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Inositol and Prevention of Gestational Diabetes, Possible Reduction in Risk of Neural Tube Defect in Offspring, and Beyond…

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Research Glimpse: Integrative healthcare providers have become well-versed in the role of myo-inositol as an important, first-line treatment of PCOS. More recently, an explosion of research has emerged evaluating the role of myo-inositol as an intervention capable of preventing onset of gestational diabetes (GDM), as well as treating GDM if established. A handful of small trials have also evaluated and suggested efficacy of myo-inositol in reducing risk of neural tube defect (NTD) above and beyond protection afforded by supplementation with folic acid.

First evaluated in 2011 (1), a brief PubMed search identified 15 intervention trials evaluating the role of supplemental myo-inositol in preventing gestational diabetes, and three intervention trials evaluating risk of neural tube defect. The list of these papers is available upon request from the publishers of this blog. A recent, and seemingly well-controlled trial focused on GDM prevention is summarized below (2).

Santamaria and colleagues (2) randomized in open-label fashion 220 pregnant woman to receive 4g myo-inositol plus 400mcg folic acid or placebo plus 400mcg folic acid from first trimester to delivery. Participants were overweight yet non-obese (BMI >25, <30). 27.4% of women assigned to placebo, versus 11.6% of women assigned to myo-inositol, developed GDM, representing a 67% risk reduction.

Beyond gestational diabetes, myo-inositol has been successfully utilized for treatment of diabetes types I and II. Classically, integrative healthcare providers were encouraged to consider prescriptions for gymnema, bitter melon peel, chromium, fenugreek, and others, yet the evidence-base and subsequent clinical outcomes for these agents are lacking. Myo-inositol has emerged as an important tool for consideration in any setting of diabetes. Likewise, recent evidence has highlighted important roles for cinnamon and curcumin in improving glucose control among individuals with diabetes. It appears the nutraceutical landscape is rapidly changing with regards to management of this raging epidemic.

Beyond being entrenched as a first line treatment in PCOS, and now a very compelling first-line strategy for prevention of GDM, myo-inositol is showing promise in treating all types of diabetes, preventing neural tube defect above and beyond the effect of folic acid, improving male fertility, Hashimoto’s thyroiditis, and autoimmune thyroiditis. This is clearly an agent worth keeping an eye on! Given such broad-spectrum benefit, excellent affordability, and unquestioned safety, myo-inositol should become a more common prescription among integrative healthcare providers.

References:
1. Corrado F, D'Anna R, Di Vieste G, Giordano D, Pintaudi B, Santamaria A, Di Benedetto A. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med. 2011 Aug;28(8):972-5.

2. Santamaria A, Di Benedetto A, Petrella E, Pintaudi B, Corrado F, D'Anna R, Neri I, Facchinetti F. Myo-inositol may prevent gestational diabetes onset in overweight women: a randomized, controlled trial. J Matern Fetal Neonatal Med. 2016 Oct;29(19):3234-7.