Efficacy of inositol supplementation for the prevention and treatment of gestational diabetes in pregnant women: Results from an umbrella meta-analysis.

BACKGROUND

Inositol (ISL) refers to a group of simple carbohydrates known for their insulin-sensitizing effects, with Myo-inositol (MYO) and d-chiro-inositol (DCI) being the most prevalent isoforms.

OBJECTIVE

This umbrella meta-analysis aimed to evaluate the impact of inositol supplementation on gestational diabetes (GDM) as well as maternal and neonatal outcomes in women with GDM. We performed a systematic search of the literature in the PubMed and Scopus databases up until September 2024 to identify relevant studies.

METHOD: Publications with the following criteria were eligible: (i) the study design was a meta-analysis of RCTs, (ii) the population consisted of pregnant women with GDM, (iii) the intervention involved ISL supplementation, compared to a placebo, and (iv) the primary outcome was the incidence of GDM. The secondary outcomes included glycemic indices, preterm birth, pregnancy-induced hypertension, birth weight, neonatal hypoglycemia, gestational age at birth, cesarean delivery, shoulder dystocia, macrosomia, and neonatal intensive care unit admission. The pooled results were presented as standardized mean differences for continuous outcomes and relative risks (RR) with 95% confidence intervals (CI) for dichotomous outcomes, using a random effects model.

RESULTS

A total of 19 studies involving 17 932 participants were included in the analysis. ISL supplementation was linked to a lower risk of GDM (RR: 0.42; 95% CI = 0.37-0.49), reduced need for insulin therapy (RR: 0.33; 95% CI = 0.19-0.58), decreased incidence of pregnancy-induced hypertension (RR: 0.34; 95% CI = 0.27-0.44), lower rates of preterm birth (RR: 0.38; 95% CI = 0.31-0.47), and a reduced rate of neonatal hypoglycemia. Additionally, ISL significantly lowered oral glucose tolerance test results, fasting blood sugar levels, and birth weight, while increasing fasting serum insulin levels and gestational age at birth. Subgroup analyses indicated that the effects varied based on the type of intervention and dosage of ISL used.

CONCLUSION

Administering ISL during pregnancy might offer a promising approach to the prevention and management of GDM and its related health outcomes.