Myo-Inositolo: protocollo non farmacologico per la prevenzione del Diabete Gestazionale - Outcomes clinici e metabolici

OBJECTIVE: To evaluate clinical and metabolic outcomes in women at risk for gestational diabetes mellitus and supplemented with myo-inositol. METHODS: A statistical evaluation has been performed putting together databases (595 women enrolled) from 3 randomized, controlled trials, in which pregnant women with risk factors for GDM (a parent with type 2 diabetes, obese and overweight respectively) were supplemented with myo-inositol throughout pregnancy. Main outcome measures were the reduction of GDM onset and of adverse clinical outcomes (macrosomia, pre-term birth and gestational hypertension) in the treated group. RESULTS: GDM onset in the group treated with myo-inositol was decreased compared to control group (11.0% vs 25.3, p<0.001). A significant reduction was highlighted also for the other main outcome measures: pre-term birth (3.4% vs 7.6%, p=0.03), macrosomia (2.1% vs 5.3%, p=0.04), and only a border line significance for gestational hypertension (1.4% vs 3.9%, p=0.07). These data were confirmed by the logistic regression analysis in which was shown that myo-inositol treatment influenced significantly the outcomes considered, with a reduced mean risk of about 60%: GDM onset (p<0.001, OR 0.36, CI 0.23 – 0.57), pre-term birth (p=0.03, OR 0.44, CI 0.20 – 0.93), macrosomia (p=0.04, OR 0.38, CI 0.14 – 0.98) and with a border line value gestational hypertension (p=0.06, OR 0.34, CI 0.11 – 1.06). CONCLUSION: This study confirmed the positive effect of myo-inositol in reducing GDM diagnosis and its main adverse outcomes, with a possible cost saving impact on public health expenditure.