Glycaemic behaviour during lactation: Postpartum practical guidelines for women with type I diabetes

Abstract

The aim of the study was to examine the pattern of glycaemic behaviour and insulin requirements over two months postpartum in women with type 1 diabetes, to analyse differences between breastfeeding and non-breastfeeding mothers and to assess the relationship between hypoglycaemic episodes and nursing sessions. Blood glucose records (six glucose readings per day), HbA1c and insulin requirements for the last month preconception, the first week postpartum, the first month postpartum and the second month postpartum were analysed in 36 women with type 1 diabetes. Women were asked to keep a daily record of breastfeeding hours during the first month postpartum. The number of glucose readings did not differ during the four periods. Mean glucose values were only significantly lower during the first week postpartum. HbA1c values at the end of the first and second postpartum months did not differ from preconception values. Insulin requirements were significantly lower over the first postpartum week than during the preconception period, and remained significantly lower over the two postpartum months. Comparison of glycaemic control and insulin requirements between lactating and non-lactating mothers revealed no statistically significant differences. The 13 women who kept a record of breastfeeding hours had fewer hypoglycaemic episodes related to nursing sessions than episodes unrelated to nursing sessions. Both lactating and non-lactating mothers with type 1 diabetes will have lower glucose levels in the first week following delivery, and insulin requirements will remain lower than before pregnancy throughout the first two months postpartum. Hypoglycaemic episodes do not occur more frequently during or immediately after nursing sessions. Copyright © 2003 John Wiley & Sons, Ltd.