Breastfeeding and the basal insulin requirement in type 1 diabetic women
Abstract
Objective To evaluate whether breastfeeding in women with type 1 diabetes mellitus is associated with a decreased insulin requirement.Methods In this prospective study conducted between September 2006 and August 2008, type 1 diabetic pregnant women were recruited before the third trimester of pregnancy. Eligible women had no evidence of diabetes-related complications and were treated with continuous subcutaneous insulin infusion pump therapy. During pregnancy and in the first 8 weeks of the postpartum period, participants performed daily fingerstick blood glucose monitoring with at least 12 measurements per day; insulin dosages were adjusted to maintain normoglycemia. Participant characteristics, diabetic parameters, and neonatal growth were compared between women who breastfed exclusively and women who did not breastfeed.Results Of 18 women, 12 breastfed and 6 did not. Compared with nonbreastfeeding mothers, breastfeeding mothers showed a decreased need for total daily basal insulin (0.21 +/- 0.05 units/kg per day vs 0.33 +/- 0.02 units/kg per day). The mean value of total daily basal insulin was significantly lower in the breastfeeding group than in the non-breastfeeding group. The mean number of hyperglycemic episodes in the first 2 weeks post partum and during the third to eighth weeks was not different between the groups. However, the mean number of hypoglycemic episodes in the first 2 weeks post partum in the breastfeeding group was significantly higher than in the nonbreastfeeding group (11.9 +/- 2.6 episodes vs 5.5 +/- 1.6 episodes, P<.001). No differences were observed between the groups in neonatal birth weight or infant weight after 8 weeks of age.Conclusions Decreased need in total daily basal insulin is caused by increased glucose use during lactation. We recommend that the starting total daily basal insulin dosage for type 1 diabetic women who breastfeed be calculated as 0.21 units times the weight in kg per day. This regimen results in normoglycemia and minimizes the risk of severe hypoglycemia associated with lactation.
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Breastfeeding may also be a risk factor for hypoglycemia in women with insulin-treated diabetes.
“Breastfeeding may also be a risk factor for hypoglycemia in women with insulin-treated diabetes (82).”
From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [82]
Breastfeeding may also be a risk factor for hypoglycemia in women with insulin-treated diabetes.
“Breastfeeding may also be a risk factor for hypoglycemia in women with insulin-treated diabetes (82).”
From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [82]
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“Breastfeeding may also be a risk factor for hypoglycemia in women with insulin-treated diabetes (82).”
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- Authors
- Riviello, C., Mello, G., & Jovanovic, L. G.
- Affiliations
- University of Florence (IT)
- Sansum Diabetes Research Institute (US)
- Corresponding author
- Riviello, Chiara
- ORCID
- Jovanovic, Lois G.
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 15
- Issue
- 3
- Pages
- 187-193
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W2171891185
- Cited by
- 87
- References
- 14
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 3 · 2023: 6 · 2022: 3 · 2021: 12 · 2020: 7 · 2019: 6 · 2018: 3 · 2017: 7 · 2016: 4 · 2015: 4 · 2014: 6 · 2013: 6 · 2012: 7
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Keywords
- breastfeeding, type 1 diabetes, insulin dose adjustment, lactation, hypoglycemia, hyperglycemia, insulin pump therapy, pregnancy, neonatal growth, postpartum period
- MeSH terms
- Adult, Blood Glucose, Breast Feeding, Diabetes Mellitus, Type 1, Dose-Response Relationship, Drug, Female, Humans, Hypoglycemia, Infant, Newborn, Insulin, Insulin Infusion Systems, Pregnancy, Pregnancy in Diabetics, Infusion Pumps, Implantable, Incidence, Insulin, Long-Acting, Postpartum Period, Drug Dosage Calculations
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