Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 5/2024

12.06.2023 | Maternal-Fetal Medicine

Inositol supplementation for the prevention and treatment of gestational diabetes mellitus: a meta-analysis of randomized controlled trials

verfasst von: Chaolin Li, Hao Shi

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2024

Einloggen, um Zugang zu erhalten

Abstract

Background

Inositol is a potential new therapeutic agent for gestational diabetes mellitus (GDM), but its effectiveness is still controversial. The aim of the report was to evaluate the effectiveness of inositol to preventing or reducing the severity of GDM.

Methods

We searched PubMed, EmBase, Web of science, Cochrane library databases, Clinicaltrials.gov, and International Clinical Trials Registry Platform for randomized controlled trials (RCTs) assessing the effectiveness of inositol supplementation to prevent and treat GDM. This meta-analysis was performed using the random-effects model.

Results

A total of 7 RCTs (1319 pregnant women at high risk of GDM) were included in the meta-analysis. The meta-analysis found that inositol supplementation resulted in a significantly lower incidence of GDM in the inositol versus the control group (odds ratio [OR] 0.40; 95% confidence interval [CI] 0.24–0.67; P = 0.0005). The inositol group had improved fasting glucose oral glucose tolerance test (FG OGTT; mean difference [MD] = − 3.20; 95% CI − 4.45 to − 1.95; P < 0.00001), 1-h OGTT (MD = − 7.24; 95% CI − 12.23 to − 2.25; P = 0.004), and 2-h OGTT (MD = − 7.15; 95% CI − 12.86 to − 1.44; P = 0.01) results. Inositol also reduced the risk of pregnancy-induced hypertension (OR 0.37; 95% CI 0.18–0.75; P = 0.006) and preterm birth (OR 0.35; 95% CI 0.18–0.69; P = 0.003). A meta-analysis of 4 RCTs including 320 GDM patients showed that the patients' insulin resistance (P < 0.05) and neonatal hypoglycemia risk (OR 0.10, 95% CI 0.01–0.88; P = 0.04) were lower in the inositol than in the control group.

