Energy restriction, weight loss, glycemia, and breastfeeding outcomes in gestational diabetes: a DiGest trial secondary analysis

Dib, Sarah, Kusinski, Laura C, Atta, Nooria, De Lucia Rolfe, Emanuella, Murphy, Helen R, Taylor, Roy and Meek, Claire L (2025) Energy restriction, weight loss, glycemia, and breastfeeding outcomes in gestational diabetes: a DiGest trial secondary analysis. Diabetes Care. (doi:10.2337/dc24-2625).

Abstract

OBJECTIVE: We aimed to assess whether energy restriction, weight loss, or maternal glycemia in late pregnancy were associated with breastfeeding outcomes.

RESEARCH DESIGN AND METHODS: This is a secondary analysis of the Dietary Intervention in Gestational Diabetes (DiGest) randomized controlled trial, which included 425 participants with gestational diabetes who were randomly assigned to receive a standard-energy (2,000 kcal/day) or reduced-energy (1,200 kcal/day) diet box from 29 weeks until delivery, with masked continuous glucose monitoring. Breastfeeding intentions and outcomes were documented (n = 304 of 425) and analyzed using regression models.

RESULTS: Energy restriction in late pregnancy did not affect breastfeeding outcomes. Achieving ≥90% time in range (3.5-6.7 mmol/L; 63-120 mg/dL) with a low glycemic variability (coefficient of variation and SD), but not weight loss, were associated with any breastfeeding at 3 months postnatally.

CONCLUSIONS: Improved late pregnancy glycemia and decreased glucose variability, but not weight loss or energy restriction, were associated with breastfeeding after gestational diabetes.

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Contributors

Author: Emanuella De Lucia Rolfe

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