Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2021; 9(3): 565-572
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.565
Impact of different stereoisomers of inositol on insulin sensitivity of gestational diabetes mellitus patients
Jing He, Yan-Li Zhang, Li-Ping Wang, Xiao-Chun Liu
Jing He, Yan-Li Zhang, Li-Ping Wang, Xiao-Chun Liu, Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Shanxi Medical University, Taiyuan 030032, Shanxi Province, China
Author contributions: He J and Zhang YL designed this study and wrote the article; Wang LP drafted the work and collected the data; Liu XC revised the paper for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Bethune Hospital of Shanxi Province Institutional Review Board [Approval No. YXLL-2020-062].
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiao-Chun Liu, MD, Associate Professor, Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Shanxi Medical University, No. 99 Longcheng Street, Taiyuan 030032, Shanxi Province, China. tyxchliu@163.com
Received: October 27, 2020
Peer-review started: October 27, 2020
First decision: November 20, 2020
Revised: November 29, 2020
Accepted: December 6, 2020
Article in press: December 6, 2020
Published online: January 26, 2021
Abstract
BACKGROUND

Inositol is a hexa-carbon polyol, a naturally soluble vitamin, often found in various foods.

AIM

To discuss the impact of different stereoisomers of inositol on insulin sensitivity of gestational diabetes mellitus (GDM) patients.

METHODS

Eighty GDM pregnant women were divided into four groups according to their treatment received: A group (placebo folic acid 400 μg/d), B group [myo-inositol (MI) 1500 mg, twice a day], C group [D-chiro-inositol (DCI) 250 mg, twice a day], and D group (inositol MI and inositol DCI 1500 mg/250 mg, twice a day). Each patient routinely used dietary guidance adjustments and did some safe and effective aerobic exercise in addition to receiving placebo or inositol from GDM diagnosis to delivery. Triglyceride, total cholesterol, fasting plasma glucose, oral glucose tolerance test postprandial glucose (2 h postprandial blood glucose), fasting insulin, fasting plasma glucose, and glycosylated hemoglobin levels and Homeostasis Model Assessment-insulin resistance (HOMA-IR) and Homeostasis Model Assessment-insulin sensitivity index (HOMA-ISI) scores were determined before treatment and 8 wk after treatment onset. Adverse maternal and infant outcomes, including hypoglycemia, excessive amniotic fluid, premature infants, macrosomia, fetal distress etc., were also recorded.

RESULTS

There was no statistical difference in the baseline data of each group. The levels of 2 h blood glucose, glycosylated hemoglobin, fasting insulin, total cholesterol, and triglyceride in the B, C, and D groups were significantly lower than those in the control group (A group) after treatment (P < 0.05). Moreover, compared with the B group, the level of the above indexes in the C and D groups decreased more significantly, and the differences were statistically significant (P < 0.05). The HOMA-IR of B, C, and D groups decreased significantly, and the HOMA-ISI increased significantly compared with the A group, and the differences were statistically significant (P < 0.05), among which the decrease of HOMA-IR and the increase of HOMA-ISI were more significant in the C and D group compared with the B group (P < 0.05). The occurrence rate of adverse maternal and infant outcomes in the C and D group was significantly lower than that in the control group (A group), and the differences were statistically significant (P < 0.05).

CONCLUSION

Treatment with different inositol stereoisomers (inositol MI and inositol DCI) can improve insulin sensitivity and reduce insulin resistance in diabetic patients, and inositol DCI has a better curative effect than inositol MI.

Keywords: Gestational diabetes mellitus, Myo-inositol, Insulin resistance during pregnancy

Core Tip: We compared the impact of different stereoisomers of inositol on insulin sensitivity and prognosis of gestational diabetes mellitus patients.