A pilot study of gestational diabetes mellitus not controlled by diet alone: First-line medical treatment with myoinositol may limit the need for insulin

Abstract

Aim: This study assessed whether myoinositol might be a first-line medical treatment for gestational diabetes mellitus (GDM).

Methods: For 12 months, women with GDM not controlled by diet (n=32) were prospectively treated with myoinositol 1200mg and folic acid 400μg/day, while consecutive women (n=28) with insulin-requiring GDM treated during the previous year at our centre constituted the control group. Baseline characteristics and care were similar in both groups.

Results: Insulin was required in eight women (25%) in the myoinositol group who, compared with the 24 who did not need insulin, were older (37±5 vs. 32±5 years, respectively; P=0.018) and had a larger percentage of high self-monitored glucose values (45±8% vs. 32±14%; P<0.0001) during the week prior to the introduction of myoinositol treatment. All of the women had similar pregnancy outcomes regardless of their GDM management, although less labour induction was required in the myoinositol group (OR: 0.22 [0.07-0.65]), which had no side effects.

Conclusion: This pilot study suggests that myoinositol may be a safe first-line medical treatment for uncontrolled GDM.

Keywords: Diabetes; Gestational diabetes mellitus; Insulin; Macrosomia; Myoinositol; Pregnancy.