title: Glycaemic behaviour during breastfeeding in women with Type 1 diabetes.
abstract: To describe glycaemia in both breastfeeding women and artificially feeding women with Type 1 diabetes, and the changes in glycaemia induced by suckling.
  
  
  
  A blinded continuous glucose monitor was applied for up to 6 days in eight breastfeeding and eight artificially feeding women with Type 1 diabetes 2-4 months postpartum. Women recorded glucose levels, insulin dosages, oral intake and breastfeeding episodes. A standardized breakfast was consumed on 2 days. A third group (clinic controls) were identified from a historical database.
  
  
  
  Carbohydrate intake tended to be higher in breastfeeding than artificially feeding women (P = 0.09) despite similar insulin requirements. Compared with breastfeeding women, the high blood glucose index and standard deviation of glucose were higher in artificially feeding women (P = 0.02 and 0.06, respectively) and in the clinical control group (P = 0.02 and 0.05, respectively). The low blood glucose index and hypoglycaemia were similar. After suckling, the low blood glucose index increased compared with before (P < 0.01) and during (P < 0.01) suckling. Hypoglycaemia (blood glucose < 4.0 mmol/l) occurred within 3 h of suckling in 14% of suckling episodes, and was associated with time from last oral intake (P = 0.04) and last rapid-acting insulin (P = 0.03). After a standardized breakfast, the area under the glucose curve was positive. In breastfeeding women the area under the glucose curve was positive if suckling was avoided for 1 h after eating and negative if suckling occurred within 30 min of eating.
  
  
  
  Breastfeeding women with Type 1 diabetes had similar hypoglycaemia but lower glucose variability than artificially feeding women. Suckling reduced maternal glucose levels but did not cause hypoglycaemia in most episodes.
authors.affiliation: School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.|Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Achong
authors.affiliation: School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.|The Mater Medical Research Institute, Brisbane, Queensland, Australia.
authors.forename: H D
authors.initials: HD
authors.lastname: McIntyre
authors.affiliation: School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.|Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Callaway
authors.affiliation: School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.|Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.|The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia.|The University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia.
authors.forename: E L
authors.initials: EL
authors.lastname: Duncan
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D001942:Breast Feeding; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000378:metabolism*; D004435:Eating; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007223:Infant; D041943:Infant Formula; D007328:Insulin / Q000008:administration & dosage; D018670:Monitoring, Ambulatory; D049590:Postpartum Period; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin