Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Feb 15;2(2):CD011507.
doi: 10.1002/14651858.CD011507.pub3.

Antenatal dietary supplementation with myo-inositol for preventing gestational diabetes

Soana K Motuhifonua #  1 , Luling Lin #  1 , Jane Alsweiler  2 , Tineke J Crawford  1 , Caroline A Crowther  1
Affiliations
Review

Antenatal dietary supplementation with myo-inositol for preventing gestational diabetes

Soana K Motuhifonua et al. Cochrane Database Syst Rev. .

Abstract

Background: Gestational diabetes with onset or first recognition during pregnancy is an increasing problem worldwide. Myo-inositol, an isomer of inositol, is a naturally occurring sugar commonly found in cereals, corn, legumes and meat. Myo-inositol is one of the intracellular mediators of the insulin signal and correlates with insulin sensitivity in type 2 diabetes. The potential beneficial effect of improving insulin sensitivity suggests that myo-inositol may be useful for women in preventing gestational diabetes. This is an update of a review first published in 2015.

Objectives: To assess if antenatal dietary supplementation with myo-inositol is safe and effective, for the mother and fetus, in preventing gestational diabetes.

Search methods: We searched the Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, WHO ICTRP (17 March 2022) and the reference lists of retrieved studies.

Selection criteria: We included published and unpublished randomised controlled trials (RCTs) including cluster-RCTs and conference abstracts, assessing the effects of myo-inositol for the prevention of gestational diabetes in pregnant women. We included studies that compared any dose of myo-inositol, alone or in a combination preparation, with no treatment, placebo or another intervention. Quasi-randomised and cross-over trials were not eligible. We excluded women with pre-existing type 1 or type 2 diabetes.

Data collection and analysis: Two review authors independently assessed studies for inclusion, assessed risk of bias and extracted the data. We checked the data for accuracy. We assessed the certainty of the evidence using the GRADE approach.

Main results: We included seven RCTs (one conducted in Ireland, six conducted in Italy) reporting on 1319 women who were 10 weeks to 24 weeks pregnant at the start of the studies. The studies had relatively small sample sizes and the overall risk of bias was low. For the primary maternal outcomes, meta-analysis showed that myo-inositol may reduce the incidence of gestational diabetes (risk ratio (RR) 0.53, 95% confidence interval (CI) 0.31 to 0.90; 6 studies, 1140 women) and hypertensive disorders of pregnancy (RR 0.34, 95% CI 0.19 to 0.61; 5 studies, 1052 women). However, the certainty of the evidence was low to very low. For the primary neonatal outcomes, only one study measured the risk of a large-for-gestational-age infant and found myo-inositol was associated with both appreciable benefit and harm (RR 1.40, 95% CI 0.65 to 3.02; 1 study, 234 infants; low-certainty evidence). None of the included studies reported on the other primary neonatal outcomes (perinatal mortality, mortality or morbidity composite). For the secondary maternal outcomes, we are unclear about the effect of myo-inositol on weight gain during pregnancy (mean difference (MD) -0.25 kilogram (kg), 95% CI -1.26 to 0.75 kg; 4 studies, 831 women) and perineal trauma (RR 4.0, 95% CI 0.45 to 35.25; 1 study, 234 women) because the evidence was assessed as being very low-certainty. Further, myo-inositol may result in little to no difference in caesarean section (RR 0.91, 95% CI 0.77 to 1.07; 4 studies, 829 women; low-certainty evidence). None of the included studies reported on the other secondary maternal outcomes (postnatal depression and the development of subsequent type 2 diabetes mellitus). For the secondary neonatal outcomes, meta-analysis showed no neonatal hypoglycaemia (RR 3.07, 95% CI 0.90 to 10.52; 4 studies; 671 infants; very low-certainty evidence). However, myo-inositol may be associated with a reduction in the incidence of preterm birth (RR 0.35, 95% CI 0.17 to 0.70; 4 studies; 829 infants). There were insufficient data for a number of maternal and neonatal secondary outcomes, and no data were reported for any of the long-term childhood or adulthood outcomes, or for health service utilisation outcomes.

