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The Prevention of Gestational Diabetes Mellitus With Antenatal Oral Inositol Supplementation: A Randomized Controlled Trial

Maria Farren, Niamh Daly, Aoife McKeating, Brendan Kinsley, Michael J. Turner, Sean Daly
2017 Diabetes Care  
OBJECTIVE This study investigated if inositol in a combination of myo-inositol and D-chiro-inositol would prevent gestational diabetes mellitus (GDM) in women with a family history of diabetes. RESEARCH DESIGN AND METHODS This was a randomized controlled trial that examined whether inositol from the first antenatal visit prevents GDM. The trial was carried out in a single-center tertiary referral center. Women with a family history of diabetes were enrolled at the first antenatal visit. They
more » ... atal visit. They were randomized to the intervention group, which received a combination of 1,100 mg myo-inositol, 27.6 mg D-chiro-inositol, and 400 mg folic acid, or to the control group, which received 400 mg folic acid only. All women had an oral glucose tolerance test between 24 and 28 weeks' gestation. The primary end point was the incidence of GDM. Statistical analysis was carried out using SPSS Statistical Package version 20. RESULTS Two hundred forty women, 120 in each arm, were recruited between January 2014 and July 2015. There were no differences in characteristics between the groups. The incidence of GDM was 23.3% (n = 28) in the intervention group compared with 18.3% (n = 22) in the control group (P = 0.34). The mean fasting plasma glucose at the glucose tolerance test was 81 mg/dL in both groups. CONCLUSIONS Commencing an inositol combination in early pregnancy did not prevent GDM in women with a family history of diabetes. Further studies are required to examine whether inositol supplements at varying doses may prevent GDM. Gestational diabetes mellitus (GDM) may be defined as glucose intolerance with onset or first recognition during pregnancy (1). The prevalence of GDM varies widely depending, for example, on the diagnostic methodology, the population studied, and whether screening is universal or selective (2,3). GDM is associated with increased clinical risk for the woman and her offspring, including hypertensive disorders, cesarean section, fetal macrosomia, shoulder dystocia, and neonatal hypoglycemia (1). Following the Hyperglycemia and Adverse Outcomes (HAPO) Study, the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recommended new thresholds for the diagnosis of GDM (4). These were
doi:10.2337/dc16-2449 pmid:28325784 fatcat:5fo4tclqfnhbblkw4pk4r2phuu