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OBJECTIVE--To examine the association between breastfeeding intensity in relation to maternal blood glucose and insulin and glucose intolerance based on the postpartum 2-h 75-g oral glucose tolerance test (OGTT) results at 6-9 weeks after a pregnancy with gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS--We selected 522 participants enrolled into the Study of Women, Infant Feeding, and Type 2 Diabetes (SWIFT), a prospective observational cohort study of Kaiser Permanente Northern California members diagnosed with GDM using the 3-h 100-g OGTT by the Carpenter and Coustan criteria. Women were classified as normal, prediabetes, or diabetes according to American Diabetes Association criteria based on the postpartum 2-h 75-g OGTT results. RESULTS--Compared with exclusive or mostly formula feeding (>17 oz formula per 24 h), exclusive breastfeeding and mostly breastfeeding (≤6 oz formula per 24 h) groups, respectively, had lower adjusted mean (95% CI) group differences in fasting plasma glucose (mg/dL) of -4.3 (-7.4 to -1.3) and -5.0 (-8.5 to -1.4), in fasting insulin (µU/mL) of -6.3 (-10.1 to -2.4) and -7.5 (-11.9 to -3.0), and in 2-h insulin of -21.4 (-41.0 to -1.7) and -36.5 (-59.3 to -13.7) (all P < 0.05). Exclusive or mostly breastfeeding groups had lower prevalence of diabetes or prediabetes (P = 0.02). CONCLUSIONS--Higher intensity of lactation was associated with improved fasting glucose and lower insulin levels at 6-9 weeks' postpartum. Lactation may have favorable effects on glucose metabolism and insulin sensitivity that may reduce diabetes risk after GDM pregnancy. [ABSTRACT FROM AUTHOR]

Background: Contemporary data comparing weight status and diabetes (DM) prevalence among U.S. East Asians and Filipinos are limited. Methods: Among 23,050 Chinese and 28,201 Filipinos aged 45-64 years (mean age 55±6) with a 2016 outpatient visit in a U.S. integrated healthcare delivery system, body mass index (BMI) and DM prevalence (based on clinical diagnosis and pharmacotherapy) were ascertained. BMI was classified using Asian-specific thresholds: healthy or underweight (BMI <23), overweight (23-27.4) and obese (≥27.5 kg/m2). Differences were examined by subgroups and log-binomial regression was used to examine the independent association of ethnicity and DM risk. Results: Among Chinese women (14,871) and men (8,179) and Filipino women (18,406) and men (9,795), overweight/obesity was higher in men vs. women and Filipino vs. Chinese (Figure, BMI distribution). Obesity was highest in Filipino men (50%). DM prevalence was highest in those with obesity; however, Filipinos of both sexes had higher DM prevalence across all weight categories (Figure) compared to Chinese, with a relative risk of 1.7 (CI 1.6-1.8), adjusting for age, BMI and sex. Conclusion: Filipino adults have substantially higher BMI and independently higher risk of DM compared to Chinese adults. While limited to adults receiving healthcare, the data highlight the need for heightened DM surveillance and targeted care in high risk ethnic populations. Disclosure: K. Gu: None. N.P. Gordon: None. M. Chandra: None. G. Lau: None. J.R. Gonzalez: None. J.C. Lo: Research Support; Self; Amgen Inc. Research Support; Spouse/Partner; GlaxoSmithKline plc., Novartis Pharmaceuticals Corporation, Sanofi-Aventis. Research Support; Self; Sanofi-Aventis. Funding: Kaiser Permanente Northern California [ABSTRACT FROM AUTHOR]