Authors' conclusions: Evidence from seven studies shows that antenatal dietary supplementation with myo-inositol during pregnancy may reduce the incidence of gestational diabetes, hypertensive disorders of pregnancy and preterm birth. Limited data suggest that supplementation with myo-inositol may not reduce the risk of a large-for-gestational-age infant. The current evidence is based on small studies that were not powered to detect differences in outcomes such as perinatal mortality and serious infant morbidity. Six of the included studies were conducted in Italy and one in Ireland, which raises concerns about the lack of generalisability to other settings. There is evidence of inconsistency among doses of myo-inositol, the timing of administration and study population. As a result, we downgraded the certainty of the evidence for many outcomes to low or very low certainty. Further studies for this promising antenatal intervention for preventing gestational diabetes are encouraged and should include pregnant women of different ethnicities and varying risk factors. Myo-inositol at different doses, frequency and timing of administration, should be compared with placebo, diet and exercise, and pharmacological interventions. Long-term follow-up should be considered and outcomes should include potential harms, including adverse effects.

Trial registration: ClinicalTrials.gov NCT01511835 NCT01047982.

PubMed Disclaimer

Conflict of interest statement

Soana K Motuhifonua: reports no conflicts of interest.

Jane Alsweiler: reports working as a health professional as a Neonatal Paediatrician, Auckland District Health Board, but no other conflicts of interest.

Tineke J Crawford: reports no conflicts of interest.

Luling Lin: reports no conflicts of interest.

Caroline A Crowther: reports no conflicts of interest.

Figures

1
1
Study flow diagram for updated review
2
2
Applying the trustworthiness screening tool criteria. TST: Trustworthiness Screening Tool.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
4
4
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
1.1
1.1. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 1: Gestational diabetes mellitus
1.2
1.2. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 2: Fasting OGTT
1.3
1.3. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 3: One hour OGTT
1.4
1.4. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 4: Two hour OGTT
1.5
1.5. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 5: Hypertensive disorders of pregnancy
1.6
1.6. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 6: Large‐for‐gestational‐age
1.7
1.7. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 7: Caesarean section
1.8
1.8. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 8: Weight gain during pregnancy
1.9
1.9. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 9: Relevant biomarker changes associated with the intervention
1.10
1.10. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 10: Perineal trauma
1.11
1.11. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 11: Postpartum haemorrhage
1.12
1.12. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 12: Adherence to intervention
1.13
1.13. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 13: Supplementary insulin
1.14
1.14. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 14: Gestational age at birth
1.15
1.15. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 15: Preterm birth (less than 37 weeks' gestation)
1.16
1.16. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 16: Macrosomia
1.17
1.17. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 17: Birthweight
1.18
1.18. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 18: Shoulder dystocia
1.19
1.19. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 19: Respiratory distress syndrome
1.20
1.20. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 20: Neonatal hypoglycaemia
1.21
1.21. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 21: Small‐for‐gestational‐age
1.22
1.22. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 22: Neonatal hyperbilirubinaemia
1.23
1.23. Analysis
Comparison 1: Myo‐inositol versus control, Outcome 23: Admission to neonatal intensive care unit or special care baby unit
See this image and copyright information in PMC

