Beta-cell function and visceral fat in lactating women with a history of gestational diabetes

Lactation has been recommended as beneficial for the maternal metabolic abn ormalities associated with glucose intolerance and diabetes risk, although associations between breastfeeding (BF), glucose tolerance, and adipose tis sue distribution are unknown. Therefore, a population of women with recent gestational diabetes (GDM) was evaluated with comparison of results for lac tating versus nonlactating women. A total of 26 women participated (14 BF a nd 12 nonbreastfeeding [nonBFI]) with a singleton vaginal delivery after 36 weeks gestation. At 3 months postpartum, each woman completed a 75-g oral glucose tolerance test (OGTT), a frequently sampled intravenous glucose tol erance test (FSIGT), and computed tomography (CT) scanning for adipose dist ribution and mass. Insulin sensitivity was not significantly different betw een BF and nonBF groups (4.97 +/- 0.78 v 3.44 +/- 1.0 x 10(-4) min(-1)/(muU /ml) nor was glucose effectiveness (1.92 +/- 0.22 v 1.56 +/- 0.19 x 10(-2) min(-1)). However, the disposition index (DI) (insulin sensitivity [S-1] x acute insulin response to glucose [AIRg]) was higher in the Bf group (129.9 +/- 26.0 v 53.4 +/- 18.0 x 10(-4) min(-1); P = .03), Visceral fat (103 +/- 14 v 97 +/- 15 cm(2)) and subcutaneous fat (362 +/- 36 v 460 +/- 68 cm(2)) were similar between the groups. We conclude that 3 months of BF in a popu lation with previous GDM was associated with improved pancreatic beta -cell function, but not with any difference in measures of adiposity, Copyright (C) 2001 by W.B. Saunders Company.