Conclusions

Inositol supplementation during pregnancy has the potential to prevent GDM, improve glycemic control, and reduce preterm birth rates.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Wang Y, Pan XF, Pan A (2023) Lipidomics in gestational diabetes mellitus. Curr Opin Lipidol 34(1):1–11CrossRefPubMed Wang Y, Pan XF, Pan A (2023) Lipidomics in gestational diabetes mellitus. Curr Opin Lipidol 34(1):1–11CrossRefPubMed
2.
Zurück zum Zitat Lowe WL, Scholtens DM, Lowe LP et al (2018) Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity. JAMA 320(10):1005–1016CrossRefPubMedPubMedCentral Lowe WL, Scholtens DM, Lowe LP et al (2018) Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity. JAMA 320(10):1005–1016CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Mendez-Figueroa H, Schuster M, Maggio L et al (2017) Gestational diabetes mellitus and frequency of blood glucose monitoring: a randomized controlled trial. Obstet Gynecol 130(1):163–170CrossRefPubMed Mendez-Figueroa H, Schuster M, Maggio L et al (2017) Gestational diabetes mellitus and frequency of blood glucose monitoring: a randomized controlled trial. Obstet Gynecol 130(1):163–170CrossRefPubMed
4.
Zurück zum Zitat Chiefari E, Arcidiacono B, Foti D et al (2017) Gestational diabetes mellitus: an updated overview. J Endocrinol Investig 40(9):899–909CrossRef Chiefari E, Arcidiacono B, Foti D et al (2017) Gestational diabetes mellitus: an updated overview. J Endocrinol Investig 40(9):899–909CrossRef
5.
Zurück zum Zitat Tranidou A, Dagklis T, Tsakiridis I et al (2021) Risk of developing metabolic syndrome after gestational diabetes mellitus—a systematic review and meta-analysis. J Endocrinol Investig 44(6):1139–1149CrossRef Tranidou A, Dagklis T, Tsakiridis I et al (2021) Risk of developing metabolic syndrome after gestational diabetes mellitus—a systematic review and meta-analysis. J Endocrinol Investig 44(6):1139–1149CrossRef
6.
Zurück zum Zitat Zheng W, Huang W, Liu C et al (2021) Weight gain after diagnosis of gestational diabetes mellitus and its association with adverse pregnancy outcomes: a cohort study. BMC Pregnancy Childbirth 21(1):216CrossRefPubMedPubMedCentral Zheng W, Huang W, Liu C et al (2021) Weight gain after diagnosis of gestational diabetes mellitus and its association with adverse pregnancy outcomes: a cohort study. BMC Pregnancy Childbirth 21(1):216CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Devarshi PP, Grant RW, Ikonte CJ et al (2019) Maternal omega-3 nutrition, placental transfer and fetal brain development in gestational diabetes and preeclampsia. Nutrients 11(5):1107CrossRefPubMedPubMedCentral Devarshi PP, Grant RW, Ikonte CJ et al (2019) Maternal omega-3 nutrition, placental transfer and fetal brain development in gestational diabetes and preeclampsia. Nutrients 11(5):1107CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Bain E, Crane M, Tieu J, Han S, Crowther CA, Middleton P (2015) Diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database Syst Rev 4:CD010443 Bain E, Crane M, Tieu J, Han S, Crowther CA, Middleton P (2015) Diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database Syst Rev 4:CD010443
9.
Zurück zum Zitat Brown J, Ceysens G, Boulvain M (2017) Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes. Cochrane Database Syst Rev 6(3):CD012202PubMed Brown J, Ceysens G, Boulvain M (2017) Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes. Cochrane Database Syst Rev 6(3):CD012202PubMed
10.
Zurück zum Zitat Davenport MH, Ruchat SM, Poitras VJ et al (2018) Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med 52(21):1367–1375CrossRefPubMed Davenport MH, Ruchat SM, Poitras VJ et al (2018) Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med 52(21):1367–1375CrossRefPubMed
11.
Zurück zum Zitat Tieu J, Coat S, Hague W et al (2017) Oral anti-diabetic agents for women with established diabetes/impaired glucose tolerance or previous gestational diabetes planning pregnancy, or pregnant women with pre-existing diabetes. Cochrane Database Syst Rev 10(10):CD007724PubMed Tieu J, Coat S, Hague W et al (2017) Oral anti-diabetic agents for women with established diabetes/impaired glucose tolerance or previous gestational diabetes planning pregnancy, or pregnant women with pre-existing diabetes. Cochrane Database Syst Rev 10(10):CD007724PubMed
12.
Zurück zum Zitat Facchinetti F, Cavalli P, Copp AJ et al (2020) An update on the use of inositols in preventing gestational diabetes mellitus (GDM) and neural tube defects (NTDs). Expert Opin Drug Metab Toxicol 16(12):1187–1198CrossRefPubMed Facchinetti F, Cavalli P, Copp AJ et al (2020) An update on the use of inositols in preventing gestational diabetes mellitus (GDM) and neural tube defects (NTDs). Expert Opin Drug Metab Toxicol 16(12):1187–1198CrossRefPubMed
13.
Zurück zum Zitat Shears SB, Wang H (2020) Metabolism and functions of inositol pyrophosphates: insights gained from the application of synthetic analogues. Molecules 25(19):4515CrossRefPubMedPubMedCentral Shears SB, Wang H (2020) Metabolism and functions of inositol pyrophosphates: insights gained from the application of synthetic analogues. Molecules 25(19):4515CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Brown J, Crawford TJ, Alsweiler J et al (2016) Dietary supplementation with myo-inositol in women during pregnancy for treating gestational diabetes. Cochrane Database Syst Rev 9(9):CD012048PubMed Brown J, Crawford TJ, Alsweiler J et al (2016) Dietary supplementation with myo-inositol in women during pregnancy for treating gestational diabetes. Cochrane Database Syst Rev 9(9):CD012048PubMed