Update of

References

References to studies included in this review

D'Anna 2013 {published data only}
    1. D'Anna R, Scilipoti A, Giordano D, Caruso C, Cannata ML, Interdonato ML, et al. Myo-inositol supplementation and onset of gestational diabetes mellitus in pregnant women with a family history of type 2 diabetes: a prospective, randomized, placebo-controlled study. Diabetes Care 2013;36(4):854-8. - PMC - PubMed
    1. NCT01511835. Efficacy of Myo-inositol in preventing gestational diabetes in high-risk pregnant women. clinicaltrials.gov/ct2/show/NCT01511835 (first received 2011).
    1. Santamaria A, Alibrandi A, Di Benedetto A, Pintaudi B, Corrado F, Facchinetti F, et al. Clinical and metabolic outcomes in pregnant women at risk for gestational diabetes mellitus supplemented with myo-inositol: a secondary analysis from 3 RCTs. American Journal of Obstetrics and Gynecology 2018;219(3):300.e1-300.e6. - PubMed
D'Anna 2015 {published data only}
    1. D'Anna R, Di Benedetto A, Scilipoti A, Santamaria A, Interdonato ML, Petrella E, et al. Myo-Inositol supplementation for prevention of gestational diabetes in obese pregnant women. a randomized controlled trial. Obstetrics and Gynecology 2015;126(2):310-5. - PubMed
    1. D'Anna R, Santamaria A, Corrado F, Di Benedetto A, Petrella E, Facchinetti F. Myo-inositol in the prevention of gestational diabetes and its complications. Pregnancy Hypertension 2015;5(1):6. [DOI: 10.1016/j.preghy.2014.10.015] - DOI
    1. Facchinetti F, Pignatti L, Interdonato ML, Neri I, Bellei G, D'Anna R. Myoinositol supplementation in pregnancies at risk for gestational diabetes. Interim analysis of a randomized controlled trial. American Journal of Obstetrics and Gynecology 2013;208(1 Suppl):S36.
    1. NCT01047982. Myo-inositol for preventing gestational diabetes in overweight and obese women. clinicaltrials.gov/show/NCT01047982 (first received 2010).
    1. Santamaria A, Alibrandi A, Di Benedetto A, Pintaudi B, Corrado F, Facchinetti F, et al. Clinical and metabolic outcomes in pregnant women at risk for gestational diabetes mellitus supplemented with myo-inositol: a secondary analysis from 3 RCTs. American Journal of Obstetrics and Gynecology 2018;219(3):300.e1-300.e6. - PubMed
Farren 2017 {published data only}
    1. Farren M, Daly N, McKeating A, Kinsley B, Turner MJ, Daly S. The prevention of gestational diabetes mellitus with antenatal oral inositol supplementation: a randomized controlled trial. Diabetes Care 2017;40(6):759-763. - PubMed
    1. Farren M, Daly N, McKeating A, Turner MJ, Daly S. The role of myo-inositol/D-chiro-inositol in a physiological ratio of 40: 1 in preventing the onset of gestational diabetes mellitus. British Journal of Obstetrics and Gynaecology 2016;123(13):e3.
    1. ISRCTN92466608. A trial to investigate the role of the food supplement inositol in the general health of those at risk of developing gestational diabetes mellitus. www.isrctn.com/ISRCTN92466608 (first received 2013).
Malvasi 2014 {published data only}
    1. Malvasi A, Casciaro F, Minervini MM, Kosmas I, Mynbaev OA, Pacella E, et al. Myo-inositol, D-chiro-inositol, folic acid and manganese in second trimester of pregnancy: a preliminary investigation. European Review for Medical and Pharmacological Sciences 2014;18(2):270-4. - PubMed
Malvasi 2017 {published data only}
    1. Malvasi A, Kosmas I, Mynbaev OA, Sparic R, Gustapane S, Guido M, Tinelli A. Can transresveratrol plus d-chiro-inositol and myo-inositol improve maternal metabolic profile in overweight pregnant patients? Clinica Terapeutica 2017;168(4):e240-7. - PubMed
Santamaria 2016 {published data only}
    1. Santamaria A, Alibrandi A, Di Benedetto A, Pintaudi B, Corrado F, Facchinetti F, et al. Clinical and metabolic outcomes in pregnant women at risk for gestational diabetes mellitus supplemented with myo-inositol: a secondary analysis from 3 RCTs. American Journal of Obstetrics and Gynecology 2018;219(3):300.e1-300.e6. - PubMed
    1. Santamaria A, Di Benedetto A, Petrella E, Pintaudi B, Corrado F, D'Anna R, et al. Myo-inositol may prevent gestational diabetes onset in overweight women: a randomized, controlled trial. Journal of Maternal-Fetal and Neonatal Medicine 2016;29(19):3234-37. - PubMed
Vitale 2019 {published data only}
    1. Vitale SG, Corrado F, Caruso S, Di Benedetto A, Giunta L, Cianci A, et al. Myo-inositol supplementation to prevent gestational diabetes in overweight non-obese women: bioelectrical impedance analysis, metabolic aspects, obstetric and neonatal outcomes; a randomized and open-label, placebo-controlled clinical trial. International Journal of Food Sciences and Nutrition 2021;72(5):670-9. [PMID: ] - PubMed
    1. Vitale SG, Corrado F. Myo-inositol supplementation to prevent gestational diabetes and effect on bioelectrical impendence analysis in overweight non-obese women: a randomized placebo-controlled trial. European Journal of Obstetrics Gynecology and Reproductive Biology 2019;234:e150.

