Abstract

To verify whether myo-inositol plus α-lactalbumin may reduce insulin resistance and excessive fetal growth in women with gestational diabetes mellitus. In a 12-month period, 120 women with a diagnosis of gestational diabetes mellitus were consecutively enrolled with an allocation of 1:1 in each group and randomly treated with myo-inositol plus α-lactalbumin plus folic acid (treated group) or folic acid (control group) for 2 months. Primary outcome was the variation of insulin resistance through the study evaluated by HOMA-IR. Secondary outcome was the evaluation, through the study, of fetal growth by ultrasound measurements of abdominal circumference centiles and estimated fat thickness. Some clinical outcomes were also considered. After 2 months, in the treated group, a significant reduction in insulin resistance (HOMA values 3.1 ± 1.4 vs 6.1 ± 3.4, p = 0.0002) and fetal growth was shown (Abdominal circumference centiles 54.9 ± 23.5 vs 67.5 ± 22.6, P = 0.006). Among clinical outcomes, a significant decrease in the rate of women who needed insulin (6.7% vs 20.3%, p = 0.03) and of pre-term birth (0 vs 15.2%, p = 0.007) was evidenced. A combination of myo-inositol and α-lactalbumin may reduce insulin resistance and excessive fetal growth.Clinical trial registration: ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT 03763669, first posted date 04/12/2018; last posted date December 06/12/2018.

Highlights

  • To verify whether myo-inositol plus α-lactalbumin may reduce insulin resistance and excessive fetal growth in women with gestational diabetes mellitus

  • We considered for the final evaluation clinical outcomes, which were: (a) the number of women who needed insulin, (b) the rate of Caesarean Section (CS) in emergency, (c) the rate of Large for Gestational Age (LGA) fetuses, with a birth weight ≥ 95 centile, in accordance with Italian C­ harts[15], (d) the rate of pre-term birth, (e) the rate of hypertensive disorders and of (f) admission to Neonatal Intensive Care Unit (NICU)

  • After 2 months of treatment, in the women treated with only diet, homeostasis assessment of insulin resistance (HOMA-IR) values were significant decreased in the treated group and the difference was Scientific Reports | (2021) 11:8866 |

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Summary

Introduction

To verify whether myo-inositol plus α-lactalbumin may reduce insulin resistance and excessive fetal growth in women with gestational diabetes mellitus. Our group carried out a s­ tudy[4] on the use of diet plus myo-inositol, one of the isomers of inositol, to treat GDM, obtaining a significant reduction in insulin resistance compared with the group treated only with diet In another recent study, Lubin et al.[5] demonstrated that the use of myo-inositol may reduce the number of women with GDM not controlled by diet that needed insulin. We treated women with GDM with this new compound (myo-inositol plus α-lactalbumin), with the aim to demonstrate a possible reduction effect on insulin resistance and excessive fetal growth

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