Ichiro Yasuhi1, Hiroshi Yamashita1, Kazuhisa Maeda2, Makoto Nomiyama3, Tomoya Mizunoe4, Katsuhiko Tada5, Moe Yorozu5, Masanobu Ogawa6, Takashi Kodama7, Ken Yamaguchi8, Naofumi Okura9, Kosuke Kawakami9, Yuka Maekawa10, Kimikazu Hayashi11. 1. Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan. 2. Department of Obstetrics and Gynecology, Shikoku Medical Center for Children and Adults, Zentsuji, Japan. 3. Department of Obstetrics and Gynecology, Saga Hospital, Saga, Japan. 4. Department of Obstetrics and Gynecology, Kure Medical Center, Kure, Japan. 5. Department of Obstetrics and Gynecology, Okayama Medical Center, Okayama, Japan. 6. Department of Obstetrics and Gynecology, Kyusyu Medical Center, Fukuoka, Japan. 7. Department of Obstetrics and Gynecology, Higashihiroshima Medical Center, Higashihiroshima, Japan. 8. Department of Obstetrics and Gynecology, Kyoto Medical Center, Kyoto, Japan. 9. Department of Obstetrics and Gynecology, Kokura Medical Center, Kitakyushu, Japan. 10. Department of Obstetrics and Gynecology, Mie Chuo Medical Center, Tsu, Japan. 11. Department of Obstetrics and Gynecology, Kanmon Medical Center, Shimonoseki, Japan.
Abstract
AIM: To investigate whether high-intensity breastfeeding (HIB) reduces insulin resistance during early post-partum period in women with gestational diabetes (GDM), independent of post-partum weight change (PWC). MATERIALS AND METHODS: In this multicentre prospective study, we included Japanese women with GDM who underwent a 75-g oral glucose tolerance test (OGTT) during early post-partum. We measured plasma insulin during OGTT to obtain a homeostasis model of assessment of insulin resistance (HOMA-IR). We defined the condition in which infants were fed by breastfeeding alone or greater than or equal to 80% of the volume as HIB, and other statuses, including partial and nonbreastfeeding, as non-HIB. We investigated the association between post-partum HOMA-IR and the breastfeeding status after adjusting for confounders including PWC. RESULTS: Among 222 women with GDM who underwent the OGTT at 7.9 ± 2.3 weeks post-partum with a PWC of -7.8 ± 3.4 kg, although the rate of abnormal glucose tolerance (prediabetes and diabetes) did not differ between the groups (33% vs 32%), the HOMA-IR in the HIB women (n = 166) was significantly lower than that in the non-HIB women (n = 56) (1.12 ± 0.85 vs 1.72 ± 1.43, P = 0.0002). The effect of the HIB was independently associated with lower HOMA-IR after adjusting for confounders including PMC. However, the subgroup analysis according to their pre-pregnancy obesity states showed that the effect was seen only in the obese subjects (BMI ≥ 25). CONCLUSIONS: In obese Japanese women with GDM, HIB has a significant effect in reducing insulin resistance during early post-partum, independent of the post-partum weight loss.
AIM: To investigate whether high-intensity breastfeeding (HIB) reduces insulin resistance during early post-partum period in women with gestational diabetes (GDM), independent of post-partum weight change (PWC). MATERIALS AND METHODS: In this multicentre prospective study, we included Japanese women with GDM who underwent a 75-g oral glucose tolerance test (OGTT) during early post-partum. We measured plasma insulin during OGTT to obtain a homeostasis model of assessment of insulin resistance (HOMA-IR). We defined the condition in which infants were fed by breastfeeding alone or greater than or equal to 80% of the volume as HIB, and other statuses, including partial and nonbreastfeeding, as non-HIB. We investigated the association between post-partum HOMA-IR and the breastfeeding status after adjusting for confounders including PWC. RESULTS: Among 222 women with GDM who underwent the OGTT at 7.9 ± 2.3 weeks post-partum with a PWC of -7.8 ± 3.4 kg, although the rate of abnormal glucose tolerance (prediabetes and diabetes) did not differ between the groups (33% vs 32%), the HOMA-IR in the HIB women (n = 166) was significantly lower than that in the non-HIB women (n = 56) (1.12 ± 0.85 vs 1.72 ± 1.43, P = 0.0002). The effect of the HIB was independently associated with lower HOMA-IR after adjusting for confounders including PMC. However, the subgroup analysis according to their pre-pregnancy obesity states showed that the effect was seen only in the obese subjects (BMI ≥ 25). CONCLUSIONS: In obese Japanese women with GDM, HIB has a significant effect in reducing insulin resistance during early post-partum, independent of the post-partum weight loss.
Authors: Amanda Rodrigues Amorim Adegboye; Danilo Dias Santana; Pedro Paulo Teixeira Dos Santos; Paula Guedes Cocate; Camila Benaim; Maria Beatriz Trindade de Castro; Michael Maia Schlüssel; Gilberto Kac; Berit Lilienthal Heitmann Journal: Nutrients Date: 2021-02-27 Impact factor: 5.717