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Lactation and Progression to Type 2 Diabetes After Gestational Diabetes FREE

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This article was published online first at www.annals.org on 24 November 2015.

The full report is titled “Lactation and Progression to Type 2 Diabetes Mellitus After Gestational Diabetes Mellitus. A Prospective Cohort Study.” It is in the 15 December 2015 issue of Annals of Internal Medicine (volume 163, pages 889-898). The authors are E.P. Gunderson, S.R. Hurston, X. Ning, J.C. Lo, Y. Crites, D. Walton, K.G. Dewey, R.A. Azevedo, S. Young, G. Fox, C.C. Elmasian, N. Salvador, M. Lum, B. Sternfeld, and C.P. Quesenberry, for the Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy Investigators.

This article was published online first at www.annals.org on 24 November 2015.

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.

Ann Intern Med. 2015;163(12):I-36. doi:10.7326/P15-9038
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What is the problem and what is known about it so far?

Breastfeeding has positive effects on the health of infants as well as their mothers. Some of the positive effects of breastfeeding in mothers include improved meta-bolism of glucose and lipids. Whether breastfeeding a child can prevent women with gestational diabetes (or diabetes during pregnancy) from developing type 2 diabetes after delivery is unclear.

Why did the researchers do this particular study?

To see whether the level and duration of breastfeeding lowered the mother's future risk for new-onset type 2 diabetes after a pregnancy with gestational diabetes.

Who was studied?

1035 Hispanic, Asian, black, or white women who had gestational diabetes and enrolled in the study at 2 months after delivery.

How was the study done?

At the time the women were enrolled in the study, they were classified as either exclusively breastfeeding, mostly breastfeeding, mostly formula or mixed/inconsistent feeding, or exclusively formula feeding. The women had an oral glucose tolerance test at 2 months after delivery (baseline), and those who did not have diabetes at 2 months were tested again every year for 2 years, in addition to other tests. The investigators determined how many women developed type 2 diabetes during the follow-up period.

What did the researchers find?

Higher amounts of breastfeeding (mostly breastfeeding or breastfeeding only) and breastfeeding for longer periods of time (>2 months) were both associated with a decreased risk for type 2 diabetes.

What were the limitations of the study?

The women were followed for only 2 years after delivery. It is possible that some women may have developed type 2 diabetes after the study ended.

What are the implications of the study?

Higher intensity of breastfeeding and breastfeeding for longer periods of time may prevent type 2 diabetes in women with a history of gestational diabetes.





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