15.
Zurück zum Zitat Iervolino M, Lepore E, Forte G et al (2021) Natural molecules in the management of polycystic ovary syndrome (PCOS): an analytical review. Nutrients 13(5):1677CrossRefPubMedPubMedCentral Iervolino M, Lepore E, Forte G et al (2021) Natural molecules in the management of polycystic ovary syndrome (PCOS): an analytical review. Nutrients 13(5):1677CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Genazzani AD (2016) Inositol as putative integrative treatment for PCOS. Reprod Biomed Online 33(6):770–780CrossRefPubMed Genazzani AD (2016) Inositol as putative integrative treatment for PCOS. Reprod Biomed Online 33(6):770–780CrossRefPubMed
17.
Zurück zum Zitat Cabrera-Cruz H, Oróstica L, Plaza-Parrochia F et al (2020) The insulin-sensitizing mechanism of myo-inositol is associated with AMPK activation and GLUT-4 expression in human endometrial cells exposed to a PCOS environment. Am J Physiol Endocrinol Metab 318(2):E237–E248CrossRefPubMed Cabrera-Cruz H, Oróstica L, Plaza-Parrochia F et al (2020) The insulin-sensitizing mechanism of myo-inositol is associated with AMPK activation and GLUT-4 expression in human endometrial cells exposed to a PCOS environment. Am J Physiol Endocrinol Metab 318(2):E237–E248CrossRefPubMed
18.
Zurück zum Zitat Farren M, Daly N, McKeating A et al (2017) The prevention of gestational diabetes mellitus with antenatal oral inositol supplementation: a randomized controlled trial. Diabetes Care 40(6):759–763CrossRefPubMed Farren M, Daly N, McKeating A et al (2017) The prevention of gestational diabetes mellitus with antenatal oral inositol supplementation: a randomized controlled trial. Diabetes Care 40(6):759–763CrossRefPubMed
19.
Zurück zum Zitat Celentano C, Matarrelli B, Pavone G et al (2020) The influence of different inositol stereoisomers supplementation in pregnancy on maternal gestational diabetes mellitus and fetal outcomes in high-risk patients: a randomized controlled trial. J Matern Fetal Neonatal Med 33(5):743–751CrossRefPubMed Celentano C, Matarrelli B, Pavone G et al (2020) The influence of different inositol stereoisomers supplementation in pregnancy on maternal gestational diabetes mellitus and fetal outcomes in high-risk patients: a randomized controlled trial. J Matern Fetal Neonatal Med 33(5):743–751CrossRefPubMed
20.
Zurück zum Zitat Vitagliano A, Saccone G, Cosmi E et al (2019) Inositol for the prevention of gestational diabetes: a systematic review and meta-analysis of randomized controlled trials. Arch Gynecol Obstet 299(1):55–68CrossRefPubMed Vitagliano A, Saccone G, Cosmi E et al (2019) Inositol for the prevention of gestational diabetes: a systematic review and meta-analysis of randomized controlled trials. Arch Gynecol Obstet 299(1):55–68CrossRefPubMed
21.
Zurück zum Zitat Cumpston M, Li T, Page MJ et al (2019) Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev 10:ED000142PubMed Cumpston M, Li T, Page MJ et al (2019) Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev 10:ED000142PubMed
22.
Zurück zum Zitat Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7):e1000100CrossRefPubMedPubMedCentral Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7):e1000100CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Luo D, Wan X, Liu J, Tong T (2018) Optimally estimating the sample mean from the sample size, median, mid-range, and/or mid-quartile range. Stat Methods Med Res 27(6):1785–1805CrossRefPubMed Luo D, Wan X, Liu J, Tong T (2018) Optimally estimating the sample mean from the sample size, median, mid-range, and/or mid-quartile range. Stat Methods Med Res 27(6):1785–1805CrossRefPubMed
24.
Zurück zum Zitat Shi J, Luo D, Weng H et al (2020) Optimally estimating the sample standard deviation from the five-number summary. Res Synth Methods 11(5):641–654CrossRefPubMed Shi J, Luo D, Weng H et al (2020) Optimally estimating the sample standard deviation from the five-number summary. Res Synth Methods 11(5):641–654CrossRefPubMed
25.
Zurück zum Zitat Guyatt GH, Oxman AD, Vist GE et al (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336(7650):924–926CrossRefPubMedPubMedCentral Guyatt GH, Oxman AD, Vist GE et al (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336(7650):924–926CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat D’Anna R, Scilipoti A, Giordano D et al (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):854–857CrossRefPubMedPubMedCentral D’Anna R, Scilipoti A, Giordano D et al (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):854–857CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat D’Anna R, Di Benedetto A, Scilipoti A et al (2015) Myo-inositol supplementation for prevention of gestational diabetes in obese pregnant women: a randomized controlled trial. Obstet Gynecol 126(2):310–315CrossRefPubMed D’Anna R, Di Benedetto A, Scilipoti A et al (2015) Myo-inositol supplementation for prevention of gestational diabetes in obese pregnant women: a randomized controlled trial. Obstet Gynecol 126(2):310–315CrossRefPubMed
