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Breastfeeding Helps Prevent Mothers from Developing Diabetes after Childbirth
A team of South Korean researchers found that lactation can lower the incidence and reduce the risk of maternal postpartum diabetes. The researchers identified that lactation increases the mass and function of pancreatic beta cells through serotonin production. The team suggested that sustained improvements in pancreatic beta cells, which can last for years even after the cessation of lactation, improve mothers’ metabolic health in addition to providing health benefits for infants.
Pregnancy imposes a substantial metabolic burden on women through weight gain and increased insulin resistance. Various other factors, including a history of gestational diabetes, maternal age, and obesity, further affect women’s risk of progressing to diabetes after delivery, and the risk of postpartum diabetes increases more in women who have had gestational diabetes and/or repeated deliveries.
Diabetes-related complications include damage to blood vessels, which can lead to cardiovascular and cerebrovascular diseases such as heart attack and stroke, and problems with the nerves, eyes, kidneys, and many more. Since diabetes can pose a serious threat to mothers’ metabolic health, the management of maternal metabolic risk factors is important, especially in the peripartum period. Previous epidemiological studies have reported that lactation reduces the risk of postpartum diabetes, but the mechanisms underlying this benefit have remained elusive.
The study, published in Science Translational Medicine on April 29, explains the biology underpinning this observation on the beneficial effects of lactation. Professor Hail Kim from the Graduate School of Medical Science and Engineering at KAIST led and jointly conducted the study in conjunction with researchers from the Seoul National University Bundang Hospital (SNUBH) and Chungnam National University (CNU) in Korea, and the University of California, San Francisco (UCSF) in the US.
In their study, the team observed that the milk-secreting hormone ‘prolactin’ in lactating mothers not only promotes milk production, but also plays a major role in stimulating insulin-secreting pancreatic beta cells that regulate blood glucose in the body.
The researchers also found that ‘serotonin’, known as a chemical that contributes to wellbeing and happiness, is produced in pancreatic beta cells during lactation. Serotonin in pancreatic beta cells act as an antioxidant and reduce oxidative stress, making mothers’ beta cells healthier. Serotonin also induces the proliferation of beta cells, thereby increasing the beta cell mass and helping maintain proper glucose levels.
The research team conducted follow-up examinations on a total of 174 postpartum women, 85 lactated and 99 non-lactated, at two months postpartum and annually thereafter for at least three years. The results demonstrated that mothers who had undergone lactation improved pancreatic beta cell mass and function, and showed improved glucose homeostasis with approximately 20mg/dL lower glucose levels, thereby reducing the risk of postpartum diabetes in women. Surprisingly, this beneficial effect was maintained after the cessation of lactation, for more than three years after delivery.
Professor Kim said, “We are happy to prove that lactation benefits female metabolic health by improving beta cell mass and function as well as glycemic control.”
“Our future studies on the modulation of the molecular serotonergic pathway in accordance with the management of maternal metabolic risk factors may lead to new therapeutics to help prevent mothers from developing metabolic disorders,” he added.
This work was supported by grants from the National Research Foundation (NRF) and the National Research Council of Science and Technology (NST) of Korea, the National Institutes of Health (NIH), the Larry L. Hillblom Foundation, and the Health Fellowship Foundation.
Image credit: Professor Hail Kim, KAIST
Image usage restrictions: News organizations may use or redistribute this image, with proper attribution, as part of news coverage of this paper only.
Publication:
Moon, J. H et al. (2020) ‘Lactation improves pancreatic β cell mass and function through serotonin production.’ Science Translational Medicine, 12, eaay0455. Available online at https://doi.org/10.1126/scitranslmed.aay0455
Profile: Hail Kim, MD, PhD
hailkim@kaist.edu
Associate Professor
Graduate School of Medical Science and Engineering (GSMSE)
Korea Advanced Institute of Science and Technology (KAIST)
Profile: Hak Chul Jang, MD, PhD
janghak@snu.ac.kr
Professor
Division of Endocrinology and Metabolism
Seoul National University Bundang Hospital (SNUBH)
President
Korean Diabetes Association
Profile: Joon Ho Moon, MD, PhD
moonjoonho@gmail.com
Clinical Fellow
Division of Endocrinology and Metabolism
SNUBH
Profile: Hyeongseok Kim, MD, PhD
hskim85kor@gmail.com
Assistant Professor
Chungnam National University (CNU)
Profile: Professor Michael S. German, MD
Michael.German@ucsf.edu
Professor
Diabetes Center
University of California, San Francisco (UCSF)
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2020.04.29 View 16117 -
KAIST GSAI and SNUBH Join Hands for AI in Healthcare
< Dean Song Chong (left) and Director Chang Wan Oh (right)
at the KAIST GSAI - SNUBH MOU Signing Ceremony >
The Graduate School of AI (GSAI) at KAIST and the Seoul National University Bundang Hospital (SNUBH) signed a memorandum of understanding (MOU) to cooperate in AI education and research in the field of healthcare last month. The two institutions have agreed to collaborate on research and technology development through the implementation of academic and personnel exchange programs.