References to studies excluded from this review

Celentano 2020 {published data only}
    1. Celentano C, Matarrelli B, Pavone G, Vitacolonna E, Mattei PA, Berghella V, et al. 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. Journal of Maternal Fetal and Neonatal Medicine 2020;33(5):743-51. - PubMed
Corrado 2011 {published data only}
    1. Corrado F, D'Anna R, Di Vieste G, Giordano D, Pintaudi B, Santamaria A, et al. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabetic Medicine 2011;28(8):972-5. - PubMed
Godfrey 2017 {published data only}
    1. Godfrey KM, Cutfield W, Chan S-Y, Baker PN, Chong Y-S, Aris IB, et al. Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health ("NiPPeR"): study protocol for a randomised controlled trial. Trials 2017;18(1):131. - PMC - PubMed
Matarrelli 2013 {published data only}
    1. Matarrelli B, Vitacolonna E, D'angelo M, Pavone G, Mattei PA, Liberati M, et al. Effect of dietary myo-inositol supplementation in pregnancy on the incidence of maternal gestational diabetes mellitus and fetal outcomes: a randomized controlled trial. Journal of Maternal-Fetal and Neonatal Medicine 2013;26(10):967-72. - PubMed

References to studies awaiting assessment

Esmaeilzadeh 2021 {published data only}
    1. Esmaeilzadeh S, Ghadimi R, Mashayekhamiri S, Delavar MA, Basirat Z. The effect of myo-inositol supplementation on the prevention of gestational diabetes in overweight pregnant women: a randomized, double-blind, controlled trial; 16 April 2021, PREPRINT (Version 1). www.researchsquare.com/article/rs-260476/v1 (accessed April 2021). [DOI: 10.21203/rs.3.rs-260476/v1] - DOI
    1. IRCT20160208026446N2. The impact of myo-inositol supplementation to gestational diabetes in overweight pregnant women. www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT20160208026446N2 (first received 2017). [CENTRAL: CN-01903667]