28.
Zurück zum Zitat Facchinetti F, Pignatti L, Interdonato ML et al (2013) 60: myoinositol supplementation in pregnancies at risk for gestational diabetes Interim analysis of a randomized controlled trial (RCT). Am J Obstet Gynecol 208(1):S36CrossRef Facchinetti F, Pignatti L, Interdonato ML et al (2013) 60: myoinositol supplementation in pregnancies at risk for gestational diabetes Interim analysis of a randomized controlled trial (RCT). Am J Obstet Gynecol 208(1):S36CrossRef
29.
Zurück zum Zitat Santamaria A, Di Benedetto A, Petrella E et al (2016) Myo-inositol may prevent gestational diabetes onset in overweight women: a randomized, controlled trial. J Matern Fetal Neonatal Med 29(19):3234–3237CrossRefPubMed Santamaria A, Di Benedetto A, Petrella E et al (2016) Myo-inositol may prevent gestational diabetes onset in overweight women: a randomized, controlled trial. J Matern Fetal Neonatal Med 29(19):3234–3237CrossRefPubMed
30.
Zurück zum Zitat Vitale SG, Corrado F, Caruso S et al (2021) 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. Int J Food Sci Nutr 72(5):670–679CrossRefPubMed Vitale SG, Corrado F, Caruso S et al (2021) 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. Int J Food Sci Nutr 72(5):670–679CrossRefPubMed
31.
Zurück zum Zitat Corrado F, D’Anna R, Di Vieste G et al (2011) The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med 28(8):972–975CrossRefPubMed Corrado F, D’Anna R, Di Vieste G et al (2011) The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med 28(8):972–975CrossRefPubMed
32.
Zurück zum Zitat Fraticelli F, Celentano C, Zecca IA et al (2018) Effect of inositol stereoisomers at different dosages in gestational diabetes: an open-label, parallel, randomized controlled trial. Acta Diabetol 55(8):805–812CrossRefPubMed Fraticelli F, Celentano C, Zecca IA et al (2018) Effect of inositol stereoisomers at different dosages in gestational diabetes: an open-label, parallel, randomized controlled trial. Acta Diabetol 55(8):805–812CrossRefPubMed
33.
Zurück zum Zitat Kulshrestha V, Balani S, Kachhawa G et al (2021) Efficacy of myoinositol in treatment of gestational diabetes mellitus in Asian Indian women: a pilot randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 260:42–47CrossRefPubMed Kulshrestha V, Balani S, Kachhawa G et al (2021) Efficacy of myoinositol in treatment of gestational diabetes mellitus in Asian Indian women: a pilot randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 260:42–47CrossRefPubMed
34.
Zurück zum Zitat Matarrelli B, Vitacolonna E, D’Angelo M et al (2013) Effect of dietary myo-inositol supplementation in pregnancy on the incidence of maternal gestational diabetes mellitus and fetal outcomes: a randomized controlled trial. J Matern Fetal Neonatal Med 26(10):967–972CrossRefPubMed Matarrelli B, Vitacolonna E, D’Angelo M et al (2013) Effect of dietary myo-inositol supplementation in pregnancy on the incidence of maternal gestational diabetes mellitus and fetal outcomes: a randomized controlled trial. J Matern Fetal Neonatal Med 26(10):967–972CrossRefPubMed
35.
Zurück zum Zitat Pintaudi B, Di Vieste G. Comment on Farren et al. The Prevention of Gestational Diabetes Mellitus with Antenatal Oral Inositol Supplementation: A Randomized Controlled Trial. Diabetes Care 2017; 40:759–763. Diabetes Care. 2017; 40(12):e172. Pintaudi B, Di Vieste G. Comment on Farren et al. The Prevention of Gestational Diabetes Mellitus with Antenatal Oral Inositol Supplementation: A Randomized Controlled Trial. Diabetes Care 2017; 40:759–763. Diabetes Care. 2017; 40(12):e172.
36.
Zurück zum Zitat Zhang H, Lv Y, Li Z, Sun L, Guo W (2019) The efficacy of myo-inositol supplementation to prevent gestational diabetes onset: a meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med 32(13):2249–2255CrossRefPubMed Zhang H, Lv Y, Li Z, Sun L, Guo W (2019) The efficacy of myo-inositol supplementation to prevent gestational diabetes onset: a meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med 32(13):2249–2255CrossRefPubMed
37.
Zurück zum Zitat Brown J, Crawford TJ, Alsweiler J, Crowther CA (2016) Dietary supplementation with myo-inositol in women during pregnancy for treating gestational diabetes. Cochrane Database Syst Rev 9(9):CD012048PubMed Brown J, Crawford TJ, Alsweiler J, Crowther CA (2016) Dietary supplementation with myo-inositol in women during pregnancy for treating gestational diabetes. Cochrane Database Syst Rev 9(9):CD012048PubMed
Metadaten
Titel
Inositol supplementation for the prevention and treatment of gestational diabetes mellitus: a meta-analysis of randomized controlled trials
verfasst von
Chaolin Li
Hao Shi
Publikationsdatum
12.06.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 5/2024
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-023-07100-x

Weitere Artikel der Ausgabe 5/2024

Archives of Gynecology and Obstetrics 5/2024 Zur Ausgabe

Alter der Mutter beeinflusst Risiko für kongenitale Anomalie

28.05.2024 Kinder- und Jugendgynäkologie Nachrichten

Welchen Einfluss das Alter ihrer Mutter auf das Risiko hat, dass Kinder mit nicht chromosomal bedingter Malformation zur Welt kommen, hat eine ungarische Studie untersucht. Sie zeigt: Nicht nur fortgeschrittenes Alter ist riskant.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.