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
Abstract
Objective: To identify the effects of different dietary inositol stereoisomers on insulin resistance and the development of gestational diabetes mellitus (GDM) in women at high risk for this disorder.Design: A preliminary, prospective, randomized, placebo controlled clinical trial.Participants: Nonobese singleton pregnant women with an elevated fasting glucose in the first or early second trimester were studied throughout pregnancy.Intervention: Supplementation with myo-inositol, d-chiro-inositol, combined myo- and d-chiro-inositol or placebo.Main outcome measure: Development of GDM on a 75 grams oral glucose tolerance test at 24–28 weeks’ gestation. Secondary outcome measures were increase in BMI, need for maternal insulin therapy, macrosomia, polyhydramnios, neonatal birthweight and hypoglycemia.Results: The group of women allocated to receive myo-inositol alone had a lower incidence of abnormal oral glucose tolerance test (OGTT). Nine women in the control group (C), one of the myo-inositol (MI), five in d-chiro-inositol (DCI), three in the myo-inositol/D-chiro-inositol group (MI/DCI) required insulin (p = .134). Basal, 1-hour, and 2 hours glycemic controls were significantly lower in exposed groups (p < .001, .011, and .037, respectively). The relative risk reduction related to primary outcome was 0.083, 0.559, and 0.621 for MI, DCI, and MI/DCI groups.Conclusions: This study compared the different inositol stereoisomers in pregnancy to prevent GDM. Noninferiority analysis demonstrated the largest benefit in the myo-inositol group. The relevance of our findings is mainly related to the possibility of an effective approach in GDM. Our study confirmed the efficacy of inositol supplementation in pregnant women at risk for GDM.
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Myo-inositol alone at a dosage of 4000 mg daily gave a lower relative risk for an abnormal maternal oral glucose tolerance test.
“The relevance of these findings is mainly related to the possibility of an effective therapeutic approach in GDM using myo-inositol alone at a dosage of 4000 mg daily, which gave a lower relative risk for an abnormal maternal OGTT [80].”
From From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management (2020) · cites this paper as [80]
Several clinical studies demonstrated significant efficacy of inositols, mainly myo-inositol, in gestational diabetes mellitus prevention.
“In the last years, several clinical studies demonstrated the significant efficacy of inositols (mainly myo-inositol) in GDM prevention [76–80].”
From From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management (2020) · cites this paper as [80]
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Lecis, S., D’Anna, R., Garzon, S., & Facchinetti, F. (2026) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2026.09.007
- Authors
- Celentano, C., Matarrelli, B., Pavone, G., Vitacolonna, E., Mattei, P. A., Berghella, V., & Liberati, M.
- Affiliations
- University of Chieti-Pescara (IT)
- Thomas Jefferson University (US)
- Corresponding author
- Celentano, Claudio
- ORCID
- Venue
- The Journal of Maternal-Fetal & Neonatal Medicine
- Publisher
- Informa UK Limited
- Published
- 2018-12-17
- Volume
- 33
- Issue
- 5
- Pages
- 743-751
- ISSN
- 1476-4954 (ISSN-L)
- 1476-7058
- OpenAlex
- W2904800571
- Cited by
- 54
- References
- 40
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 7 · 2023: 10 · 2022: 10 · 2021: 8 · 2020: 6 · 2019: 3
- FWCI
- 4.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Maternal-Fetal & Neonatal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Natural Antidiabetic Agents Studies
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- myo-inositol, D-chiro-inositol, gestational diabetes mellitus, insulin resistance, pregnancy, dietary supplementation, oral glucose tolerance test, fetal outcomes, macrosomia, neonatal hypoglycemia, high-risk pregnancy
- MeSH terms
- Adult, Female, Humans, Inositol, Isomerism, Pregnancy, Pregnancy Outcome, Prospective Studies, Vitamin B Complex, Diabetes, Gestational, Dietary Supplements
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