References to ongoing studies

Amaefule 2018 {published data only}
    1. Amaefule CE, Drymoussi Z, Dodds J, Sweeney L, Pizzo E, Daru J, et al. Effectiveness and acceptability of myo-inositol nutritional supplement in the prevention of gestational diabetes (EMmY): a protocol for a randomised, placebo-controlled, double-blind pilot trial. BMJ Open 2018;8(9):e022831. - PMC - PubMed
    1. Amaefule CE, Sweeney L, Thangaratinam S. Effectiveness and acceptability of myo-inositol nutritional supplement in the prevention of gestational diabetes (EMmY): a randomised, placebo-controlled, double-blind multi-centred pilot trial with nested qualitative evaluation. British Journal of Obstetrics and Gynaecology 2019;126(S1):26. [CENTRAL: CN-01936587] [EMBASE: 627142813]
    1. Heighway JM, Drymoussi Z, Lanz D, Thangaratinam S. Approaches to data cleaning in a pilot study: (EMmY) Effectiveness and acceptability of myo-inositol nutritional supplement in the prevention of gestational diabetes: a pilot placebo controlled double blind randomised trial. Trials 2019;20:10. [CENTRAL: CN-02006813] [EMBASE: 629760350]
    1. ISRCTN48872100. Preventing gestational diabetes with myo-inositol supplement. www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN48872100 (first received 2018). [CENTRAL: CN-01902369]
Asimakopoulos 2020 {published data only}
    1. Asimakopoulos G, Pergialiotis V, Anastasiou E, Antsaklis P, Theodora M, Vogiatzi E, et al. Effect of dietary myo-inositol supplementation on the insulin resistance and the prevention of gestational diabetes mellitus: study protocol for a randomized controlled trial. Trials 2020;21(1):633. [CENTRAL: CN-02130113] [EMBASE: 144473532] [PMID: ] - PMC - PubMed
    1. ISRCTN16142533. Myo-inositol supplementation for the prevention of gestational diabetes. www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN16142533 (first received 2017). [CENTRAL: CN-01856278]
CTRI/2018/06/014477 {published data only}
    1. CTRI/2018/06/014477. A clinical study to assess the potential of myo-d-chiro-inositol in prevention of the development of GDM in pregnant women. www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2018/06/014477 (first received 2018). [CENTRAL: CN-01905638]
Ibrahim 2022 {published data only}
    1. Ibrahim I, Abdullahi H, Fagier Y, Ortashi O, Terrangera A, Okunoye G. Effect of antenatal dietary myo-inositol supplementation on the incidence of gestational diabetes mellitus and fetal outcome: protocol for a double-blind randomised controlled trial. BMJ Open 2022;12(1):e055314. [CENTRAL: CN-02361232] [EMBASE: 636884973] - PMC - PubMed
    1. ISRCTN16448440. The study of myo-inositol supplements for reducing the risk of gestational diabetes mellitus [Effect of antenatal dietary Myo-inositol supplementation in women during pregnancy on the incidence of gestational diabetes mellitus (GDM) and fetal outcome: a randomized controlled trial]. www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN16448440 (first received 2021). [CENTRAL: CN-02279815]
IRCT20120826010664N4 {published data only}
    1. IRCT20120826010664N4. The effect of myoinositol supplementation on the prevention of gestational diabetes mellitus. www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT20120826010664N4 (first received 2019). [CENTRAL: CN-01971330]
NCT04801485 {published data only}
    1. NCT04801485. Myo-inositol in prevention of gestational diabetes mellitus in China [Myo-inositol in prevention of gestational diabetes mellitus in high risk pregnant women in China]. clinicaltrials.gov/show/NCT04801485 (first received 17 March 2021). [CENTRAL: CN-02242297]
NL7799 {published data only}
    1. NL7799. Mypp-trial: myo-inositol supplementation to prevent pregnancy complications in women with polycystic ovary syndrome: a multicentre double-blind randomised controlled trial. www.who.int/trialsearch/Trial2.aspx?TrialID=NL7799 (first received 2019). [CENTRAL: CN-01971105]

