Beneficial effects of breastfeeding in women with gestational diabetes mellitus

Abstract

Gestational diabetes mellitus (GDM) increases the future risk of developing type 2 diabetes mellitus (T2DM). There is now a growing evidence that breastfeeding has short- and long-term health benefits for mothers with GDM. Mothers with GDM who breastfeed have improved lipid and glucose metabolic profiles for the first 3 months after birth. However, women with GDM are less likely to breastfeed and, if they do, breastfeeding is usually continued for a shorter duration compared with women without GDM. One long-term prospective study followed women with GDM from delivery for up to 19 years postpartum, and found that breastfeeding for ≥3 months reduced the risk of T2DM and delayed the development of T2DM by a further 10 years compared with breastfeeding for <3 months. However, the physiological mechanisms underlying the protective effects of breastfeeding are still unknown, even though it is important to gain a full understanding of the pathways involved in these effects. Therefore, the purpose of this review is to provide a comprehensive analysis of the recent developments in the field of GDM and breastfeeding. We reviewed data from animal experiments and human studies. We also provide insight into the molecular pathways and describe promising topics for future research.

Keywords: Breastfeeding; Gestational diabetes mellitus; Glucose homeostasis; Type 2 diabetes mellitus.

Figure 1

Cumulative life-table risk of postpartum diabetes in 304 women with GDM who were followed prospectively for up to 19 years postpartum. The numbers below the graph indicate the number of women at each follow-up. Published previously in Ziegler et al. Long term protective effect of lactation on the development of type 2 diabetes mellitus in women with recent gestational diabetes mellitus.

Figure 2

Cumulative life-table risk of postpartum diabetes in islet autoantibody negative women with gestational diabetes who breastfed for >3 months (dashed line) compared with those who did not breastfeed or breastfed for ≤3 months (dotted line). The numbers below the graph indicate the number of subjects at each follow-up. Published previously in Ziegler et al. Long term protective effect of lactation on the development of type 2 diabetes mellitus in women with recent gestational diabetes mellitus.

Figure 3

Potential mechanisms involved in the short-term effects of breastfeeding on glucose metabolism and its long-term effect on the development of T2DM based on evidence from animal models. T2DM: type 2 diabetes mellitus.