American journal of obstetrics and gynecology · 2026
Myo-inositol to prevent gestational diabetes: "What do conflicting trials tell clinicians?".
Редакционная статьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lecis Serena, D'Anna Rosario, Garzon Simone, Facchinetti Fabio
Аннотация
BACKGROUND: A recent meta-analysis reported that myo-inositol supplementation was associated with a reduced risk of gestational diabetes mellitus. However, the primary outcome showed substantial between-study heterogeneity, complicating the interpretation and clinical applicability of the evidence.
OBJECTIVE: To discuss why randomized trials may have produced different results and identify the information needed to guide future research and clinical interpretation.
STUDY DESIGN: We critically appraised the clinical and methodological characteristics of the randomized controlled trials included in the published meta-analysis to explore factors that may have contributed to their variability in results.
RESULTS: Substantial differences were found in population characteristics, including the prevalence of a family history of diabetes, previous gestational diabetes mellitus, and overweight or obesity. Trials also differed in the timing of treatment initiation (before or after the 14th week) and in their supplementation protocols. The available evidence does not allow conclusions regarding treatment effect modification, because study-level analyses cannot distinguish true differences in treatment effects from differences in statistical power or other study characteristics. Short-term tolerability has been consistently reported; however, long-term neonatal outcomes have rarely been reported, and safety data remain limited.
CONCLUSION: The recent meta-analysis provided a signal of benefit of myo-inositol for prevention of gestational diabetes mellitus. This clinical perspective identifies and discusses clinical and methodological differences that may have contributed to the variability in results across trials. However, the available evidence does not establish the optimal target population, supplementation protocol, or timing of treatment initiation. Adequately powered randomized trials focusing on short- and long-term neonatal outcomes are needed to better define the efficacy and safety of myo-inositol for the prevention of gestational diabetes mellitus.
OBJECTIVE: To discuss why randomized trials may have produced different results and identify the information needed to guide future research and clinical interpretation.
STUDY DESIGN: We critically appraised the clinical and methodological characteristics of the randomized controlled trials included in the published meta-analysis to explore factors that may have contributed to their variability in results.
RESULTS: Substantial differences were found in population characteristics, including the prevalence of a family history of diabetes, previous gestational diabetes mellitus, and overweight or obesity. Trials also differed in the timing of treatment initiation (before or after the 14th week) and in their supplementation protocols. The available evidence does not allow conclusions regarding treatment effect modification, because study-level analyses cannot distinguish true differences in treatment effects from differences in statistical power or other study characteristics. Short-term tolerability has been consistently reported; however, long-term neonatal outcomes have rarely been reported, and safety data remain limited.
CONCLUSION: The recent meta-analysis provided a signal of benefit of myo-inositol for prevention of gestational diabetes mellitus. This clinical perspective identifies and discusses clinical and methodological differences that may have contributed to the variability in results across trials. However, the available evidence does not establish the optimal target population, supplementation protocol, or timing of treatment initiation. Adequately powered randomized trials focusing on short- and long-term neonatal outcomes are needed to better define the efficacy and safety of myo-inositol for the prevention of gestational diabetes mellitus.