Additional references

Alberti 1998
    1. Alberti K, Zimmet P. Definition, diagnosis and classification of diabetes mellitus. Part 1: Diagnosis and classification of diabetes mellitus: World Health Organization Report. Diabetic Medicine 1998;15(7):539-53. - PubMed
Ali 2011
    1. Ali S, Dornhorst A. Diabetes in pregnancy: health risks and management. Postgraduate Medical Journal 2011;87(1028):417-27. - PubMed
Bain 2015
    1. Bain E, Crane M, Tieu J, Han S, Crowther CA, Middleton P. Diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database of Systematic Reviews 2015, Issue 4. Art. No: CD010443. [DOI: 10.1002/14651858.CD010443.pub2] - DOI - PubMed
Boney 2005
    1. Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 2005;115:e290–6. - PubMed
Carlisle 2017
    1. Carlisle JB. Data fabrication and other reasons for non-random sampling in 5087 randomised, controlled trial in anaesthetic and general medical journals. Anaesthesia 2017;72:944-95. - PubMed
Carlomagno 2011
    1. Carlomagno G, Unfer V, Buffo S, D'Ambrosio F. Myo-inositol in the treatment of premenstrual dysphoric disorder. Human Psychopharmacology: Clinical and Experimental 2011;26(7):526-30. - PubMed
Chiswick 2015
    1. Chiswick C, Reynolds R, Denison F, Drake A, Forbes S, Newby D, et al. Effect of metformin on maternal and fetal outcomes in obese pregnant women (EMPOWaR): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinology 2015;3(10):778-86. [DOI: 10.1016/S2213-8587(15)00219-3] - DOI - PMC - PubMed
Croze 2013
    1. Croze ML, Soulage CO. Potential role and therapeutic interests of myo-inositol in metabolic diseases. Biochimie 2013;95(10):1811-27. - PubMed
D'Anna 2012
    1. D'Anna R, Di Bendetto V, Rizzo P, Raffone E, Interdanto ML, Corado F, et al. Myo-inositol may prevent gestational diabetes in PCOS women. Gynecological Endocrinology 2012;28(6):440-2. - PubMed
Di Benedetto 2013
    1. Di Benedetto A, Giunta A, Ruffo MC, Cannizzaro D. New evidence on inositol supplementation in gestational diabetes [Nuove evidenze sul ruolo della supplementazione con inositolo nel diabete gestazionale]. Giornale Italiano di Diabetologia e Metabolismo 2013;33(4):199-203.
Ferrara 2007
    1. Ferrara A. Increasing prevalence of gestational diabetes mellitus. Diabetes Care 2007;30 (Suppl 2):S141-6. - PubMed
Genazzani 2008
    1. Genazzani AD, Lanzoni C, Ricchieri F, Jasonni VM. Myo-inositol administration positively affects hyperinsulinemia and hormonal parameters in overweight patients with polycystic ovarian syndrome. Gynecological Endocrinology 2008;24:139-44. - PubMed
Glueck 2008
    1. Glueck CJ, Pranikoff J, Aregawi D, Wang P. Prevention of gestational diabetes by metformin plus diet in patients with polycystic ovarian syndrome. Fertility and Sterility 2008;89:625-34. - PubMed
Guo 2018
    1. Guo X, Guo S, Miao Z, Li Z, Zhang H. Myo-inositol lowers the risk of developing gestational diabetic mellitus in pregnancies: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis. Journal of Diabetes and Its Complications 2018;32:342-8. - PubMed
Han 2012
    1. Han S, Crowther CA, Middleton P. Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No: CD009021. [DOI: 10.1002/14651858.CD009021.pub2] - DOI - PMC - PubMed
Higgins 2021
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (updated February 2021). Cochrane, 2021. Available from www.cochrane-handbook.org.
IADPSG 2010
    1. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010;33(3):676-82. - PMC - PubMed
Kennington 1990
    1. Kennington AS, Hill CR, Craig J, Bogardus C, Raz I, Ortmeyer HK, et al. Low urinary chiro-inositol excretion in non-insulin-dependent diabetes mellitus. New England Journal of Medicine 1990;323:373-8. - PubMed
Kim 2002
    1. Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care 2002;25:1862-8. - PubMed
Minozzi 2008
    1. Minozzi M, D'Andrea G, Unfer V. Treatment of hirsutism with myo-inositol: a prospective clinical study. Reproductive Biomedicine Online 2008;17(4):579-82. - PubMed
MoH 2014
    1. MInistry of Health. Screening, diagnosis and management of gestational diabetes in New Zealand: a clinical practice guideline. Wellington: Ministry of Health, 2014.
Nankervis 2013
    1. Nankervis A, Conn J. Gestational diabetes mellitus-negotiating the confusion. Australian Family Physician 2013;42(8):528-31. - PubMed
Nestler 1999
    1. Nestler JE, Jakubowicz DJ, Reamer P, Gunn RD, Allan G. Ovulatory and metabolic effects of D-chiro-inositol in the polycystic ovary syndrome. New England Journal of Medicine 1999;340:1314-20. - PubMed
NICE 2015
    1. National Institute for Health and Clinical Excellence. Diabetes in Pregnancy: Management of Diabetes and its Complications from Pre-conception to the Postnatal Period. NICE guidelines [NG3]. London (UK): NICE, 2015.
