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Diabetes Research
20.07.2016

Breastfeeding alters maternal metabolism and protects against diabetes for up to 15 years after delivery

An interdisciplinary team of scientists at the Helmholtz Zentrum München has studied the metabolism of women with gestational diabetes after giving birth. Along with partners at the Technical University of Munich (TUM) and the German Center for Diabetes Research (DZD), they were able to show that breastfeeding for more than three months brings about long-term metabolic changes. The research findings have been published in the journal Diabetologia.

Samples

In this study the Helmholtz scientists analyzed approximately two hundred patient samples, Source: Fotolia / cassis

Four percent of all pregnant women in Germany develop gestational diabetes before the birth of their child. Although their blood sugar levels initially return to normal after delivery, one in two of the mothers affected develops type 2 diabetes within the next ten years. While it has been shown that lactation can lower this risk by 40 percent, the reasons for this are not yet understood.

In an earlier study, researchers led by Professor Anette-Gabriele Ziegler, Director of the Institute of Diabetes Research (IDF) at the Helmholtz Zentrum München, showed that breastfeeding for more than three months postpartum has a protective effect, which lasts for up to 15 years after gestational diabetes. In their most recent study, they examined whether the metabolism could be responsible for this.*

For their analyses, the scientists examined almost 200 patients who had developed gestational diabetes. The participants in the study received a standardized glucose solution and gave a fasting blood sample beforehand, and during the test. The scientists then compared the samples on the basis of 156 different, known metabolites. On average, the women had given birth three and half years earlier.

“We observed that the metabolites in women who had breastfed for more than three months differed significantly from those who had had shorter lactation periods,” first-author Dr. Daniela Much from the IDF reports. “Longer periods of lactation are linked to a change in the production of phospholipids and to lower concentrations of branched-chain amino acids in the mothers’ blood plasma.” This is interesting because the metabolites involved were linked in earlier studies with insulin resistance and type 2 diabetes, the authors say.

“The findings of our study provide new insights into disease-related metabolic pathways that are influenced by lactation and could thus be the underlying reason for the protective effect,” concludes Dr. Sandra Hummel, head of the Gestational Diabetes working group at the IDF, who led the study. Breastfeeding, she explains, is a cost-effective intervention which aims to reduce the long-term risk of developing type 2 diabetes among women with gestational diabetes. 

In the future, the scientists will look at ways of translating this knowledge into concrete treatment recommendations. “On average, women with gestational diabetes breastfeed less often and for shorter duration than non-diabetic mothers,” Hummel says. “The aim is now to develop strategies that will improve the breastfeeding behaviors of mothers with gestational diabetes.”

 

Further information

Background:
* This refers specifically to a targeted metabolomics approach, i.e. the targeted identification and qualification of a number of known metabolites.

Original publication:
Much, D. et al. (2016). Lactation is Associated with Altered Metabolomic Signatures in Women with Gestational Diabetes, Diabetologia, DOI: 10.1007/s00125-016-4055-8

Seminal paper:
Ziegler, AG. et al. (2012). Long-term protective effect of lactation on the development of type 2 diabetes in women with recent gestational diabetes mellitus, Diabetes, DOI: 10.2337/db12-0393

The Helmholtz Zentrum München, the German Research Center for Environmental Health, pursues the goal of developing personalized medical approaches for the prevention and therapy of major common diseases such as diabetes and lung diseases. To achieve this, it investigates the interaction of genetics, environmental factors and lifestyle. The Helmholtz Zentrum München is headquartered in Neuherberg in the north of Munich and has about 2,300 staff members. It is a member of the Helmholtz Association, a community of 18 scientific-technical and medical-biological research centers with a total of about 37,000 staff members. 

The Institute of Diabetes Research (IDF) focuses on the pathogenesis and prevention of type 1 diabetes and type 2 diabetes as a long-term effect of gestational diabetes. A top-priority project is the development of an insulin vaccination against type 1 diabetes. In large-scale, long-term studies the IDF examines the implication of genes, environmental factors and the immune system in the pathogenesis of type 1 diabetes. Using data from the BABYDIAB cohort, which was established in 1989 as the world’s first prospective diabetes birth cohort, risk genes and antibody profiles can both be identified. This allows predictions about the development and onset of type 1 diabetes and will change the classification and the time of diagnosis. The IDF is part of the Helmholtz Diabetes Center (HDC). 

Technical University of Munich (TUM) is one of Europe’s leading research universities, with more than 500 professors, around 10,000 academic and non-academic staff, and 39,000 students. Its focus areas are the engineering sciences, natural sciences, life sciences and medicine, reinforced by schools of management and education. TUM acts as an entrepreneurial university that promotes talents and creates value for society. In that it profits from having strong partners in science and industry. It is represented worldwide with a campus in Singapore as well as offices in Beijing, Brussels, Cairo, Mumbai, San Francisco, and São Paulo. Nobel Prize winners and inventors such as Rudolf Diesel, Carl von Linde, and Rudolf Mößbauer have done research at TUM. In 2006 and 2012 it won recognition as a German "Excellence University." In international rankings, TUM regularly places among the best universities in Germany. 

The German Center for Diabetes Research (DZD) is a national association that brings together experts in the field of diabetes research and combines basic research, translational research, epidemiology and clinical applications. The aim is to develop novel strategies for personalized prevention and treatment of diabetes. Members are Helmholtz Zentrum München – German Research Center for Environmental Health, the German Diabetes Center in Düsseldorf, the German Institute of Human Nutrition in Potsdam-Rehbrücke, the Paul Langerhans Institute Dresden of the Helmholtz Zentrum München at the University Medical Center Carl Gustav Carus of the TU Dresden and the Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Zentrum München at the Eberhard-Karls-University of Tuebingen together with associated partners at the Universities in Heidelberg, Cologne, Leipzig, Lübeck and Munich.