MDIR were continuously lower compared to BF_no. 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 BF_no (p < 0.001). Although neither were statistically significant, from 3 months postpartum HbA1c levels were highest in the BF_no and BF_no had a higher pregnancy weight retention compared to BF_yes (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.

Keywords: Hb1Ac; Insulin requirements; Postpartum; Pregnancy Weight Retention; T1DM.