Oral Myoinositol and D-Chiro-Inositol Does not Reduce Incidence of Gestational Diabetes Mellitus

by | May 6, 2019 | 2017, Diabetes, Pregnancy and Lactation, Women's Health

Written by Halima Phelps, Staff Writer. This study showed that an inositol combination given in early pregnancy did not reduce the incidence of GDM in women with a family history of diabetes.

pregnancyMyo-inositol (MI) and D-chiro-inositol (DCI) have been studied for various reasons, both individually and in combinations, to determine its effectiveness in treating PCOS, metabolic diseases, insulin control, hyperandrogenism and the restoration of ovary function. Inositol is a pseudovitamin precursor to phosphoinositides which are indirectly involved in glucose control.1 A 2016 study found that myoinositol and D-chiro-inositol supplementation decreased insulin rise in obese children following glucose ingestion.2 Another study found that a combination of MI and DCI improved the metabolic profile in women with PCOS.3 This randomized controlled trial, analyzed whether oral ingestion of MI with DCI, would prevent gestation diabetes mellitus (GDM) in pregnant women who had a positive family history of diabetes.1

Two hundred and forty pregnant women, between 10 and 16 weeks gestation, mean age 31.3 years, mean BMI 26.1 kg/m2, with a family history of type 1 or type 2 diabetes were randomized into two groups of 120 each: the control group supplemented daily with either 400 μg folic acid; the intervention arm supplemented daily with a combination of 1,100 mg MI, 27.6 mg of DCI, and 400 μg folic acid.1 The primary outcome was the occurrence of GDM diagnosed with a 75-g oral glucose tolerance test (OGTT) performed between 24 and 28 weeks’ gestation. Secondary outcomes included the development of preeclampsia or pregnancy-induced hypertension, induction of labor, the mode of delivery, perineal trauma, birth weight, shoulder dystocia, brachial plexus palsy, neonatal intensive care unit (NICU) admission, neonatal hypoglycemia, and respiratory distress syndrome. The aim of the intervention was to show a 50% reduction in the incidence of GDM.1

The incidence of GDM in the intervention group was 23% (n=28), compared with 18% (n=22 ) in the control group (P=0.34).1 The mean fasting plasma glucose at the glucose tolerance test was 81 mg/dL in both groups. 11 A postpartum secondary analyses of 117 qualifying women were evaluated in each group. No difference was present between the groups for birth weight (P = 0.52), preterm delivery (P=0.11); and neonatal hypoglycemia intervention (P=0.01), macrosomia (P=0.65), birth weight below the 10th centile, caesarean delivery (P=0.58); perineal trauma (P=0.17); primary postpartum hemorrhage (P=0.21); and shoulder dystocia or brachial plexus injury.1

This study combination of MI and DCI did not reduce the incidence of GDM in women with a family history of diabetes. Future studies might consider dietary modifications along with higher dose of combined MI and DCI and with a larger study population to assess efficacy of GDM prevention.

Sources: Farren, Maria, Niamh Daly, Aoife McKeating, Brendan Kinsley, Michael J. Turner, and Sean Daly. “The prevention of gestational diabetes mellitus with antenatal oral inositol supplementation: a randomized controlled trial.” Diabetes care 40, no. 6 (2017): 759-763.

© 2017 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals .org/content/license.

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Posted May 6, 2019.

Halima Phelps, BA, AA, PBT, is a graduate of the University of Wisconsin Parkside. She graduated in 2014 with a bachelor of arts in Spanish and a biology minor. She is currently a student staff member in the department of postgraduate education and completing a medical degree at the National University of Health Sciences in Lombard, IL.

References:

  1. Farren M, Daly N, McKeating A, Kinsley B, Turner MJ, Daly S. The Prevention of Gestational Diabetes Mellitus With Antenatal Oral Inositol Supplementation: A Randomized Controlled Trial. Diabetes Care. 2017;40(6):759-763.
  2. Mancini M, Andreassi A, Salvioni M, Pelliccione F, Mantellassi G, Banderali G. Myoinositol and D-Chiro Inositol in Improving Insulin Resistance in Obese Male Children: Preliminary Data. Int J Endocrinol. 2016;2016:8720342.
  3. Minozzi M, Nordio M, Pajalich R. The Combined therapy myo-inositol plus D-Chiro-inositol, in a physiological ratio, reduces the cardiovascular risk by improving the lipid profile in PCOS patients. Eur Rev Med Pharmacol Sci. 2013;17(4):537-540.