Myo-inositol supplementation to prevent gestational diabetes in overweight  non-obese women: bioelectrical impedance analysis, metabolic aspects, obstetric  and neonatal outcomes - a randomized and open-label, placebo-controlled clinical  trial

Vitale SG; Corrado F; Caruso S; Giunta L; Cianci A; D'Anna R; Di Benedetto A

doi:10.1080/09637486.2020.1852191

Lifestyle and Environment · Nutrition and Metabolic Health

Myo-inositol supplementation to prevent gestational diabetes in overweight non-obese women: bioelectrical impedance analysis, metabolic aspects, obstetric and neonatal outcomes - a randomized and open-label, placebo-controlled clinical trial

Vitale SG, Corrado F, Caruso S, Giunta L, Cianci A, D'Anna R, Di Benedetto A

Published August 2021 International Journal of Food Sciences and Nutrition, 72(5), 670-679

DOI 10.1080/09637486.2020.1852191 PMID 33238798

RRM Academy Synopsis

Myo-inositol cut gestational diabetes in overweight non-obese women

Gestational diabetes was less common with myo-inositol than with placebo in overweight pregnant women who were not obese. The Italian trial was randomized and open-label. It analyzed 223 women. About 8 out of 100 on myo-inositol developed the condition, against about 21 out of 100 on placebo.

Key Findings

Gestational diabetes developed in 9 of 110 women (8.2%) taking myo-inositol and 24 of 113 women (21.2%) taking placebo (p = 0.006).
With age, smoking and body mass index accounted for, placebo carried higher odds of gestational diabetes: OR 3.74 (95% CI 1.67–8.39; p = 0.0014).
Pregnancy-induced hypertension affected 8 of 110 women (7.3%) taking myo-inositol and 24 of 113 women (21.2%) taking placebo (p = 0.0434).
Extracellular water differed between groups at the 26th/27th week, at the 31st/32nd week and again after delivery. Total and intracellular water differed at those last two time points.
The lipid panel worsened more on placebo, but changes were not significant. Birth weight, gestational age, emergency cesarean, macrosomia, shoulder dystocia, neonatal hypoglycemia and NICU transfer were similar in both groups.

Interpretation

This randomized, open-label trial followed 223 overweight pregnant women through delivery. Each had a body mass index of 25 to under 30. Myo-inositol was linked with lower rates of gestational diabetes and high blood pressure in pregnancy. Birth outcomes were similar between groups. The findings support larger studies of myo-inositol in pregnancy.

RRM Context

Restorative reproductive medicine treats insulin resistance as a root cause behind pregnancy problems. Some women in this trial had polycystic ovary syndrome (PCOS). PCOS is now also called polyendocrine metabolic ovarian syndrome, or PMOS. 11 women on myo-inositol had PCOS. 12 women on placebo had PCOS.

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

Abstract

This study aims to evaluate the effects of myo-inositol supplementation on gestational diabetes mellitus (GDM) rates and body water distribution in overweight non-obese women. 223 overweight non-obese women pregnant were randomly assigned to the treatment group (2 g of myo-inositol plus 200 µg of folic acid) or to the placebo one (200 µg of folic acid). The treatment lasted until three weeks after delivery. A tetrapolar impedance analyser was used to study body composition. The incidence of GDM was significantly reduced in the myo-inositol group compared with the placebo group. There was a significant increase in TBW, ECW and ICW values in the placebo group compared to the myo-inositol group. We have recorded a significant reduction in the overall incidence of pregnancy-induced hypertension in the myo-inositol group compared with the placebo group. Our results demonstrate the effectiveness of myo-inositol supplementation in preventing GDM in overweight non-obese pregnant women.

Topics

Lifestyle and Environment › Nutrition and Metabolic Health › Blood Sugar and Insulin · Therapeutics › Metabolic and Endocrine Agents › Insulin Sensitizing Agents · Pregnancy › Pregnancy Complications › Gestational Diabetes

Francesco Corrado, Salvatore Caruso, Antonio Cianci, Rosario D'Anna, Antonino DI Benedetto, Loretta Giunta, Salvatore Giovanni Vitale

F Corrado, S Caruso, A Cianci, R D'Anna, A Benedetto, L Giunta, S Vitale

PMID 33238798 33238798 DOI 10.1080/09637486.2020.1852191 10.1080/09637486.2020.1852191 Vitale et al. 2021, Vitale 2021

Keywords

Inositol, Folic Acid