Oral Concurrent Session 7 - Diabetes
Oral Concurrent Sessions
Minhazur R. Sarker, MD (he/him/his)
Fellow
University of California, San Diego
San Diego, California, United States
Marni B. Jacobs, PhD
University of California, San Diego Health
San Diego, California, United States
Kim Boggess, MD
Professor
University of North Carolina
Chapel Hill, North Carolina, United States
Ashley N. Battarbee, MD, MSCR
Assistant Professor
Center for Women’s Reproductive Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
Gladys (Sandy) A. Ramos, MD
Attending Physician
University of California, San Diego
San Diego, California, United States
Insulin resistance is associated with decreased milk supply in those lactating. Metformin is hypothesized to increase breast milk production by presumptively improving insulin resistance, suggesting use in pregnancy may increase breastfeeding (BF) success. We aimed to determine the association between metformin use for treatment of preexisting type 2 diabetes mellitus (T2DM) or DM diagnosed in early pregnancy (early DM) and BF patterns.
Study Design:
This was a planned secondary analysis of the MOMPOD randomized controlled trial of metformin versus placebo in insulin treated T2DM or early DM. We included parturients who delivered a living neonate, received at least one dose of study treatment, endorsed an intention to BF, and completed a BF survey. BF intentions and BF outcomes were collected utilizing a BF questionnaire at 24-30 weeks and 30 days postpartum (PP) respectively. The primary outcome was immediate BF, defined as any BF on PP day 1-3. Secondary outcomes included time to milk production, exclusive or partial BF at 30 days PP, breast size and issues with BF. Baseline characteristics and outcomes were compared using either chi-square, t-test, or Wilcoxon tests, as appropriate.
Results:
Among the 794 women randomized and receiving medication in the primary trial, 378 (47.6%) met inclusion criteria with 194 (51.3%) in metformin and 184 (49.7%) in placebo groups. There were no significant differences in baseline demographics (Table 1). Immediate BF was comparable between groups (91.1% vs 88.9%, p=0.53) and there was no difference in time to milk production (Table 2). Thirty days PP, BF was lower in both groups but there was no difference between metformin and placebo groups (76.0% vs 66.7%, p=0.11). There were also no differences in partial or exclusive BF, in breast cup or bra size, or issues with BF (Table 2).
Conclusion:
Our data suggest no association between metformin use and BF patterns in those with T2DM or early DM. Antepartum metformin should not be recommended to improve BF success. Further studies should focus on methods to improve sustained BF in this population.
