Myoinositol for Prevention Of Gestational Diabetes Mellitus in High Risk Pregnant Patients

Abstract

Background: Gestational diabetes mellitus is the most common metabolic complication of pregnancy. It is one of the leading causes of pregnancy-related maternal and perinatal morbidity and long-term adverse outcomes for women and their children.  Myo-inositol, one of the intracellular mediators of the insulin signal, has been shown to correlate with insulin sensitivity in type 2 diabetes mellitus.

Objectives: This study was aimed to compare the myo-inositol (a dietary supplement) and control in frequency of prevention of gestational diabetes mellitus in high risk pregnant women.

Methods: This randomized control trial was undertaken at the Gynecology and Obstetrics Department, MCH Unit 1 PIMS Hospital, Islamabad during December 2020 to  May 2021. A sample size of 122 pregnant women was considered in this study. After taking an informed consent, a detailed history was taken. A screening OGTT was performed. Each patient in the intervention group was given myo-inositol in a dose of 2 gram once daily for 3 months and women in control group were given standard management. Women were followed according to the usual schedule typically every 4 weeks. Pregnant women were undergoing to second OGTT at 24-28 weeks for the diagnosis of gestational diabetes mellitus.

Results: An overall mean age of subjects was 36.39±3.27 years. A total 35 (28.7%) patient presented with GDM in this study of which 14.75% were from Group A (lifestyle modification + myo-inositol) whereas 42.62% were from group B considering lifestyle modification only and chi-square test showed a significant difference (p-value = 0.001) considering a good effect of myo-inositol to avoid GDM. Of total 35 GDM, 28 (80.0%) were diagnosed at gestational age of 24-28 weeks of gestation.

Conclusion: Myo-inositol supplementation among high risk group of GDM, has been proved to have a significantly better (p<0.0001) effect in reducing the occurrence of GDM as only 9/61(14.75%) high risk women with prior history of GDM showed recurrence subsequently in comparison to 26/61 (42.62%), who were not using Myo-inositol supplementation.