Nordio 2013
    1. Nordio M, Pajalich R. Combined treatment with myo-inositol and selenium ensures euthyroidism in subclinical hypothyroidism patients with autoimmune thyroiditis. Journal of Thyroid Research 2013;2013:424163. [DOI: 10.1155/2013/424163] - DOI - PMC - PubMed
Noventa 2016
    1. Noventa M, Vitagliano A, Quaranta M, Borgato S, Abdulrahim B, Gizzo S. Preventive and therapeutic role of dietary inositol supplementation in periconceptional period and during pregnancy: a summary of evidences and future applications. Reproductive Sciences 2016;23(3):278-88. - PubMed
Papaleo 2007
    1. Papaleo E, Unfer V, Baillargeon JP, De Santis L, Fusi F, Brigante C, et al. Myoinositol in patients with polycystic ovarian syndrome: a novel method for ovulation induction. Gynecological Endocrinology 2007;23:700-3. - PubMed
Pettitt 1983
    1. Pettitt DJ, Baird HR, Aleck KA, Bennett PH, Knowler WC. Excessive obesity in offspring of Pima Indian women with diabetes during pregnancy. New England Journal of Medicine 1983;308:242-5. - PubMed
Pettitt 1988
    1. Pettitt DJ, Aleck KA, Baird HR, Carraher MJ, Bennett PH, Knowler WC. Congenital susceptibility to NIDDM: role of intrauterine environment. Diabetes 1988;37:622-8. - PubMed
Review Manager 2020 [Computer program]
    1. Review Manager 5 (RevMan 5). Version 5.4. Copenhagen: The Cochrane Collaboration, 2020.
Rogozinska 2015
    1. Rogozinska E, Chamillard M, Hitman G, Khan K, Thangaratinam S. Nutritional manipulation for the primary prevention of gestational diabetes mellitus: a meta-analysis of randomised studies. PLoS One 2015;10(2):e0115526. [DOI: 10.1371/journal.pone.0115526] - DOI - PMC - PubMed
Silverman 1998
    1. Silverman BL, Rizzo TA, Cho NH, Metzger BE. Long-term effects of the intrauterine environment: The Northwestern University Diabetes in Pregnancy Center. Diabetes Care 1998;21 (Suppl 2):B142-B149. - PubMed
Suzuki 1994
    1. Suzuki S, Kawasaki H, Satoh Y. Urinary chiro-inositol excretion is an index marker of insulin sensitivity in Japanese type 2 diabetes. Diabetes Care 1994;17:1465-8. - PubMed
Tang 2012
    1. Tang T, Lord JM, Norman RJ, Yasmin E, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No: CD003053. [DOI: 10.1002/14651858.CD003053.pub5] - DOI - PubMed
Tieu 2017
    1. Tieu J, Shepherd E, Middleton P, Crowther CA. Dietary advice in pregnancy for preventing gestational diabetes mellitus. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No: CD006674. [DOI: 10.1002/14651858.CD006674] - DOI - PubMed
Unfer 2011
    1. Unfer V, Raffone E, Rizzo P, Buffo S. Effect of a supplementation with myo-inositol plus melatonin on oocyte quality in women who failed to conceive in previous in vitro fertilization cycles for poor oocyte quality: a prospective, longitudinal, cohort study. Gynecological Endocrinology 2011;27:857-61. - PubMed
Vitagliano 2019
    1. Vitagliano A, Saccone G, Cosmi E, Visentin S, Dessole F, Ambrosini G, et al. Inositol for the prevention of gestational diabetes: a systematic review and meta‑analysis of randomized controlled trials. Archives of Gynecology and Obstetrics 2019;299:55-68. - PubMed
Vounzoulaki 2020
    1. Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ 2020;369:m1361. [DOI: 10.1136/bmj.m1361.] - DOI - PMC - PubMed
Zhang 2019
    1. Zhang H, Lv Y, Li Z, Sun L, Guo W. The efficacy of myo-inositol supplementation to prevent gestational diabetes onset: a meta-analysis of randomized controlled trials. Journal of Maternal-fetal & Neonatal Medicine 2019;32(13):2249-55. - PubMed
Zheng 2015
    1. Zheng X, Liu Z, Zhang Y, Lin Y, Song J, Zheng L, Lin S. Relationship between myo-inositol supplementary and gestational diabetes mellitus. Medicine 2015;94(42):e1604. - PMC - PubMed
Zhu 2016
    1. Zhu Y, Zhang C. Prevalence of gestational diabetes and risk of progression to type 2 diabetes: a global perspective. Current Diabetes Reports 2016;16(1):7. [DOI: 10.1007/s11892-015-0699-x] - DOI - PMC - PubMed

References to other published versions of this review

Brown 2015
    1. Brown J, Crawford TJ, Alsweiler J, Crowther CA. Myo-inositol for preventing gestational diabetes. Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No: CD011507. [DOI: 10.1002/14651858.CD011507] - DOI - PMC - PubMed
Crawford 2015
    1. Crawford TJ, Crowther CA, Alsweiler J, Brown J. Antenatal dietary supplementation with myo-inositol in women during pregnancy for preventing gestational diabetes. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No: CD011507. [DOI: 10.1002/14651858.CD011507.pub2] - DOI - PMC - PubMed

Associated data