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Inositol for the prevention of gestational diabetes: a systematic review and meta-analysis of randomized controlled trials

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Abstract

Purpose

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).

Methods

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).

Results

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.

Conclusions

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.

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Authors and Affiliations

  1. Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy

    Amerigo Vitagliano, Erich Cosmi, Silvia Visentin & Guido Ambrosini

  2. Department of Neuroscience Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy

    Gabriele Saccone

  3. Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 12, 07100, Sassari, Italy

    Francesco Dessole

  4. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Vincenzo Berghella

Authors
  1. Amerigo Vitagliano
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  2. Gabriele Saccone
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  3. Erich Cosmi
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  4. Silvia Visentin
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  5. Francesco Dessole
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  6. Guido Ambrosini
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  7. Vincenzo Berghella
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Contributions

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

Corresponding author

Correspondence to Amerigo Vitagliano.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Figure S1

: PRISMA Flow-Diagram (PDF 176 kb)

Figure S2

: Risk of bias graph. Authors’ judgment about each risk of bias item for included studies. (PDF 281 kb)

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Vitagliano, A., Saccone, G., Cosmi, E. et al. Inositol for the prevention of gestational diabetes: a systematic review and meta-analysis of randomized controlled trials. Arch Gynecol Obstet 299, 55–68 (2019). https://doi.org/10.1007/s00404-018-5005-0

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  • DOI: https://doi.org/10.1007/s00404-018-5005-0

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