Although gestational diabetes mellitus (GDM) has several short- and long-term adverse
effects on the mother and the offspring, no medicine is generally prescribed to prevent
GDM. The present systematic review and meta-analysis aimed to investigate the effect
of inositol supplementation in preventing GDM and related outcomes. Systematic search
was performed in CENTRAL, MEDLINE, and Embase until 13 September 2023. Eligible randomized
controlled trials (RCTs) compared the efficacy of inositols to placebo in pregnant
women at high risk for GDM. Our primary outcome was the incidence of GDM, whereas
secondary outcomes were oral glucose tolerance test (OGTT) and maternal and fetal
complications. (PROSPERO registration number: CRD42021284939). Eight eligible RCTs
were identified, including the data of 1795 patients. The incidence of GDM was halved
by inositols compared to placebo (RR = 0.42, CI: 0.26-0.67). Fasting, 1-h, and 2-h
OGTT glucose levels were significantly decreased by inositols. The stereoisomer myoinositol
also reduced the risk of insulin need (RR = 0.29, CI: 0.13-0.68), preeclampsia or
gestational hypertension (RR = 0.38, CI: 0.2-0.71), preterm birth (RR = 0.44, CI:
0.22-0.88), and neonatal hypoglycemia (RR = 0.12, CI: 0.03-0.55). Myoinositol decrease
the incidence of GDM in pregnancies high-risk for GDM. Moreover, myoinositol supplementation
reduces the risk of insulin need, preeclampsia or gestational hypertension, preterm
birth, and neonatal hypoglycemia. Based on the present study 2-4 g myoinositol canbe
suggested from the first trimester to prevent GDM and related outcomes.
