Journal article
Lactation Duration and Long-term Risk for Incident Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus
Diabetes care, Vol.43(4), pp.793-798
04/01/2020
DOI: 10.2337/dc19-2237
PMCID: PMC7085808
PMID: 32041900
Abstract
OBJECTIVE
We examined the association of lactation duration with incident type 2 diabetes among women with a history of gestational diabetes mellitus (GDM).
RESEARCH DESIGN AND METHODS
We monitored 4,372 women with a history of GDM participating in the Nurses’ Health Study II for incident type 2 diabetes over 25 years up to 2017. Lactation history was obtained through follow-up questionnaires to calculate lactation duration. Follow-up blood samples were collected from a subset of these women at median age of 58 years through the Diabetes & Women’s Health Study.
RESULTS
We documented 873 incident cases of type 2 diabetes during 87,411 person-years of follow-up. Longer duration of lactation was associated with lower risk of type 2 diabetes for both total lactation (hazard ratio 1.05 [95% CI 0.83–1.34] for up to 6 months, 0.91 [0.72–1.16] for 6–12 months, 0.85 [0.67–1.06] for 12–24 months, and 0.73 [0.57–0.93] for >24 months, compared with 0 months; P-trend = 0.003) and exclusive breastfeeding (P-trend = 0.002) after adjustment for age, ethnicity, family history of diabetes, parity, age at first birth, smoking, diet quality, physical activity, and prepregnancy BMI. Longer duration of lactation was also associated with lower HbA1c, fasting plasma insulin, and C-peptide concentrations among women without type 2 diabetes at follow-up (all adjusted P-trend ≤0.04).
CONCLUSIONS
Longer duration of lactation is associated with a lower risk of type 2 diabetes and a favorable glucose metabolic biomarker profile among women with a history of GDM. The underlying mechanisms and impact on diabetes complications, morbidity, and mortality remain to be determined.
Details
- Title: Subtitle
- Lactation Duration and Long-term Risk for Incident Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus
- Creators
- Sylvia H. Ley - Tulane UniversityJorge E. Chavarro - Harvard UniversityMengying Li - Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentWei Bao - University of IowaStefanie N. Hinkle - Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentPandora L. Wander - University of WashingtonJanet Rich-Edwards - Brigham and Women's HospitalSjurdur Olsen - Statens Serum InstitutAllan Vaag - Steno Diabetes CenterPeter Damm - University of CopenhagenLouise G. Grunnet - RigshospitaletJames L. Mills - Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentFrank B. Hu - Harvard UniversityCuilin Zhang - Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Resource Type
- Journal article
- Publication Details
- Diabetes care, Vol.43(4), pp.793-798
- DOI
- 10.2337/dc19-2237
- PMID
- 32041900
- PMCID
- PMC7085808
- ISSN
- 0149-5992
- eISSN
- 1935-5548
- Grant note
- DOI: 10.13039/100009633, name: Eunice Kennedy Shriver National Institute of Child Health and Human Development, award: HHSN275201000020C; DOI: 10.13039/100000057, name: National Institute of General Medical Sciences, award: P20-GM-109036
- Language
- English
- Date published
- 04/01/2020
- Academic Unit
- Epidemiology
- Record Identifier
- 9984364556202771
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