Inositol for the prevention of gestational diabetes: a systematic review and meta-analysis of randomized controlled trials
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Inositol (ISL) embraces a family of simple carbohydrates with insulin-sensitizing properties, whose most common isoforms are Myo-inositol (MYO) and d-chiro inositol (DCI). The aim of the present study was to assess the efficacy and safety of ISL supplementation during pregnancy for the prevention of gestational diabetes (GDM).
We conducted a systematic literature search in electronic databases until October 2017. We included all randomized controlled trials (RCTs) comparing pregnant women with GDM who were randomized to either ISL (i.e., intervention group) or either placebo or no treatment (i.e., control group). The primary outcome was the preventive effect on GDM, defined as the rate of GDM in women without a prior diagnosis of GDM. Pooled results were expressed as odds ratio (OR) with a 95% confidence interval (95% CI).
Five RCTs were included (including 965 participants). ISL supplementation was associated with lower rate of GDM (OR 0.49, 95% CI 0.24–1.03, p = 0.01) and lower preterm delivery rate (OR 0.35, 95% CI 0.17–0.74, p = 0.006). No adverse effects were reported. Adjusting for the type of intervention (MYO 2 g twice daily vs MYO 1100 mg plus DCI 27.6 mg daily), a significant effect was found only in patients receiving 2 g MYO twice daily.
ISLs administration during pregnancy appears to be safe and may represent a novel strategy for GDM prevention. In particular, the double administration of MYO 2 g per day may improve the glycemic homeostasis and may reduce GDM rate and preterm delivery rate.
KeywordsInositol Gestational diabetes Diabetes prevention Preterm delivery Maternal–fetal health
AV: Conceptualization, data curation, formal analysis, investigation, methodology, original draft writing. GS: Investigation, validation, formal analysis original draft writing, review and editing. EC: Supervision, review and editing. SV: Validation, original draft writing, review and editing. FD: Manuscript review and editing. GA: Supervision, validation, review and editing. VB: Conceptualization, project administration, supervision, review and editing
Compliance with ethical standards
Conflict of interest
Nothing to declare.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 4.Vitagliano A, Noventa M, Gizzo S (2015) Is it time to consider patients suffering from endometriosis-related infertility as “novel candidates” for targeted peri-conceptional d-chiro inositol supplementation? Hypothesis, rationale and some considerations. J Assist Reprod Genet 32(3):407–408CrossRefGoogle Scholar
- 11.Crawford TJ, Crowther CA, Alsweiler J, Brown J (2015) Antenatal dietary supplementation with myo-inositol in women during pregnancy for preventing gestational diabetes. Cochrane Database Syst Rev. 12:CD011507Google Scholar
- 16.Matarrelli B, Vitacolonna E, D’Angelo M, Pavone G, Mattei PA, Liberati M, Celentano C (2013) Effect of dietary myo-inositol supplementation in pregnancy on theincidence of maternal gestational diabetes mellitus and fetal outcomes: a randomized controlled trial. J Matern Fetal Neonatal Med 26(10):967–972CrossRefGoogle Scholar
- 17.Malvasi A, Kosmas I, Mynbaev OA, Sparic R, Gustapane S, Guido M, Tinelli A (2017) Can trans resveratrol plus d-chiro-inositol and myo-inositol improve maternal metabolic profile in overweight pregnant patients? Clin Ther 168(4):e240–e247Google Scholar
- 19.Ferrari F, Facchinetti F, Ontiveros AE, Roberts RP, Saade MM, Blackwell SC, Sibai BM, Refuerzo JS, Longo M (2016) The effect of combined inositol supplementation on maternal metabolic profile in pregnancies complicated by metabolic syndrome and obesity. Am J Obstet Gynecol 215(4):503.e1–503.e8CrossRefGoogle Scholar
- 22.Malvasi A, Casciaro F, Minervini MM, Kosmas I, Mynbaev OA, Pacella E, MontiCondesnitt V, Creanza A, Di Renzo GC, Tinelli A (2014) Myo-inositol, d-chiro-inositol, folic acid and manganese in secondtrimester of pregnancy: a preliminaryinvestigation. Eur Rev Med Pharmacol Sci 18(2):270–274PubMedGoogle Scholar
- 23.D’Anna R, Scilipoti A, Giordano D, Caruso C, Cannata ML, Interdonato ML, Corrado F, Di Benedetto A (2013) myo-Inositol supplementation and onset of gestational diabetes mellitus in pregnant women with a family history of type 2 diabetes: a prospective, randomized, placebo-controlled study. Diabetes Care 36(4):854–857CrossRefGoogle Scholar
- 24.DʼAnna R, Di Benedetto A, Scilipoti A, Santamaria A, Interdonato ML, Petrella E, Neri I, Pintaudi B, Corrado F, Facchinetti F (2015) Myo-inositol supplementation for prevention of gestational diabetes in obese pregnant women: a randomized controlled trial. Obstet Gynecol 126(2):310–315CrossRefGoogle Scholar
- 25.International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, Dyer AR, Leiva Ad, Hod M, Kitzmiler JL, Lowe LP, McIntyre HD, Oats JJ, Omori Y, Schmidt MI (2010) International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 33(3):676–682CrossRefGoogle Scholar
- 37.Laganà AS, Vitagliano A, Noventa M, Ambrosini G, D’Anna R (2018) Myo-inositol supplementation reduces the amount of gonadotropins and length of ovarian stimulation in women undergoing IVF: a systematic review and meta-analysis of randomized controlled trials. Arch Gynecol Obstet 298(4):675–684CrossRefGoogle Scholar
- 39.Plows JF, Budin F, Andersson RA, Mills VJ, Mace K, Davidge ST, Vickers MH, Baker PN, Silva-Zolezzi I, Stanley JL (2017) The effects of Myo-Inositol and B and D vitamin supplementation in the db/+mouse model of gestational diabetes mellitus. Nutrients. https://doi.org/10.3390/nu9020141