Analysis of Insulin in Human Breast Milk in Mothers with Type 1 and Type 2 Diabetes Mellitus

Whitmore, Timothy J; Trengove, Naomi; Graham, Dorothy; Hartmann, Peter

doi:10.1155/2012/296368

Cited by 63 publications

(64 citation statements)

References 37 publications

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“…Previous findings on the relationship of maternal BMI to milk insulin have been mixed. Our results are consistent with several other studies reporting a positive correlation with maternal pregnancy BMI . In contrast, Shehadeh et al reported postpartum maternal BMI (measured at the time of breast milk sample collection) to have no influence on insulin concentration in transitional milk (days 3 and 10).…”

Section: Discussionsupporting

confidence: 92%

Relationship of Maternal Weight Status Before, During, and After Pregnancy with Breast Milk Hormone Concentrations

Dadres

Whitaker

Haapala

et al. 2019

Obesity

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Objective The aim of this study was to test associations of prepregnancy BMI, gestational weight gain, oral glucose challenge test results, and postpartum weight loss as predictors of breast milk leptin, insulin, and adiponectin concentrations and whether these relationships vary over time. Methods Milk was collected at 1 and 3 months from 135 exclusively breastfeeding women from the longitudinal Mothers and Infants Linked for Healthy Growth (MILk) study. Hormones were assayed in skimmed samples using ELISA. Mixed‐effects linear regression models were employed to assess main effects and effect‐by‐time interactions on hormone concentrations. Results In adjusted models, BMI was positively associated with milk leptin (P < 0.001) and insulin (P = 0.03) and negatively associated with milk adiponectin (P = 0.02); however, the association was stronger with insulin and weaker with adiponectin at 3 months than at 1 month (time interaction P = 0.017 for insulin and P = 0.045 for adiponectin). Gestational weight gain was positively associated and postpartum weight loss was negatively associated with milk leptin (both P < 0.001), independent of BMI. Oral glucose challenge test results were not associated with these milk hormone concentrations. Conclusions Maternal weight status before, during, and after pregnancy contributes to interindividual variation in human milk composition. Continuing work will assess the role of these and other milk bioactive factors in altering infant metabolic outcomes.

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Section: Discussionsupporting

confidence: 92%

Relationship of Maternal Weight Status Before, During, and After Pregnancy with Breast Milk Hormone Concentrations

Dadres

Whitaker

Haapala

et al. 2019

Obesity

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“…The mean milk insulin concentration of 16.7 mU/l was similar to reported milk insulin levels of about 15.64 ± 1.03 mU/l [20]. The mean adiponectin concentration of 35.0 ng/ml was slightly higher than previously reported milk concentrations at 1 year of lactation of 25.7 ± 1.4 ng/ml [21].…”

Section: Resultssupporting

confidence: 81%

Excessive Weight Gain during Full Breast-Feeding

et al. 2014

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Background: Breast-feeding is considered to offer optimal nutrition for healthy infant growth and development. Observational studies have linked breast-feeding to reduced obesity. Case Observation: We observed an infant who was born macrosomic (4.56 kg) and showed excessive weight gain markedly exceeding the 97th percentile of weight during full breast-feeding. At the age of 4 months, the weight was greater than 11 kg. Clinical evaluation did not reveal any underlying pathology. After the introduction of complementary feeding and hence reduction of the breast milk intake, the excessive weight gain was attenuated and the slope of the percentile curve paralleled upper percentiles. Since this pattern suggested full breast-feeding as the driver of excessive weight gain, we analyzed the human milk composition at the infant age of 1 year and compared the results with published data on composition at this stage of lactation. Results: The milk contents of lactose, fat, fatty acids, polar lipids, carnitine species, and insulin were similar to the reference data. The adiponectin content was increased. The most remarkable alteration was a high milk protein content (mean 1.25 g/dl, reference 0.8 g/dl). Conclusions: A very high protein supply in infancy has been previously shown to increase plasma concentrations of the growth factors insulin and IGF-1, weight gain, and later obesity. We speculate that interindividual variations in human milk adiponectin and protein contents may contribute to modulation of the growth of fully breast-fed infants and in this case may have contributed to excessive weight gain during full breast-feeding. This hypothesis merits being tested in future cohort studies.

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“…The insulin concentration in early milk does not appear to be affected by the mother's gestational diabetes status. While the insulin concentration in mature milk of nondiabetic women is not different from that of women with GDM (Ley et al 2012), maternal prenatal metabolic indicators, such as BMI, fasting glucose, insulin resistance, insulin sensitivity, and adiponectin levels, can predict insulin concentration in mature milk (Ley et al 2012;Whitmore et al 2012).…”

Section: Feedingmentioning

confidence: 96%

Pediatric Type 2 Diabetes: Prevention and Treatment Through a Life Course Health Development Framework

Salsberry

Tanda

Anderson

et al. 2017

Handbook of Life Course Health Development

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Estimates project that one in three US adults may have diabetes in 2050. Until very recently, type 2 diabetes mellitus (T2DM) was a disease diagnosed in adults, but as the childhood obesity epidemic has spread, the diagnosis of T2DM in adolescents has become more common. Early indicators suggest that the disease may be more severe and more difficult to manage when diagnosed in adolescents. It is projected that adolescents with T2DM will lose approximately 15 years of life. The economic burden of T2DM rises significantly as the years with disease increase. This grim forecast highlights that not only will the disease burden be significant but the economic burden will be high. The risk for developing T2DM begins in utero. Individual health development trajectories build from this starting point, the result of multiple factors that accumulate across time and are the result of biological conditioning during sensitive developmental periods. A major aim of this chapter is to demonstrate that a life course health development approach to pediatric T2DM is critical to a sound national strategy to prevent and treat pediatric T2DM. We review major factors known to influence the development of pediatric T2DM and track these across childhood. While these factors will likely change over the next decade, what will not change is the importance of placing these factors into context and recognizing that T2DM development is highly sensitive to the timing and social structures of multiple environmental exposures. Research recommendations are discussed through a life course lens.

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Analysis of Insulin in Human Breast Milk in Mothers with Type 1 and Type 2 Diabetes Mellitus

Cited by 63 publications

References 37 publications

Relationship of Maternal Weight Status Before, During, and After Pregnancy with Breast Milk Hormone Concentrations

Relationship of Maternal Weight Status Before, During, and After Pregnancy with Breast Milk Hormone Concentrations

Excessive Weight Gain during Full Breast-Feeding

Pediatric Type 2 Diabetes: Prevention and Treatment Through a Life Course Health Development Framework

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