Myo-inositol may prevent gestational diabetes onset in overweight women: a  randomized, controlled trial

Santamaria A; Petrella E; Pintaudi B; Corrado F; D'Anna R; Neri I; Facchinetti F; Di Benedetto A

doi:10.3109/14767058.2015.1121478

Therapeutics Metabolic and Endocrine Agents

Myo-inositol may prevent gestational diabetes onset in overweight women: a randomized, controlled trial

Santamaria A, Petrella E, Pintaudi B, Corrado F, D'Anna R, Neri I, Facchinetti F, Di Benedetto A

Published October 2016 The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 29(19), 3234-3237

DOI 10.3109/14767058.2015.1121478 PMID 26698911

RRM Academy Synopsis

Myo-inositol lowers gestational diabetes risk in overweight women

Myo-inositol lowered the rate of gestational diabetes in a trial of 220 overweight pregnant women. About 12 in 100 on myo-inositol developed it; about 27 in 100 on placebo did (p = 0.004).

Key Findings

Gestational diabetes occurred in 11.6% of women (11 of 95) who took myo-inositol, versus 27.4% (28 of 102) on placebo (p=0.004).
After adjusting for maternal age, pre-pregnancy BMI, weight gain, parity, and family history of diabetes, myo-inositol remained linked to lower gestational diabetes risk (OR 0.33; 95% CI 0.15-0.70).
Among women who developed gestational diabetes, 2 of 11 in the myo-inositol group needed insulin, compared with 4 of 28 in the placebo group.
Secondary outcomes, including cesarean section rate, birth weight, preterm delivery, and gestational hypertension, did not differ significantly between the two groups.

Interpretation

This is an open-label, randomized trial at two university hospitals in Italy. Researchers enrolled 220 overweight pregnant women, all of Caucasian background. They gave women myo-inositol or placebo, from early pregnancy through delivery. A blood test confirmed each case of gestational diabetes. Some women left the study through miscarriage, dropout, or delivery at another hospital. The final count included 95 women on myo-inositol and 102 on placebo. The authors note that birth weight and preterm birth did not differ between groups. They call for larger trials to confirm the benefit and test it on these outcomes too.

RRM Context

Extra weight before pregnancy often brings insulin resistance. Insulin resistance is a known driver of gestational diabetes. Myo-inositol is a nutrient the body already makes. Whole grains, legumes, and corn also contain it. This trial tested it as a food supplement. Restorative reproductive medicine shares the same idea behind this trial. Correcting a metabolic problem early can change how a pregnancy unfolds.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To evaluate whether myo-inositol supplementation may reduce gestational diabetes mellitus (GDM) rate in overweight women.

Methods

In an open-label, randomized trial, myo-inositol (2 g plus 200 μg folic acid twice a day) or placebo (200 μg folic acid twice a day) was administered from the first trimester to delivery in pregnant overweight non-obese women (pre-pregnancy body mass index ≥ 25 and < 30 kg/m(2)). The primary outcome was the incidence of GDM.

Results

From January 2012 to December 2014, 220 pregnant women were randomized at two Italian University hospitals, 110 to myo-inositol and 110 to placebo. The incidence of GDM was significantly lower in the myo-inositol group compared to the placebo group (11.6% versus 27.4%, respectively, p = 0.004). Myo-inositol treatment was associated with a 67% risk reduction of developing GDM (OR 0.33; 95% CI 0.15-0.70).

Conclusions

Myo-inositol supplementation, administered since early pregnancy, reduces GDM incidence in overweight non-obese women.

Topics

Therapeutics › Metabolic and Endocrine Agents › Insulin Sensitizing Agents · Lifestyle and Environment › Nutrition and Metabolic Health › Blood Sugar and Insulin

Angelo Santamaria, Antonino DI Benedetto, Elisabetta Petrella, Basilio Pintaudi, Francesco Corrado, Isabella Neri, Fabio Facchinetti, Rosario D'Anna

A Santamaria, A Benedetto, E Petrella, B Pintaudi, F Corrado, I Neri, F Facchinetti, R D'Anna

PMID 26698911 26698911 DOI 10.3109/14767058.2015.1121478 10.3109/14767058.2015.1121478 Santamaria et al. 2016, Santamaria 2016

Keywords

Blood Glucose, Vitamin B Complex, Inositol