The GSAI, opened in August 2019 as Korea’s first AI graduate school, has been in the forefront of nurturing top-tier AI specialists in the era of Fourth Industrial Revolution. The school employs a two-track strategy that not only provides students with core AI-related courses on machine learning, data mining, computer vision, and natural language processing, but also a multidisciplinary curriculum incorporating the five key fields of healthcare, autonomous vehicles, manufacturing, security, and emerging technologies. Its faculty members are "the cream of the crop” in their early 40s, achieving world-class performance in their respective fields.
SNUBH opened the Healthcare Innovation Park in 2016, the first hospital-led convergence research complex among Korean medical institutions. It is leading future medical research in five specialized areas: medical devices, healthcare ICT, human genetics, nano-machines, and regenerative medicine.
The Dean of the GSAI, Song Chong, said, “We have set the stage for a cooperative platform for continuous and efficient joint education and research by the two institutions.” He expressed his excitement, saying, “Through this platform and our expertise in AI engineering and medicine, we will lead future AI-based medical technology.”
The Director of the SNUBH Research Division, Chang Wan Oh, stressed that “the mutual cooperation between the two institutions will become a crucial turning point in AI education and research, which is at the core of future healthcare.” He added, “Through a high level of cooperation, we will have the ability to bring about global competitiveness and innovation.”
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2019.12.27 View 7201 -
KAIST Identifies the Cause of Sepsis-induced Lung Injury
(Professor Pilhan Kim from the Graduate School of Medical Science and Engineering)
A KAIST research team succeeded in visualizing pulmonary microcirculation and circulating cells in vivo with a custom-built 3D intravital lung microscopic imaging system. They found a type of leukocyte called neutrophils aggregate inside the capillaries during sepsis-induced acute lung injury (ALI), leading to disturbances and dead space in blood microcirculation.
According to the researchers, this phenomenon is responsible for tissue hypoxia causing lung damage in the sepsis model, and mitigating neutrophils improves microcirculation as well as hypoxia.
The lungs are responsible for exchanging oxygen with carbon dioxide gases during the breathing process, providing an essential function for sustaining life. This gas exchange occurs in the alveoli, each surrounded by many capillaries containing the circulating red blood cells.
Researchers have been making efforts to observe microcirculation in alveoli, but it has been technically challenging to capture high-resolution images of capillaries and red blood cells inside the lungs that are in constant breathing motion.
Professor Pilhan Kim from the Graduate School of Medical Science and Engineering and his team developed an ultra-fast laser scanning confocal microscope and an imaging chamber that could minimize the movement of a lung while preserving its respiratory state. They used this technology to successfully capture red blood cell circulation inside the capillaries of animal models with sepsis.
During the process, they found that hypoxia was induced by the increase of dead space inside the lungs of a sepsis model, a space where red blood cells do not circulate. This phenomenon is due to the neutrophils aggregating and trapping inside the capillaries and the arterioles. It was also shown that trapped neutrophils damage the lung tissue in the sepsis model by inhibiting microcirculation as well as releasing reactive oxygen species.
Further studies showed that the aggregated neutrophils inside pulmonary vessels exhibit a higher expression of the Mac-1 receptor (CD11b/CD18), which is a receptor involved in intercellular adhesion, compared to the neutrophils that normally circulate. Additionally, they confirmed that Mac-1 inhibitors can improve inhibited microcirculation, ameliorate hypoxia, while reducing pulmonary edema in the sepsis model.
Their high-resolution 3D intravital microscope technology allows the real-time imaging of living cells inside the lungs. This work is expected to be used in research on various lung diseases, including sepsis.
The research team’s pulmonary circulation imaging and precise analytical techniques will be used as the base technology for developing new diagnostic technologies, evaluating new therapeutic agents for various diseases related to microcirculation.
Professor Kim said, “In the ALI model, the inhibition of pulmonary microcirculation occurs due to neutrophils. By controlling this effect and improving microcirculation, it is possible to eliminate hypoxia and pulmonary edema – a new, effective strategy for treating patients with sepsis.”
Their 3D intravital microscope technology was commercialized through IVIM Technology, Inc., which is a faculty startup at KAIST. They released an all-in-one intravital microscope model called ‘IVM-CM’ and ‘IVM-C’. This next-generation imaging equipment for basic biomedical research on the complex pathophysiology of various human diseases will play a crucial role in the future global bio-health market.
This research, led by Dr. Inwon Park from the Department of Emergency Medicine at Seoul National University Bundang Hospital and formally the Graduate School of Medical Science and Engineering at KAIST, was published in the European Respiratory Journal (2019, 53:1800736) on March 28, 2019.
Figure 1. Custom-built high-speed real-time intravital microscope platform
Figure 2. Illustrative schematic and photo of a 3D intravital lung microscopic imaging system
Figure 3. Aggregation of neutrophils and consequent flow disturbance in pulmonary arteriole in sepsis-induced lung injury
2019.05.07 View 43459